Ten top tips for avoiding injury

Ten top tips for avoiding injury By Rachel Fairweather

Anyone who works intensively with their hands is prone to injuring their arms, wrists, thumbs and fingers and unfortunately massage therapists are no exception. The arms and hands are just not designed to withstand heavy work over extended periods of time leading to carpal tunnel syndrome, tennis elbow and other hand and wrist RSIs. It is rare for massage therapists to be taught how to protect their bodies leading to an exceptionally high rate of injury in the profession.

Yet the good news is that it doesn’t have to be this way. If you know the correct way to use your body you can have a long and healthy career.  Protecting your hands is easy when you absorb the principles of dynamic body use and the good news is that it also helps to give your clients an even better treatment!

Why do massage therapists and aromatherapists get injured?

There are lots of reasons why bodyworkers tend to get injured while carrying out their job:

o    Poor body mechanics: Many massage therapists have very poor training in body mechanics causing them to awkwardly twist, bend, or position their joints out of alignment while working.

o    Doing too many massages at one time: Many massage therapists (or employers!) have unrealistic expectations about the number of massages that can be done in a day or a week. Massage is physically, emotionally and spiritually demanding. A realistic (very) full time massage schedule would be no more than 20 treatments a week  ie: 4 massages a day 5 days a week, or 5 massages a day 4 days a week

o    Massaging with your table at an incorrect height: As a general rule, a table that is at your fist level while you stand beside it, allows you to use your body in a more optimal way while massaging. Many of us have been taught to have our tables much higher – around waist level for example. This is fine if you are doing incredibly gentle work. However as soon as you start to do any deeper work you will naturally hunch up into your shoulders leading to strain and injury

o    Limited techniques and repetitive motion: No one part of the body is designed to do the same motion repeatedly without rest. Most massage therapists are taught a limited repertoire of techniques that use the same muscles over and over again. This inevitably leads to injury and pain.

o    Trying too hard: Many of us don’t quite feel good enough. We think the client needs more work or harder work to get a good treatment. Pushing and straining to get a result leads to us needing a massage more than the client!

o    Using muscular strength rather than body weight and energy to work deeper: Martial artists know that muscular strength alone is a very poor way of achieving power. We need to learn how to use our body weight and energy (chi) to achieve depth and pressure. Good martial artists can break a brick with their hand while holding an egg!

o    Not listening to your body: Unfortunately many massage therapists carry on working when they are in pain due to work pressures or embarrassment. This is a big no no! If your body hurts you need to change something!

o    Doing other hand intensive activities: If you are doing other hand intensive activities such as part time computer work or a career as a professional violinist in addition to massage you may stand a higher chance of getting injured. This may also be an issue if you are combining massage with beauty therapy as this often requires activities that put the hands under additional strain.

o    Believing there is a right and wrong way to do massage: Massage is a wonderful creative art. There is no right or wrong way. Many therapists carry on doing techniques that hurt their bodies believing that this is the “right” way to do the technique.

Give yourself permission to find different ways to do things and most of all IF IT HURTS DON’T DO IT

Protecting your hands- fundamental principles of dynamic body use

Once you absorb the principles below, saving your body will become an automatic part of the way you work:

Good Body Mechanics in Massage Therapy
Developing good body mechanics is fundamental to longevity in the business. Using good body mechanics while you work not only helps you to avoid injury but enables you to use more sensitive and powerful touch. Good body mechanics requires:

o    A strong energetic connection with the ground through your feet, legs and hara (belly).
o    Your hara should usually be pointed in the direction of your work. Imagine your hara as a strong light that shines where you are working.
o    Never bend your back to carry out a move. Lunge forwards in tai chi stance or kneel down if necessary.
o    Use your body weight not muscular strength to work deeper. Always remember “lean don’t press”.
o    Breathe into your belly. Always find the quiet part within yourself by re-connecting with the breath.

Massage Stance

While working, your body should mainly be in one of the 4 stances below. Using a massage stance should be a dynamic dance and you may flow from one to the other depending on what is best for your body at that time.

o    Forward Tai Chi Stance: Similar to a lunge. Particularly useful for effleurage based strokes. Weight can transfer between the front and back leg to give power.

o    Horse Stance: Feet hip width apart and legs bent. Make sure knees roll outwards rather than medially to prevent strain.

o    Kneeling Tai Chi Stance: This can be used to maintain good body mechanics when you need to be at a lower level than standing would allow.

o    Seated: Have legs wide apart and both feet firmly connected to the ground. Make sure your own spine is not slumped.

Correct use of breath

The breath is a great tool for helping you to calm down, ground yourself and deepen your intention and pressure while working. Get into the habit of regularly checking into your breath and body while treating – you will find that at moments of stress you will tend to hold the breath and tense up your whole body. Check into the “space between breaths” ie: the slight pause after you breathe out and before you breathe in to remind yourself of the power of “less is more”

You can deepen your pressure simply by breathing energy up from the earth though your legs and down your arms and hands.
When you feel anxious or not good enough take a few deep breaths into your belly – this will calm you and slow you down. Remind yourself you are good enough.

Moving and dancing while you work

Take the opportunity to move and really dance while you work. Put on some great music, move your hips, enjoy yourself!

Listening to your body and recognising strain

During treatments, use your breath to regularly check into your body. Scan yourself from head to foot to see if anything is feeling strain or tiredness. If you hurt- change what you are doing!
Also make sure you listen to your body between treatments. If you feel tired, in pain, weepy or irritable after a days work, you need to change something about what you are doing – less massages per day or longer gaps between treatments.

Using the principles of “less is more”

Remember the best treatments are not those with the most techniques crammed in, the deepest pressure or the fanciest strokes. Your goal should always be to achieve the outcome that the client desires in the most elegant and energy efficient way. One thoughtful, slow, focussed stroke executed with listening touch is more effective than ten hasty ones. Feels much better too!

Using body weight and energy to work deeper

Working deeply is not simply the application of deep pressure to the body.  It is not a ‘harder’ massage or a more rigorous treatment.  It is an experience of engaging the body’s tissue and its structures in a manner that is connected on a ‘deeper’ level. ‘Deeper’ in connection, contact and awareness. It is not about strength or force but FOCUS.

We are able to work deeper by using our body weight to lean into the tissues and the intention and breath to penetrate deeper into the tissues.

Using a wide variety of techniques

The more techniques you have in your toolbox the less chance you have of repetitive motion on the same poor muscles .Go on more courses – expand your repetorire.

Techniques to avoid

There are many techniques commonly taught on qualifying courses that are best avoided altogether if you are intending to make a living out of massage:

o    Petrissage: “Open c closed c” – This technique uses the hands in the shape of a “C” to lift and push the tissues between them. This is very stressful to the thumbs, hands and forearm flexors. There are many other ways of creating the outcome of this stroke

o    Thumb work: Most therapists have been taught to overuse their fingers and thumbs. Your thumbs should be thought of as the most precious tool you have. Only bring them out when absolutely necessary – approx 10% of the time.  Your forearms can do so much of your broad strokes and knuckles and elbows may be employed to get into the specific points.

o    When you do use your thumbs make sure they are supported by your loose fist or are flat on the body. NEVER use your thumb with the MCP joint unsupported.

o    Effleurage with deviated wrists: Some therapists have been taught to massage the limbs with hands turned inwards to mould to the contours of the body. As far as possible wrists and hands should always be kept in line or injury may occur.

o    Effleurage from the side of the table: Many therapists learn to massage the back with strokes towards the client’s head from the side of the table. This leads to unnecessary twisting and back strain. Effleurage from the head of the table feels just as good to the client and is so much better for your body!

Incorporating still work

It feels great! And it doesn’t hurt your hands! Give yourself permission to spend time holding your clients feet, head, points on the back or anywhere you feel needs it. Focus and breathe energy into the area.

Want to learn more?

If you are interested in the approaches discussed in this article come on our 1 day Forearm and Deep Tissue Massage Course  running on the following dates:

About Rachel Fairweather and Jing

Rachel Fairweather is co-founder and director of The Jing  Institute of Advanced Massage Training – an organisation dedicated to excellence in all aspects of postgraduate massage training. We are dedicated to helping massage therapists have the lifestyle and business you deserve. Based in Brighton, we offer courses around the country including London and Edinburgh. Our courses include longer qualifications in advanced massage including our revolutionary BTEC Level 6 (degree level) in Advanced Clinical and Sports massage and 1-2 day CPD courses in Marketing, Hot Stone Fusion, trigger point, myofascial release, stretching, pregnancy, on site, living anatomy and many others. You can also check out our DVD in advanced clinical massage techniques, downloadable from the website and our new online course in low back pain.  Please call or check our website for further information and course dates. 
Tel: 01273 628942

You can also follow us on Facebook: Jing Institute of Advanced Massage Training
or Twitter! @JingInstitute

Published in the International Federation of Aromatherapists Magazine

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