Working on the Buttocks

May 17, 2024

When working on the buttocks, clear communication is needed so the client feels safe.  This area of the body is not usually 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, but in a private practice, consent is usually verbal.




In the massage profession, the buttock is often referred to as the hip. If there is pain or discomfort in the hip or lower back region, work on the hip is often included. Many muscles in the hip are often involved in lower back and hip pain.

Draping the hip is not difficult but requires the therapist’s full attention. The starting position for undraping the hip is approximately where the top of a person’s underwear would be like in images 1 and 2.



The drape is then folded back on one side, as shown in this photo. When working in the hip region, undraping the buttock must occur one side at a time. How the therapist works in this area depends on where they were 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, the drape is at the base of the sacral bone, just above the coccyx, before undraping the hip, as shown in image 4.


In this position, the top portion of the buttocks is uncovered and can be massaged. Image 5 shows that the hip is undraped from this position when working on the entire hip. In private practice, therapists work skin-to-skin more often. Permission must be obtained when working on the buttock, and special care must be taken to make the client feel safe.



The buttock is not usually included in a relaxation massage, but this area is frequently included when the reason for the massage session is pain in the lower back or hip. When working in this area, some therapists drape the rest of the back, and others do not so that they can move 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 to begin a sexual assault in the anal area or reach under the body to touch the genital.



Many clients wear their underwear during a massage, and many others choose to remove all their clothing. With permission, some therapists will undrape the hip and work over the client’s underwear.


Another common way to work on the buttocks is to combine it with working on the back of the thigh. This draping position exposes the buttock, the thigh, and the lower leg. All these draping examples are appropriate depending on the context.  Some larger spa organizations often mandate more conservative draping. This means draping to the top of the underwear line and working on the hip through the sheet.


All these draping procedures are correct and can be done appropriately. Which one is used depends on the context in which the therapist works. Predator massage therapists may use the need to work on the buttocks as a pretext to assault a client sexually.






If you’re a lawyer who is currently involved in a sexual assault case and needs an expert witness with a massage or spa background, schedule a conversation with Dr. Benjamin here.

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Ben E. Benjamin holds a Ph.D. in Sports Medicine and has been an expert witness in cases of sexual assault in a massage/spa setting since 2004, advising lawyers, testifying in depositions and trials, and writing reports. His expertise extends beyond massage therapy and ethical behavior. He also advises spas, both large and small, on the creation of comprehensive sexual assault prevention strategies that ensure safe and ethical practices in the industry.

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