Working on the Buttock

19 Feb 2024

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Expert Witness

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When working on the buttocks, clear communication is needed so the client feels safe.  This is not an area of the body that is touched by anyone other than an intimate partner.

This necessitates a conversation with the client before the session begins. If work on the buttock is requested, it should be clear whether that work will be done on the skin or through the sheet and with the client’s underwear on or off. This is usually done with a written consent form in a spa setting.

Draping the hip is not difficult, but it requires the therapist’s full attention. For most clients, the starting position for undraping the hip is approximately where the top of a person’s underwear would be.

The drape is then folded back on one side, as shown in this photo. Undraping the buttock must occur one side at a time when working the hip region. How working in this area is done depends on where the therapist was trained and the context in which they work. In some contexts, the therapist works over the sheet. Many massage spa companies only permit work on the buttock over the sheet.

In other contexts, like a private practice or an individual day spa, before undraping the hip, the drape is at the base of the sacral bone, which is just above the coccyx, as shown in this photo.

In this position, the top portion of the buttocks is uncovered and can be massaged. The hip is undraped from this position when working on the entire hip.  As shown in the next slide.


In private practice, therapists more often work skin-to-skin. When working on the buttock, permission must be obtained. Special care must be taken when working in this private area, in order to make the client feel safe.


When there is pain in the lower back or hip, working in this area can be very therapeutic.  Some therapists will drape the rest of the back, and others will not, moving back and forth from the hip to the back.


The gluteal cleft, which is just below the coccyx, should never be exposed or touched. Unfortunately, predator therapists may use this undraped position as a way to begin a sexual assault in the anal area.


Many clients wear their underwear. With permission, some therapists will undrape the hip and work over the client’s underwear.


This is also a very common draping position, exposing the buttock at the top of the thigh and lower leg. The massage then combines working on the thigh and the hip. All of these draping examples are appropriate depending on the context.

Larger spa organizations usually mandate more conservative draping.