Massage Therapist Bedside Etiquette—How to Talk to Your Clients About Lumps

Massage therapists find all sorts of bumps beneath the skin on their clients when they are working. Mostly, they are what people commonly refer to as “knots.” These knots are really tissue that has become stiff and immobile due to stress, poor posture or nutrition, lack of exercise or stretching, and a number of other causes. But what should you do if you find something different on your client?

woman examining breast for lump

One day, a woman came in to see me for deep tissue. As I began to work on her back, I noticed a lump. I had worked on her before and I’d been in practice long enough to recognize that it wasn’t a normal knot. I kept returning to the area, second-guessing myself, because I wanted to be very sure of what I had felt. Meanwhile, the deep tissue massage became a modified Swedish, as a quiet precaution. If the lump I’d felt truly were cancerous, it would also be tender. Furthermore, at the time, I believed—what current research is now disputing—that massage would spread the cancer. So I basically put her to sleep by rubbing lotion on her back. When she was dressed and ready to meet me in the hall, I knew I had to tell her about my concerns. The lump was in a place she couldn’t reach. What if I was the perfect candidate to notice for her and I kept my mouth shut? Because I knew I wanted to wait until the massage was over, I had time to think about the way I would begin the conversation.

If you are a practicing massage therapist, and you find yourself in this position, remember the following:

Speak kindly, but remain light.

For all you know, the lump is absolutely nothing. You don’t want to give your client the impression that you’re thinking about something to say at their funeral.

Be direct. If you skirt around the issue, mumbling um or uh between every word, the issue will grow. You will give the client the impression that they should be terrified and, again, so far we know nothing more than one simple fact: they have a lump.

Remind them that the lump could be one of many things:

-Lipomas: a benign tumor of mature fat cells


-swollen lymph nodes

-thyroid nodules

But, above all things, remind them that you are NOT a doctor and encourage them to see one. Better safe than sorry. Always couple your assurance that it’s probably nothing with a strong recommendation for them to seek medical attention.

If you’re still stuck, try this:

“XZY, I don’t mean to alarm you, but I found a small lump on your back while I was working. It’s probably nothing—if you’ve been sick, for example, lymph nodes can become swollen—but, to be on the safe side, you should still see your general practitioner.”

Carry on as usual. There’s no need to dwell on the topic. It’s no longer any of your business and you’ve done your part by making sure they know. It only becomes your business, as a massage therapist, if they come back to you, diagnosed with cancer. At this point, you would need to refer them to an oncology massage therapist, someone who specializes in massaging cancer patients.

Most importantly, don’t be embarrassed. I know that sounds odd, but talking about something serious, like a lump, is not like telling your client they have stinky feet. It isn’t rude to be an advocate for your client’s health. My stepmother was diagnosed with breast cancer, again, this year and if there’s anything I have learned from her, it’s that cancer should not be something we whisper about. We should speak openly and create awareness because it could save a life.






  • It can be really tough to figure out HOW to say something to a client. I especially appreciate the sentiment that it only becomes the MT’s issue if the client receives a diagnosis from a qualified medical practitioner. We can (and should) encourage the client to see their medical provider, we can arm them with resources and encourage them to advocate for themselves. But we should be mindful about butting in where we don’t belong! This is a great article, thank you.

  • As someone who struggles with communication occasionally, this article really points out how to handle an uncomfortable situation. Thanks!

  • paulakemptherapies

    I have recently had this situation arise, and it is a horrible situation to be in, as you don’t want to scare the client, but also do not want to do nothing. Thank you for helping me feel better about what to say to clients if this situation arises again.