The Complete Guide to Choosing a Head Rest for Your Massage Table

The Complete Guide to Choosing a Head Rest for Your Massage Table by Leif Montgomery

Bodyworkers are presented with a wide array of choices of head rest support for their massage tables. We break it down for you so you can make an informed choice when you are ready to purchase.

Adjustable Platform

Boiance Pillow Pad by Oakworks

Boiance Pillow Pad by Oakworks

Let’s define what we mean by “head rest”. The Head Rest is an attachment that supports and positions the head and face. It inserts into one or both ends of the table and is comprised of a platform that both inserts into the table and acts as the foundation for the pillow pad (or cushion) which attaches, usually with Velcro to the platform.

There are standard specifications for the fit of the head rest into the table, but not all manufacturers follow it. Standard dimensions are as follows – outside to outside 8”7/8, with 7/8” diameter holes. In theory, if your table has these dimensions, you may mix and match from the array of available head rests (with matching pillow pad) as well as different pillow pads with different bases. If your table does not have standard specifications, then you must use only the manufactures head rest design, or have aftermarket holes drilled to spec for the table. Here is a list of some of the more well-known companies and their specifications. (If your favorite company is not listed, simply ask them if they conform to the standard measurements, or if other manufactures head rests will fit)

Standard Head Rest Outlet Dimensions                       Non Standard Head Rest Outlet Dimensions

Nirvana                                                                                Pisces

Earthlite                                                                               Astralite

Oakworks                                                                            Golden Ratio

Stronglite (newer models)                                                   Stronglite (older models)


MT Tables

We mentioned that the head rest consists of the platform and the pillow pad. So this means, in theory, that not only can you mix and match head rests, but you can mix and match pillow pads. We will talk more about that later.

The Head Rest Candidates:

The plain vanilla Standard Head Rest 

Standard Head Rest

The first Head Rest I am presenting is as extinct as a pterodactyl: the much maligned rarely seen “plain” (straight, standard, non-adjustable) head rest. I aim to bring this head rest back to life. Buy it here.


Here’s why: Sometime, somewhere, when you least expect it, your fancy head rest will break. Perhaps your head rest is top notch with a lifetime guarantee, or a cheapo model purchased in a back alley. Regardless, all adjustable head rests have moving parts prone to breaking either through regular use, or when someone decides to use the head rest as a support when turning over or decides it’s a nice seat. When this happens, you will wish you had a backup because you will be out of business until you replace the head rest. The plain “pterodactyl” head rest is the perfect for this. Trust me on this!

Basic Adjustable Head Rest

Basic Adjustable

The most common head rest on the market is the standard single lever adjustable head rest. The single lever adjusts both the tilt (angle) and the height of the head rest. This simple design creates one of the most functional head rests. The platform allows an excellent surface foundation to affix the pillow pad (which is usually sold together as a unit). You can easily mix and match different pillow pads with this unit. Many different manufacturers use this head rest design, but quality varies widely. Stick to the major brands mentioned above. This remains my favorite head rest.

Quick Lock Adjustable Head Rest

Quick+lock+Face+Rest+PlatformThis type of head rest is manufactured by Oakworks. The double levers allow a huge range of adjustment in height and tilt, some variations totally out of the realm of what you would practically use. Two things to keep in mind with this design: because of the double pivot design, the pillow pad will sit quite a ways from the end of the table leaving a gap. Also, notice the tubular construction – this has much less surface area to affix the pillow pad – thus you will be limited to using the specific Oakworks pad, which has a platform surface built into the actual pillow. If you try using other pillow pads without reinforced backing, the pad may collapse offering little support for the face. Personally, I am not a fan of this design for tables, however, I do like this on massage chairs, for instance the Portal Pro, where it works great.

EarthLite Flex Head Rest

flex baseThe Flex Rest elaborates on the common adjustable head rest adding flex into the platform. The idea is that movement and flex aids in comfort for the recipient. The Flex flex fullRest uses a memory foam pillow pad that is designed to be used with the flex rest platform. Thoughts on this system. The design allows more adjustment than the standard single lever: it will go lower and higher. However, this comes at a price, in my opinion anyway. The head rest will not sit flush up against the table the way the simple adjustable head rest will. It does not leave as much of a gap as the Oakworks, but still that gap may be issue for some of you. The foam also is quite soft and with deeper work or if the recipient tends toward forward head posture, the recipients face could compress all the way to the platform. If you check other reviews floating around on this, you will see these points repeated.

Earthlite Caress Head Rest

caress baseThe Caress Head Rest is similar to the Flex Rest with the main difference being that it uses a sequence of petals to produce the flex in the platform. The Caress and Flex caressHead Rests use the same type of memory foam pillow pad. The pedals are more prone to getting damaged, so my advice would be: if you like this style of head rest, chose the flex if you transport your table, move it around a lot, or have many different therapists working on it. Otherwise, if your table remains mostly stationary and the head rest is treated with care, the Caress will work for you. Take into account the same considerations mentioned above regarding the flex rest while considering if this design will work for your needs.

Stronglite Curve Head Rest

curve_platform_strongliteThis head rest uses a radically curved platform on which a pillow pad is affixed. Aside from that, it shares the single lever design for height and tilt adjustment. My take is it looked more comfortable than it actually was. The pillow pad is surprisingly hard. Your mileage may vary. curve

That’s it for the most common Head Rest designs.

Now, let’s take a look at the various Pillow Pad options.

As I mentioned before, most manufacturers make the head rest platform and head rest pillow pad as a unit and sell together. But this does not stop you from being able to mix and match platforms and pillow pads if you choose. Just keep in mind that many are sold as a unit for a reason – Like the Oakworks platform (double lever Quick Lock) requires the pillow pad has the support built in, limiting your choices. Otherwise, go ahead and experiment.

Pillow Pad Candidates

Memory Foam Pillow Pad

memory foamThis pillow pad is made completely from memory foam (which contours to the shape of the face when warmed with body temp). It is covered in cloth fabric (rather than traditional, much easier to clean, Vinyl) making it essential to protect and cover this pillow pad.  You can machine wash, but it’s not the easiest thing to remove and re-cover over the foam. Note that you can buy replacement covers at a reasonable price, if needed. This pad is big and soft.  Avoid if easily claustrophobic! Because it is pure memory foam, there is the possibility of it compressing all the way down to hitting the platform with enough pressure and heat. Some like it and some don’t. The one shown in the picture is made by Earthlite.

Oakworks Boiance Pillow Pad

boianceThis creation from Oakworks incorporates multi-layer foam cushioning with water spheres. The aim of this design and construction, according the literature from Oakworks, is to create a comfortable relaxing pillow pad that conforms better and reduces pressure. In my trials of this pillow pad, I find it large and soft, like other aftermarket pillow pads. Initially it feels super plush but as soon as any pressure was applied to my back, my chin started sinking eventually resting on the head rest platform. This is the flaw of most pillow pads that mistake soft and plush for functional. You can try to limit the lack of support by adjusting the pillow pad and changing the height and angle of the platform, but I was never able to get it quite right.

Oakworks Boiance Float

floatThe Boiance Float is a companion to the Boiance. It is not strictly a pillow pad, but an insert that rests between the platform and the pillow pad. It can us used on most head rests, with the exception being the flex and caress as these probably do not offer enough stability to affix it. The Boiance Float allows the pillow pad to float, or move around, during the treatment. It’s like being on a cruise ship. Is that a good thing!? You be the judge. Oakworks’ literature states that the Float eliminates cervical compression. The only thing I noticed is that all the inherent weaknesses of head rests remained while the float was on, but my head was moving around – like a bobble head.

Nirvana Ergo Fix

At press time, this was in proto-type phase, but I was actually able to see and try the product and was pleasantly surprised. I have seen, tried and bought so many headrests over the years and this one approaches positioning from a new perspective. This design adds support to the chin to distribute the weight over the entire face which has the effect of decreasing pressure on the sinuses and relaxing the curve in the cervical spine. Oh, yeah and no more clients complaining that their chins are falling through or fidgeting around to try to get comfortable. 

Check out the video for more information.



Conclusion – So, what to make of all this? Which head rest should you use? Like many things, the answer is not straightforward. Choosing a head rest is a bit like choosing a pair of shoes. Personal preference and tastes will come into play, and what works for one person might now for another. However, within the variations one might choose, all shoes must protect and provide some sort of support for the feet. Head Rests are like shoes, some look great and don’t function well and others you might like so much you buy a pair in every color.  Choosing the right Head Rest should involve a balance between function and comfort. I’ve concluded that sometimes simpler is better.  In doing your own research you should trust your observational skills and brush up on your postural analysis and your anatomical knowledge. Hope this has been helpful.

What constitutes a lightweight massage table?

In this section we look at relative weights of massage tables from standard to lightweight to super lightweight. We are not looking at the specific construction of each table but rather at the weight categories (although we will add that every table mentioned in our review is one that we have used and sold). For more on choosing a table read Leif Montgomery’s Guide to Choosing a Massage Table in the Buyers Guide Section of this blog.
While the specific weight of each massage table is useful information, we have found a discussion of relative weight to be more relevant  for those choosing a portable massage table for transportation. How does the table “feel” to you compared to your current table? While 30 pounds may sound manageable – think about carrying your table up stairs, lifting it in an out of your car or carrying it for 2 blocks / 5 days a week!
Categories and Weights
Standard Portable – 30lbs (add kilograms too for metric) and up. This is the most common category of portable tables used and sold today. The table shown in our video is the Oakworks Nova, Other tables in this group include the Earthlite Spirit, Nirvana 2N1, Stronglite Premier, etc.
Lightweight – 25-30lbs. Here we look at the Stronglite Versalite. Others tables in this category are the Earthlite Luna and Oakworks Wellspring. You may have noticed that our measured actual weight varied by quite a bit from the manufacturer’s stated weight. Things like variations in fabric and foam can contribute to small variances in weight but over 1 pound is a big variance when you are talking under 30 pounds.
Super lightweight – 25lbs and under. Here we looked at the Dharma Super Light. The other table we like in this category is the Pisces New Wave.
Note – table weights generally refer to the table only and do not include the weight of the carry case or head rest. During actual use, you will tote a few accessories like a head rest and bolster which will add a few pounds. A carry case with well designed handles and shoulder strap will distribute the weight over your body making it easier to carry.
Bulk – Besides weight, the bulk or size of a table also factors into the ease of transporting it. Always go as narrow as you can without sacrificing comfort.
So now, we come back to the true test in choosing a table that will be transported and used for out calls. Lift it in the real world under working conditions! We have found over the years that most therapists, especially new practitioners, find that standard weight tables “feel” OK when you lift them the first few times. Many therapists re-evaluate after carrying their tables around for a few years. This is when practitioners may decide to explore purchasing a lighter table or they may even encourage their clients to buy their own table. Lightweight Massage Tables can save the practitioner up to seven pounds! This may be too heavy for some people with back or strength problems. If you fall in this category then you should consider investing in a super light massage table. These tables feel remarkably and refreshingly light, as you can see on the video, “woo hoo”!  When you get under 25lbs, even 1-2 lbs variations can make a big difference, so choosing foam and fabric variations to save weight makes sense.
Good luck in you table search! For more fun and information watch our video on the Science of Choosing Lightweight Tables