Physician, heal thyself. From its biblical origin to today’s modern interpretation, the proverb’s essence still rings true—and a 2013 study conducted at Duke University reinforces its message.
The study concludes that physicians often devalue self-care while prioritizing the care of others, resulting in possible burnout. On a positive note, the study suggests that increased self-awareness and self-care can reverse this negative pattern to benefit both physician and patient.1
As health care professionals devoted to their clients, massage therapists, too, can be at risk for burnout and injury if they don’t pay attention to developing—and maintaining—a solid self-care regimen. Self care is too often eclipsed by long hours, back-to-back sessions and the demands of lugging equipment to and from private sessions—all of which can trigger fatigue, physical imbalances, aches and pains, and potential burnout.
Defining the Problem
“It’s easy to get lost in your clients’ well-being and neglect your own self-care,” cautions Sarah Landicho, a yoga teacher based in Chicago. Maybe you repeatedly lean too hard and often to one side or you continually hunch over the client, causing some muscles to work harder and others to grow weaker. Repetitive movements can also take a toll on your strength and flexibility.
“All these examples can impact your physical health as well as your effectiveness as a massage therapist,” Landicho adds. “That’s why it’s so important to take care of yourself in order to take care of your clients.”
Although yoga has become known primarily as a set of postures (asanas), traditionally it is considered a state of mind, not just an exercise for the body. The primary text on yoga is The Yoga Sutras of Maharishi Patanjali. The classic definition of yoga is derived from the second sutra, which in Sanskrit reads: yogash chitta-vritti-nirodhah. In English, it is translated as “Yoga is the complete settling of the activity of the mind.”
A good place to begin is with various branches of hatha yoga, which rely on specific physical body postures, or asanas, to lengthen, stretch and relax muscles. In the West, yoga is primarily associated with physical postures, but traditionally breathing practices and simple meditation techniques that complement the postures are considered an integral part of the practice of yoga.
When done with consistent commitment, research points to yoga as an invaluable tool for self-care to help practitioners increase endurance, prevent physical stress, reduce inflammation, expand range of motion, build strength and ultimately extend career longevity.
Many massage therapists and yoga teachers alike agree that blending the two practices into one career naturally stretches their professional path and can help supplement their income.
Body of Knowledge
In addition to the literal self-caring physical benefits, like strength and endurance, Kaila Tatman, a yoga instructor and massage therapist in Sussex County, Delaware, credits yoga for encouraging a profound mental connection with her body. “During those 60 minutes in a yoga class, I’m focused on myself. That clears my mind to recognize, say, a tenderness in my forearm—maybe something I’ve been ignoring or accepting as part of the job.”
As you cultivate body awareness, it becomes easier to sense where you feel physically weak, uncomfortable or in downright pain. “Once you recognize the issues, a yoga instructor can guide you to what needs to be strengthened and what needs to be stretched,” explains Jeffrey Myers, yoga instructor, massage therapist, and owner of Healthways Wellness in the Boston area.
“Yoga is a similar but more balanced approach to strength training than lifting weights. The right level of hatha yoga, for example, conditions your body to perform daily activities, such as lifting, bending and all the repetitive moves associated with massage therapy,” Myers adds.
The complementary way that yoga and massage therapy sync up to promote physical well-being explains why it’s not uncommon for a massage therapist to also become a registered yoga teacher (RYT)—and vice versa. “Both careers engage your in-depth knowledge of the body’s anatomy and physiology,” Landicho adds.
As Myers says, “It’s a mutual dance between yoga and massage therapy. Both practices rely on being acutely aware of body mechanics, and this complementary overlap deepens what the massage therapist and yoga instructor can accomplish.”
While historical evidence depicts an enduring respect for yoga’s innate benefits, recent studies put a modern scientific spin on yoga’s value. The National Center for Complementary and Integrative Health (NCCIH), the Federal Government’s lead agency for scientific research on complementary and integrative health approaches and part of the National Institutes of Health (NIH) within the U.S. Department of Health and Human Services, officially classifies yoga as a recognized form of Complementary and Alternative Medicine (CAM).
One meta-analysis, Exploring the therapeutic effects of yoga and its ability to increase quality of life2, details how the practice of yoga promotes strength, endurance and flexibility—while also facilitating characteristics of friendliness, compassion, greater self-control and a sense of well-being.
Specific to lower back pain, a common musculoskeletal injury among massage therapists, the NCCIH points to multiple recent studies:
An NCCIH-funded study of 90 people with chronic low-back pain found that participants who practiced Iyengar yoga (a form of hatha yoga) had significantly less disability, pain and depression after six months.3
In another NCCIH-funded study, researchers compared yoga with conventional stretching exercises or a self-care book in 228 adults with chronic low-back pain. Results showed that yoga and stretching were more effective than a self-care book for improving function and reducing symptoms due to chronic low-back pain.4
A review of published randomized clinical trials suggests that of 313 adults with chronic or recurring low-back pain, 12 weekly yoga classes, with a holistic combination of physical exercise, mental focus, self-awareness and relaxation, resulted in better function than receiving “usual medical care.”5
Where to Begin
Not all yoga classes are created equal, and for that reason Katherine Schaefer, a yoga instructor and massage therapist in Oakland County, Michigan, stresses that the type of yoga and the teacher you choose is essential for comprehensive and safe self-care. “Some yoga practices are more like gymnastics or a workout routine, which may be too fast or strenuous and consequently may put too much stress on the massage therapist’s body—especially the spine, hips, shoulders and wrists,” Schaefer says.
For example, Landicho adds, a level 2 or 3 vinyasa yoga class will focus on advanced postures, which would be too advanced for a new yoga student and could result in incorrectly positioned poses that can exacerbate shoulder, wrist and hand pain. “You want to start slowly and gently,” Landicho says. " An introduction to yoga or a level 1 class is a great release for your wrists and back and especially for building core strength to support the spine.”
As for the right yoga teacher, look for someone who is trained in a more therapeutic approach and has a lot of experience, Schaefer says. “Many yoga teachers don’t know a great deal about anatomy and kinesiology, so the class may be more focused on achieving difficult poses or getting a workout,” she says. “Class size is also something to consider. Large classes may be fun and energetic, but if you want more individualized instruction, you are better off finding a smaller class or taking private lessons.”
Finding a class and teacher that fit you, Schaefer adds, is about getting out there, observing instructors in action and asking friends for recommendations. “Then, trust your instincts,” Schaefer stresses.
Stretching the Benefits of Yoga
It turns out that yoga is not only a good addition to a massage therapist’s self-care regimen, but can also provide a means of supplemental income. Because of overlapping knowledge and training, Myers describes the massage therapist and yoga instructor as “an almost seamless segue.”
Tatman also feels strongly that yoga and massage therapy go hand-in-hand. “When I attend a yoga training workshop, I pick up much more—because of the intense anatomy and physiology courses I took to become a massage therapist. I don’t need to start from the beginning. I have a strong base,” she explains.
Pursuing dual careers—as a massage therapist and yoga teacher—also builds trust between practitioner and client. “People here don’t touch each other much. So those with an adverse reaction to massage will likely feel the same about yoga—since both involve body manipulation,” Landicho explains. If someone goes to a massage therapist and grows comfortable with that person’s touch, Landicho suggests, it often follows that the client would translate that trust to all of the therapist’s practices. The next thing you know, the client will end up in the therapist’s yoga classes, too—or vice versa.
Schaefer explains how her expertise as a yoga instructor opens the door to more effective therapeutic massages. “As I watch someone do yoga, I learn about the way that client moves,” she explains. “So, for example, let’s say you sprain your ankle and your gait changes. But even after the ankle heals and the pain is gone, compensations may remain. If this yoga student comes to me for a therapeutic massage, I already know where they might be holding tension, not moving with ease or where they are weak, and I can adapt the massage accordingly.”
Yoga, according to Tatman, is a multifaceted approach to advancing your career. On a self-care level, it helps build strength, endurance and a deep awareness as to what your body needs to achieve peak professional performance. As for supplementing your income and increasing your professional value, adding “yoga instructor” to your résumé helps drive a fresh approach for every client. “By studying both professions, I see every one differently, and I know better what each body needs—from myself to my clients,” Tatman says. “And I definitely think yoga helps keep me young and energized about massage therapy. If that’s how you feel about your job, then you must be doing it right.”
Becoming A Yoga Instructor
If you’re interested in expanding your career by becoming a yoga instructor, here are five tips to get you started:
1. Consider your enthusiasm. “Really liking yoga makes a huge difference,” advises Sarah Landicho, a yoga teacher based in Chicago. Respected yoga training programs can cost upwards of $3,000, and they also require time, ranging from two months to two years, depending on how deeply you dive into the discipline. The financial and time commitment should feel like a positive means to expand and enhance your career.
2. Research … and then research some more. A good place to begin researching yoga training programs is with your own favorite yoga teacher. “This is the person who likely inspired you to teach,” Landicho says. “So, ask where he or she received training.” To research a specific program, visit the Yoga Alliance’s website, a nationally recognized organization. Only programs that meet certain standards—such as a specified number of hours studying asanas, teaching technique, anatomy and philosophy—can be registered with the Yoga Alliance.
3. Determine a goal. The Yoga Alliance recognizes two training certifications, both of which refer to program length. You can become a Registered Yoga Teacher (RYT) with the Yoga Alliance after completing a 200-hour or a 500-hour program. The Yoga Alliance recognizes RYTs who command significant teaching experience with an additional designation—Experienced Registered Yoga Teacher (E-RYT).
4. Study because you want to—not because you must. “In the U.S., there’s no law that you must go through a 200- or 500-hour training program,” Landicho adds, although she recommends formal study for two reasons: getting both insurance and a job. “If you want to teach at a yoga studio, you’ll more than likely need certification,” she says. (Learn more about our dual coverage for massage therapists and yoga instructors—available at no extra charge!)
5. One final note! Even if teaching yoga is not your goal, a respected teacher-training program can deepen your own yoga practice and increase your knowledge of anatomy—two strengths that can enhance your career as a massage therapist.
Liability Insurance: Dual coverage for massage therapists who are also yoga instructors or estheticians is included in an AMTA Membership at no extra charge. Learn more »
12 Self-Care Secrets | 4 Credit Hours: By integrating mind, body and spirit through this simple 12-step program, you can effortlessly make a state of balance an integral part of your daily life. Register now »
1. Schneider, Suzanne et al. Physician coaching to enhance well-being: a qualitative
analysis of a pilot intervention. Explore: The Journal of Science and Healing, Volume 10,
Issue 6, 372–379.
2. Woodyard C. Exploring the therapeutic effects of yoga and its ability to
increase quality of life. International Journal of Yoga. 2011; 4(2):49-54.
3. Williams K, Abildso C, Steinberg L, et al. Evaluation of the effectiveness and efficacy
of Iyengar yoga therapy on chronic low back pain. Spine. 2009; 34(19):2066–2076.
4. Sherman KJ, Cherkin DC, Wellman RD, et al. A randomized trial comparing
yoga, stretching, and a self-care book for chronic low back pain. Arch Intern
5. Tilbrook HE, Cox H, Hewitt CE, Kang’ombe AR, Chuang L, Jayakody S, et al. Yoga
for chronic low back pain: A Randomized Trial. Ann Intern Med. 2011;155:569-578.