How to Avoid Injury (Massage Therapists)

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Last Updated: May 13, 2021 Approved

Anyone who works intensively with their hands is prone to injuring their arms, wrists, thumbs, and fingers. Unfortunately, massage therapists are no exception. The arms and hands are just not designed to withstand heavy work over extended periods of time, and repetitive actions can easily lead 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 and this leads 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 position and use your body and hands, you can have a long and healthy career. Protecting your hands is easy when you absorb the principles of dynamic body use; better yet, it also helps to give your clients an even better treatment!

Part 1

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Proper body mechanics

Use good body mechanics while you work; this will not only help you to avoid injury but enables you to use a more sensitive and powerful touch. Good body mechanics require having a strong energetic connection with the ground through your feet, legs and hara (belly).
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.
Never bend your back to carry out a move. Lunge forwards in a tai chi stance, or kneel down if necessary.
Always remember “lean don’t press."
Always find the quiet part within yourself by re-connecting with the breath.

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Part 2

Part 2 of 7:

Massage stance

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Choose a proper stance. While working, your body should mainly be in one of the four stances described below. Using a massage stance should be a dynamic dance, allowing you to flow from one position to the other, depending on what is best for your body at that time.
- 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.
- Horse stance: Feet hip width apart and legs bent. Make sure knees roll outwards rather than medially to prevent strain.
- 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.
- Seated: Have legs wide apart and both feet firmly connected to the ground. Make sure that your own spine is not slumped.
Put on some great music, move your hips, and enjoy yourself!

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Part 3

Part 3 of 7:

Correct use of breath

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Use breath to remain calm. 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 your breath and tense up your whole body. Check into the “space between breaths”, namely, 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 through 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.

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Part 4

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Listening to your body

During treatments, use your breath to regularly check into your body. Scan yourself from head to foot to see if anything is feeling strained or tired. If you are hurt, change what you are doing! Also, listen to your body between treatments. If you feel tired, in pain, weepy or irritable after a day's work, you need to change something about what you are doing – less massages per day, or longer gaps between treatments.
Remember that 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, focused stroke executed with a listening touch is more effective than ten hasty ones. This feels much better too!

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Part 5

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Using body weight and energy to work deeper

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Engage properly. 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 about focus.
- You are able to work deeper by using your body weight to lean into the tissues and having the intention and breath to penetrate deeper into the tissues.

Part 6

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Using a wide variety of techniques

The more techniques you have in your toolbox, the less chance of having repetitive motion on the same poor muscles. Go on more courses – expand your repertoire.
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Know which techniques to avoid. There are many techniques commonly taught in qualifying courses that are best avoided altogether if you are intending to make a living out of massage. These include:
- 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.
- 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 – approximately 10 percent 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.
- 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.
- 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.
- 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!
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Part 7

Part 7 of 7:

Incorporating still work

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Include still work as part of the massage. It feels great. And it doesn’t hurt your hands. Give yourself permission to spend time holding your clients feet, head, back, or anywhere you feel needs it.
- Focus and breathe energy into the area.