Massage therapy is a physically demanding job and practicing good self-care is necessary for career longevity. For massage therapists who are new to the profession—or for those veterans who need a reminder—understanding some of the causes of injury in the massage therapy profession is a first preventive step that can add years to their career.
Here, we’ll talk about some of the most common reasons massage therapists face injury, as well as how you can assess your own risk.
Reasons for Injury in the Massage Therapy Profession
Force. Force is a part of your work in a variety of ways, some more constant and persistent than others, like deep tissue work or gripping tissue and holding trigger point work. Still, as massage therapist and certified injury prevention instructor with Save Your Hands, Joanne Kolodziej reminds us, there are other less obvious examples of force that need to be accounted for, as well. “Lifting your client’s leg during a session is an example of force,” she explains, “or transporting your massage table from location to location if you travel to clients’ homes or other work environments.”
When you’re not cognizant of the many ways force enters your work, injury can occur—most commonly musculoskeletal disorders. These injuries typically present with symptoms like increased pain with movement, body aches, muscle soreness and fatigue. “Musculoskeletal disorders with upper extremities have been the most prevalent issues for massage therapists,” Kolodziej explains. “Rotator cuff injuries, wrist tendonitis and tenosynovitis, trigger fingers, bursa injuries in the shoulder and elbows are also common.”
“Whenever you’re working big muscle groups and you really have to break adhesions that are deep or long-standing issues of the patient, it can be really taxing on a massage therapist,” adds Dr. Thomas Mitchell, D.C., CCSP, a certified chiropractic sports physician at the Chicago Institute for Health and Wellness.
Lynn Kramer, a massage therapist and injury prevention specialist, has seen deep tissue work cause injury in massage therapists’ thumbs, too.
Awkward postures. You’ve no doubt heard before that good body mechanics are key to career longevity. Awkward postures, like bent wrists, leaning or reaching too far over the table or not keeping your head and neck in neutral position, can cause a variety of injuries that can sideline a massage therapist’s career, including low-back pain and postural neck strain. “It is extremely important for the massage therapist to be aware of body mechanics, as well as to keep moving at all times so there is no static loading,” Kolodziej insists.
Repetition. “One of the most common repetitive injuries in the massage therapy profession is low back pain due to bending over,” says Kolodziej. “That’s why it’s always good to keep a standing and sitting neutral posture when possible.”
Dr. Mitchell adds that carpal tunnel syndrome, a tingling or weakness that is caused by pressure on the nerves in the hand, as well as shoulder impingement syndrome, are among some other common repetitive injuries.
Rotator cuff injuries because of excessive shoulder work, neck tension from keeping the head bent down during the length of a massage session and wrist tendonitis from bending the wrist while applying too much force at the same time are also big problems caused by repetitive motion.
“To avoid rotator cuff injuries, you should keep your elbows close to the body and make sure your table is adjusted to the proper height,” Kolodziej adds. “You should also keep your wrists in a neutral position at all times for maximum strength to avoid wrist tendonitis.”
From the archives: Read Massage Therapy Journal's "Don't Get Sidelined: Self-Care for Massage Therapists" for more information on common injuries in the massage therapy profession, as well as how to prevent them.
Risk Assessment: How to Know When Injury Is Imminent
Knowing some of the most common injuries massage therapists face is only half the battle. You also need to be able to honestly assess your working habits so you can pinpoint where in your practice you may need to make some changes in order to prevent or limit the likelihood of injury.
The risk of injury in massage therapy largely depends on four factors:
Frequency. Think about the massage techniques you’re using during the week. Are you mostly using the same massage techniques every day and with every client? Does your schedule remain the same each week or does it vary?
Duration. Duration isn’t just about the length of individual massage sessions, though that’s certainly a part of the equation. Think about the length of the massage sessions you’re doing in a given week, as well as how many days a week you’re giving massages. If your schedule is all 90-minute massage sessions five or six days a week, you need to be very vigilant in assessing how you’re feeling and where you might need to pull back in order to protect against injury.
Intensity. Intensity ties to force, so massage therapists need to be aware of the clients they’re working on and try to adjust their schedules so they aren’t doing all deep work, for example. When preparing for your day or week, ask yourself: How many clients are going to be expecting or need deep tissue work? Will I use deep work throughout most of my sessions or is there lighter work or a combination of deep and lighter work?
Combined risk factors. Many times, risk factors are going to overlap, whether that’s during individual massage sessions or your weekly schedule. Force and repetitive motion, for example, can be responsible for similar conditions.
“Awareness is the No. 1 key to everything in your work space, home life and off-work activities,” Kolodziej says. “All the things that a massage therapist does on a daily basis, from laundry to computer or phone work to gardening to pumping gas, require small hand movements.”
Kramer agrees, acknowledging that body awareness is vital to injury prevention. “It helps to have a good sense of what your body is doing,” she says.
“Prior injuries such as car accidents or broken bones also matter when it comes to musculoskeletal injury,” Kolodziej adds, “in addition to overall health, including mental health.”
The importance of self-care to career longevity can’t be overstated. When massage therapists aren’t paying attention to some of the most common reasons for injury in the profession, their own risk for injury increases—which is not only bad for you, but also for the clients who depend on massage therapy as part of their regular health and wellness regimen.