Expectations

There's a general rule with massage... if you wear clothing over an area of your body, the signal you're sending your therapist is that you don't want it massaged. The biggest example of this is people leaving on underwear. It's not a hard and fast rule. Some people may leave on socks because their feet get cold, but are fine with me taking them off when I get to that area. I've even had a nursing mother leave her nursing bra on when she got on the table, but let me unhook it while I worked on her back.

I think the underwear is part of a bigger issue. While there are several muscles in the gluteal area, and massaging this area can help relieve lower back pain among other things, many folks are uncomfortable getting... well... a butt massage. Or even possibly just exposing their butt. 

I get it; I've been there, and sometimes, I don't really feel like having that area worked either. I'll leave my underwear on, and that tells the therapist that I don't want much work there. I'm okay with some over the sheet stuff, though. Here's the moral of the story: if you are uncomfortable taking off your undergarments, but want some compressions and such in the glutes, make sure you tell your therapist!