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Should I take My Underwear Off?

Should I take my underwear off?
I get this question more than the average person.  And it is not as exciting as one may think.  This is not situations out with girlfriends, at the club, and she is concerned the VPL looks tacky.  I get this question in professional settings, in the office, from clients with genuine inquiry.
An unfortunate reality for many is coping with low back pain, arthritis in the hips, sciatica, and other ailments that come along with being human.  Massage is an effective treatment for managing these pains.  The involved and affected muscles and tissues include the spinal erectors, the thoracolumbar aponeurosis (broad sheet of connective tissue across low back and pelvis), gluteus minimus,, medius and maximus, and the six deep lateral rotators (which includes the most problematic, the piriformis). 
Each of these muscles or tissues share a common attachment- the pelvis.  Most undergarments cover the meatiest part of the glutes, and even parts of the low back, depending on the style.  Underwear can inhibit access to these areas.  Although many techniques over the sheet and undergarments are effective, a practitioner is unable to strip, flush, or perform mayofascial techniques through fabric.  Men who wear boxers or boxer briefs further limit access because the hamstrings, I.T band, adductors, and quadriceps are partially covered by the undergarment.  Women who wear undergarments with a higher rise or waistband limit the practitioner’s access to the low back. 
 Client comfort is upmost priority for me.  I refrain from using white or light colored sheets because I want the client to feel well covered and secure while in an already vulnerable position.  When a client decides to leave an article of clothing or undergarment on I perceive this as “Please, avoid this area”.  Although this may not be the intended message, I have to honor the boundary and work around the limitations during the session.  I consider these same non-verbal cues from women who wear thong or g-string underwear. 
I understand the comfort and security factor of leaving underwear on during a session.  But I also know the benefits of removing all possible obstacles that may prevent a therapist from achieving maximum results in a session.  If ever you find yourself in a situation where low back, hips and glutes are the focus of your massage, please consider removing the underwear.  If you are one who leaves underwear on regularly, try removing them once; chances are you will not go back.  As a general rule, most practitioners (including myself) will only drape (uncover with the sheet) the body part worked at that specific time. 
I completely disrobe during a massage as do most of my clients.  Those who do not may never know how beneficial a deep mayofascial release through the glutes really is.  If on the fence about this issue, talk to your massage therapist.  Any and all questions are welcome and we want you, the client, to be at ease and get every possible benefit and positive experience from your session.
Thanks for reading this,