Good set-up and draping do two jobs. They keep the client warm, comfortable and feeling safe, and they show that you are a professional. Treatment preparation is part of Provide massage treatments, and infection control is covered in Manage the prevention and control of infection.
Room preparation
- Temperature: comfortably warm for someone lying still and partly undressed, which is warmer than feels right for you while working. Clients cool down as they relax. Have an extra blanket or a heat pad ready.
- Lighting: soft and indirect. Avoid a bright light over the face-up client.
- Sound: quiet, or low music the client is happy with. Ask.
- Privacy: a closed door, a sign or lock if needed, and a clear, private place for the client to undress and leave belongings.
- Clear floor: nothing to trip over around the table. Leave room to move in a lunge stance on all sides.
- Supplies within reach: oil or lotion in a pump bottle, tissues, spare linen, hand sanitiser and a bin.
Table set-up
- Check the table is stable and the height suits you and the planned work (see Therapist self-care and body mechanics).
- Clean the table surface and face cradle with a suitable detergent or disinfectant wipe.
- Put on a fresh bottom sheet (or fitted cover) and a clean face-cradle cover.
- Lay the top sheet and, if needed, a blanket over the table ready for the client to get under.
- Place bolsters and pillows nearby so you can adjust them once the client is on the table.
Linen
- Fresh linen for every client: bottom sheet, top sheet or towel, face-cradle cover and pillowcases.
- Used linen goes straight into a closed laundry bag or hamper. Do not shake it out or hold it against your clothes.
- Wash linen in hot water with detergent and dry it thoroughly. Store clean linen covered and separate from used linen.
Bolsters and positioning
| Position | Where the support goes | Why |
|---|---|---|
| Prone (face down) | Bolster under the ankles | Takes strain off the knees and lower back |
| Supine (face up) | Bolster under the knees; small pillow under the head if wanted | Eases the lower back |
| Side-lying | Pillow between the knees; pillow under the head; a pillow to hug for the upper arm | Keeps the spine level and the top shoulder and hip supported |
Always ask, “Are you comfortable? Would you like anything adjusted?” Some clients also like a small support under the chest or a pillow under the hips when prone.
Draping principles
- Only the area being worked is exposed. Everything else stays covered.
- Secure the drape. Tuck the edge firmly under the client’s body or against the table so it cannot slip as you work or as they move.
- Explain before you start. Tell the client what they need to undress to and that they will be covered at all times except the area being worked. Leave the room while they undress and get on the table.
- Consent before each area. Tell the client which area you are about to uncover and check they are happy, for example, “I’m going to uncover your right leg now. Is that okay?” Consent can be withdrawn at any time.
- Professional boundaries. Genitals are never uncovered or touched. Breast tissue is not massaged in a relaxation treatment; for female clients, the chest is draped and work stays above the breast tissue. The gluteal area is worked only with specific consent, and usually through the drape or at its edge.
- Client modesty is their call. A client may prefer to keep underwear or clothing on. Adapt your plan rather than asking them to undress further.
- Turning over: hold the drape up and against the table on the side furthest from you (or anchor it with your body) and ask the client to turn under it. Look away.
Clear, respectful draping and communication are part of the legal and ethical duties in Manage legal and ethical compliance and client relationships in Establish and manage client relationships.
Draping by region
Back (prone): fold the drape down to just above the gluteal cleft, and tuck it into the top of the underwear or under the hips. Keep the client’s arms either by their sides under the drape or resting on arm shelves.
Leg (prone or supine): undrape one leg at a time. Fold the drape diagonally so it wraps around the inner thigh and tuck it firmly under the thigh; the other leg stays covered. For the posterior thigh, the drape sits below the gluteal fold unless the client has consented to gluteal work.
Arm (supine): bring the arm out from under the drape and rest it on top, with the drape tucked under the side of the body. Return it underneath when done.
Neck, shoulders and upper chest (supine): fold the drape down to just below the collarbones. It stays above the breast tissue.
Abdomen (supine, only with consent): for female clients, place a towel across the chest over the top sheet. Hold the towel in place while you fold the sheet down from underneath to expose the abdomen. For all clients, fold the lower edge down only to just below the navel or the top of the underwear.
Feet: uncover the foot and lower leg only. Tuck the drape around the ankle.
Side-lying: the drape covers the whole body. Uncover the back from the top edge, or the uppermost leg with the drape tucked under it. Pillows stay under the drape.
Hygiene and infection control basics
- Hand hygiene: wash or sanitise your hands before and after each client, after touching your face, phone or used linen, and before touching clean supplies.
- Nails short and clean. Remove rings, bracelets and watches before treatment.
- Cover your own cuts with a waterproof dressing. Do not massage over a client’s broken skin, rashes, infected areas or open wounds.
- Products: use pump or squeeze bottles. Never dip hands back into a shared container.
- Clean surfaces between clients: table, face cradle, bolsters (use wipeable or covered bolsters), door handles and any shared equipment.
- Linen: fresh for each client, as above.
- Stay home if you are unwell with something infectious, and reschedule clients who are. Follow cough and sneeze etiquette.
- Follow your workplace’s infection-control procedures, which should be based on the national healthcare infection-control guidelines.