“Do you prefer to start face-up or face-down?”

Craniosacral therapy and foot reflexology treatments happen with the client face-up. But massage therapy clients can start face-up or face-down, and usually turn over during each session.

How do decide?

I leave the starting position up to each client. If someone doesn’t express a choice, I’ll default to whichever way the table is set up when they come in.

Very occasionally, I’ll ask a client to start face-down if I’m going to begin with non-oil techniques on the back. It’s easier to go from oil-free to oil than the other way around. More commonly, it doesn’t matter at all to me which way a client starts.

When I ask clients their preference, some are decisive:

• “Face-up. I want to finish with work on my back because it’s my favorite.”
• “Face-down to give my sinuses a chance to drain.”
• “Face up. I started face-down last time and want to switch things around.”

I’ll take Option C

Sometimes the question opens the door for clients to express other needs.

A visitor from another state, who regularly received massage back home, talked it out some and finally said, “I really prefer being face-down.”

I asked, “Would you like to be face-down during your entire treatment?”

She responded, “Yes! No one’s ever asked me that.”

Another legitimate response to the face-up/face-down question is, “Neither.” For some, side-lying is the most comfortable position. I keep body pillows and other props available for clients who are pregnant or prefer to remain side-lying for any reason at all.

What do you prefer?