Creating a Boundary with Draping

Draping means that the areas of the body not being treated are completely and securely covered with a sheet, blanket, or towel. The practitioner must use proper draping to ensure that their clients feel safe and secure, without fear of exposure.

Many clients, especially new ones, are not clear about what constitutes appropriate draping.  If a client complains that they felt exposed – that their sheet felt loose, or that they were concerned that their breasts or genitals were going to be exposed – consider this an early warning sign that a therapist may act inappropriately.

In all of the sexual assault cases I have worked on, the predatory therapist knows how to drape appropriately but chooses not to with a particular client they have selected to assault. When a therapist is accused of sexual assault at a spa, the management often says, “It was just a draping issue,” and usually it was not.

Notice that the drape covers the front of the pelvis, plus the upper inner thigh, and it is secured by tucking the sheet under the body, both at the thigh being worked on and the lower back. The genital region and female breasts should always be covered with a drape.

In just a few states in the US, the scope of practice includes breast massage. These states require written and verbal consent from the client, a reason to do this type of work, and, depending on the state, a certain number of hours of training.

Here, you can see that the drape may be lowered comfortably to the top of the hip bones when the client is lying face down, or what we call in the prone position.  This is where the top of a person’s underwear usually is. In this draping position, the buttocks is completely covered.

Most people are comfortable with the drape in this position. This draping is common in a massage/spa franchise or when any therapist is working with a very private person or a teenager.

When working with a client who has complained of discomfort in the lower back or buttocks, the therapist may want the drape to be lowered to the base of the spine just above the coccyx so that the sacral bone is visible.

If this is the case, the therapist has to clearly communicate the reason for lowering the drape and get the client’s consent. This draping position is more common for massage therapists in private practice. If the client is not comfortable exposing that part of their body, a therapist can work over the sheet in these areas.

The buttock may be undraped only with explicit permission from the client and only one side at a time.  Some therapists would cover the back when working on the hip, and others would not so they could move back and forth between the hip and the back. Undraping the buttock from the lower position looks like this.

There are a number of ways to drape the thigh to create a secure drape. This can be done by lifting a straight leg no more than 3 or 4 inches off the table, bringing the drape securely under the thigh to define the area to be treated.

You bring the sheet under the thigh being worked on, and tuck the sheet under the low back as well. Predators tend to lift the leg very high off the table to be able to see under the drape.

The other, even safer way, is to lift the thigh at the knee to bring the drape under the thigh. Then, the drape is also tucked in at the low back to keep it firmly in place. This tucking action is always done with the palm facing down.

The primary fact to remember is that the drape is there to create a boundary defining the area of the body to be treated. That being said, all massage therapists are trained that the therapist’s hands should never go under the drape.