Good Body Mechanics and Posture Prevent Massage Therapist Injuries

You know the expression “do as I say not what I do.” Could you be guilty of advising clients about good body mechanics and posture yet failing to take your own advice? The physical demands of the profession can affect your ability to be effective as a massage therapist. Considering that your clients depend on you for their own healing, you need to prevent massage therapist injuries for their sake and yours.

Data from the U.S. Bureau of Labor Statistics issued in 2006 indicated that more than half of massage therapist injuries were sprains and strains and more than half of these were the result of worker/motion position.  In addition, more than half of injuries were to the upper extremities, including the hand and wrist.[1]  Injuries common to professional massage therapists due to repeated or forceful bending of a limb or joint, overuse and repetitive motion include:

·         Tendonitis: Repetitive stress on specific muscle groups can result in tendonitis. Overuse commonly impacts the small tendons of the hands, thumbs, wrist extensors, flexors and rotator cuff tendons. [2]

·         Carpal tunnel syndrome: Carpal tunnel syndrome is one of the most common injuries among massage therapists.  Massage therapist carpal tunnel injury comes from compression of the median nerve, which runs through the wrist. The compression can result in numbness and wrist pain.

·         Rotator cuff strain: A rotator cuff injury is a problem with the muscles and tendons surrounding the shoulder joint. Massage therapists experience rotator cuff injuries because of excessive shoulder work.

·         Thumb arthritis: The repetitive movements in massage session can lead to joint pain and stiffness. Over time, these motions can strain the thumb joint, especially when massage therapists use techniques like deep tissue. [3]

·         Lower back pain: Repetitive movements and poor posture during treatments can lead to lower back pain.

·         Neck strain: Neck strain also is a result of repetitive movements and poor posture. The pain can affect the neck muscles and may extend to the shoulder blade. [4]

·         Tenosynovitis: A Teno synovial sheath surrounds certain tendons to prevent fraying through protective lubrication. If this sheath becomes inflamed, pain, swelling, stiffness, and difficulty moving the joint may develop. Repetitive movements, particularly the use of the hands to deliver high-force treatments, can lead to tenosynovitis.[5]

Avoid massage therapist injuries

Have the proper workspace: Have enough space around your table so that you can move comfortably and maintain good body mechanics. Also, make sure your table height is appropriate to support good posture. A higher table translates to less low-back bending and a more normal wrist angle. Lower massage table heights force you to bend over more, which moves your center of gravity forward and increases stress on your lower back.[6]

Stance: Keep the spine in a neutral position to prevent back strain. Avoid hunching over the table and instead hinge from the hips, keeping the back straight. This position allows for natural body movement and reduces stress on the spine. [7] Also, place your feet shoulder width apart with your toes pointed forward. Try using an asymmetric stance, where one foot is forward and the other back.  Face the direction of the stroke with your toes, hips, shoulders, and head aligned and keep your back foot on the floor. [8]

Straighten your wrists: To prevent massage therapy carpal tunnel injury and ensure proper force transfer through the carpal bones, maintain straight wrists.[9]

Use tools: For deep pressure, use advanced manual tools like elbows and knuckles. Use device tools like cupping and scraping for additional pressure. [10]

Apply your weight, not force: During the massage, one of the best working solutions is to use your weight instead of muscular force to engage the tissue. When you drop your body weight onto the client’s tissue, you will naturally sink to the first layer of tight tissue. As that layer releases, you will sink to the next layer of tight tissue. Working layer by layer provides a deep massage experience without being painful for the client or too strenuous for you.[11]

Other steps to prevent massage therapist injuries

Choose treatments with less hand stress: Depending on client needs, try to choose treatment forms that require less stress on your hands and fingers. Also try to work more with your forearms, since they are more durable than hands, fingers, and thumbs. If possible, reserve your hands for massaging delicate areas - head, face, fingers, and toes.[12]

Stretch between clients. Stretching lengthens soft tissues, and taut soft tissues limit motion. Stretching can help to reverse this process and, even better, can prevent soft tissues from becoming taut in the first place.[13]

Alternate between standing and sitting: Alternate between standing and sitting during sessions. Standing is fatiguing to your leg muscles and lower back. Sitting allows you to rest your legs, but it also can put strain on your lower back.

Exercise: It is especially important to keep your body strong and balanced and help you relax. Here are simple exercises: [14]

·         Walk to relax and stretch and relieve pressure by being outdoors.

·         Start Yoga to improve balance and stretch and strengthen muscles.

·         Shake your hands at chest level for about 10 seconds to keep them limber and warm.

·         Squeeze a small rubber ball or putty. Cup whichever you choose in your hand, squeeze, and release repeatedly.

·         Use resistance bands to strengthen your body isometrically.

Take breaks: You need to get up and move around during the day. Also take breaks between sessions to unwind, stretch and catch up on some other duties, like checking email.

Stay hydrated: The human body is approximately 60 percent water. Since you lose water throughout the day by breathing, sweating and digestion, you need to drink fluids and eat foods that contain water to rehydrate.

Take time off: You don’t have to go out of town to decompress, though a week or two away is the best way to truly remove yourself from the day-to-day pressures and routine. Take a drive or a hike; meet friends for lunch; if you have a hobby, pursue it or just sit and read a book. You might even want to take a class totally unrelated to massage or skin care treatments.

Taking care of yourself will enable you to enjoy a long and rewarding massage therapy career, and your client will appreciate it.