Massage therapy is one of the most effective, widely used integrative therapies for reducing pain and relieving stress. As caring, compassionate health care professionals, massage therapists are committed to making positive differences in people’s lives.
Unfortunately, while providing relief to clients, massage therapists are often vulnerable to musculoskeletal injuries themselves—especially in their hands and wrists, and even though they’ve received education about proper body mechanics, positioning and the importance of self-care. For example, a 2008 survey of musculoskeletal injuries among massage therapists in Canada found a high prevalence of upper extremity pain, with the greatest pain and discomfort reported in the wrist and thumb, followed by the low back, neck and shoulders (Albert, Currie-Jackson, & Duncan, 2008).
This information helps illustrate why self-care regimens that can help massage therapists prevent injury are crucial to career longevity. Following are some great tips for helping you take better care of yourself while still taking great care of your clients.
Make Mindfulness Your Practice
Awareness of potential risks provides the vital first step to maximizing your health and safety because being able to reduce risk factors with effective ergonomics and good body mechanics, for example, is a great place to start. Make sure your work space is set up to ensure the best ergonomics possible. Here, think about the space you’ll need to move around the table while performing massage, as well as how easily you can adjust the table. Lightweight equipment you can easily maneuver around and lift and adjust is key to preventing injuries and also helps you avoid awkward body positions during massage.
You might also want to think about using handheld tools that give you the option of applying sustained pressure while maintaining optimal wrist positioning. Consider alternating between standing and sitting during a massage therapy session, and book your appointments so you give yourself enough time between sessions to stretch or do a short self-care exercise. You can also think about varying the massage therapy techniques you use during a session when possible to build recovery time into the session.
Mindfulness of breathing, posture and positioning, and body movements are critical to a massage therapist’s body mechanics. Deep, regular diaphragmatic breathing is an essential component of proper body mechanics and aligned posture, with the additional benefits of enhanced focus, presence, relaxation, and release of stress and tension. Working from a centered balance point, too, emphasizes neutral posture and promotes ease of body movements.
Related: Using Mindfulness for Massage Therapists
Developing good body mechanics also means you’re using larger muscles of the core, hips and legs to generate force rather than upper extremity muscles. From a biomechanical engineering perspective, key concepts for injury prevention include:
- Leveraging your body weight instead of using muscle force
- Stacking joints to avoid rotational forces
- Bracing the back knee and generating more force by pushing from the heel
- Applying forces at 90-degree angles, using the forearm as much as possible while keeping the hand and fingers relaxed
- Positioning the wrist in mid-range when necessary to apply force with the hand (Mohr, 2010).
To avoid hand and wrist injuries specifically, keeping wrists neutral is an absolute must—while performing massage therapy and all throughout other daily activities, such as computer and phone use, for example. To help keep wrists straight when applying pressure with your hands during a massage therapy session, try using the forearm or elbow, the back of a loose fist (proximal phalanges), ulnar stylus, ulnar edge of palm or hand tools. Additionally, to reinforce hands and fingers by using your free hand to enhance wrist stability, place one palm on top of the other when using a flat palm and use at least two fingers whenever you need to apply pressure.
Self-Massage Can Be Good Self-Care
Even when you know making massage therapy a regular part of your self-care regimen is important, making the time for yourself isn’t always easy—and that’s where knowing some good self-massage techniques can be beneficial.
Self-massage—including pressing and rolling with small balls—encourages body-mind connection and playfulness while exploring varieties of hand, wrist, forearm, elbow, shoulder, neck and middle back movements. While every massage therapist has unique needs and interests, incorporating self-care activities you enjoy into your regimen makes staying committed to taking care of yourself easier.
Small-ball self-massage techniques can easily be included throughout your workday to playfully counteract some of the repetitive movements associated with performing massage therapy. Starting out with a few ball-rolling movements gives you an effective way to take care of your hands and wrists.
While doing these self-care exercises, remember to breathe deeply and fully, releasing tightness and tension with every exhalation. Choose the amount of pressure that feels best for you, while also staying mindful of your body posture and positioning. Small-ball rolling can be performed while standing or seated at a table or counter. For your comfort, remove any jewelry or watches. If you experience any numbness or tingling in any part of your hand or wrist associated with pressure applied with the balls, stop immediately, as you may be pressing on a nerve.
Following are a few examples you can try:
A. Finger Pressing
Place one hand flat on a table or counter. With the other hand, slowly press and/or roll the mini ball over the top and between each finger with pressing, stroking and circular movements. Repeat on the other hand.
B. Joint Decompression
Place the mini ball between two fingers and curl your fingers to make a loose fist. Slowly and gently squeeze 2–3 times. Repeat the squeezing between each finger of both hands, including between your index fingers and thumbs.
C. Hand Rolling
With moderate pressure, playfully roll your hand over the mini ball using pressing, stroking and circular movements. Then with a continuous motion starting at each fingertip, press into the ball and roll up your forearm to the elbow. Repeat with your other hand.
D. Thumb Release
Press the pad of muscles at the base of your thumb into the mini ball, pinning the ball to the table, and place your other hand on top. Slowly press and release. Then with a squishing motion, try rotating your bottom hand as if making orange juice. Repeat this motion throughout the rest of your palm, and on the other hand.
E. Forearm Release
Place one forearm flat on a table or counter. With the other hand, slowly press and/or roll the mini ball over the wrist and forearm with pressing, stroking and circular movements. Explore between the radius and ulna; apply moderate pressure to the wrist extensor mass. Repeat on the other forearm.
Massage therapy is physically and emotionally demanding work that requires multifaceted self-care strategies to ensure flexibility, body awareness, endurance, balance, strength, circulation and alignment. So next time you’re too busy to book a massage therapy appointment for yourself, consider how you might use some of these self-massage techniques to help you take better care of yourself. Taking better care of yourself is the first step to taking better care of your clients.
Related: Healthy Hands: How to Properly Take Care of Forearms, Wrists & Hands | 2 CE Credits
A Holistic Self-Care Regimen Is Key
Self-care regimens that support whole-body wellness are key when considering how you can take care of yourself so you can stay in the massage therapy profession for as long as you choose. Following are some additional ideas for you to add to your self-care regimen:
- Eat nutrition-dense foods
- Hydrate throughout the day, every day
- Get plenty of sleep
- Move in a variety of ways (include moderate to vigorous exercise to total 30–60 minutes on most days). Also, don’t forget to move and stretch in opposite directions of your routine.
- Relax (meditation, yoga, listening to music, creative activities, spending time with loved ones).
- During work with clients, check in with yourself often to notice how your body is feeling, your energy level and your mood. Make time to consciously breathe, relax, stretch and rest throughout the day. Breathing deeply, slowly and regularly helps release tension and stress—calming the body and clearing the mind. Focus on exhaling fully, and allow the next breath to arrive deeply and naturally.
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Albert, W. J., Currie-Jackson, N., & Duncan, C. A. (2008). A survey of musculoskeletal injuries amongst Canadian massage therapists. Journal of Bodywork & Movement Therapies, 12, 86–93.
Field, T. (2014). Massage therapy research review. Complementary Therapies in Clinical Practice, 20, 224–229.
Mohr, E. G. (2010). Proper body mechanics from an engineering perspective. Journal of Bodywork & Movement Therapies, 14, 139–151.
Angela Kneale, OTD, OTR/L, author of Mini Ball Rolling: Playful Self-Care for Happy, Healthy Hands (2016), is an occupational therapist, integrative health coach, Franklin Method educator and certified Stott Pilates instructor. She is the author of seven other instructional books, and specializes in the integration of movement, breathing, postural alignment and relaxation techniques for optimal health and well-being. For more information, visit optp.com.