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The self-preservation of massage therapists.

As we know, massage therapy and bodywork are physical endeavours. In an ever-changing world therapists are now treating a wide variety of muscular and neuromuscular ailments, often combined with other health issues, such as obesity and the many problems that can and do arise from it. Many people who are overweight or obese sustain tremendous physical pressures on their structural joints, muscles, organs, and particularly on their nervous systems. Overweight or obese clients may also be on prescribed medications which can add another level of complexity to their pain.

All this illustrates that massage therapy today is harder than in previous times. In my time in this industry--now 17 years--I have seen too many therapists burn out from not coping with the repetition of the work and with heavier or less supple clients. It is likely that it is not exclusively the repetition of the work or the weight or rigidity of clients that are at fault.

There is also a responsibility that lies squarely on the shoulders of every massage therapist. The client should not have to listen to the puffing or groaning of a therapist who is unable to perform a task because of lack of fitness, low strength or poor posture. As a health industry worker, particularly in this field, it is a self duty to be strong, fit and to have good postural awareness, because being a massage therapist means you're in an environment that requires it.

Using a combination of cardio with resistance work, it is reasonably easy for most people to achieve a 15% improvement in strength and fitness over a period of a month to six weeks without having to invest a lot of time. Some recent research states that with just one 20-minute high intensity training session per week most people can produce this result. (1) Only twenty minutes a week. A 15% improvement may not seem a lot or hardly worth it but when you're lifting the limbs of a heavy or rigid client, you will immediately realize its worth.

Practise what you preach

As practitioners we often recommend to the general population that they use our therapy to alleviate such things as work fatigue, sports injury and many other forms of stress, and claim that our work would be of benefit to their overall wellbeing. Yet a reasonable percentage of massage therapists do not practise this themselves.

It is vital to practise what you preach as wrist, elbow, shoulder and back tendonitis or injury can slowly creep up on us over the years. Also, apart from massage being just as beneficial for us as anyone else, there's an added bonus. That is when a therapist receives a good massage and feels their own body's sore points being worked, it reminds us of how our clients feel under our hands. It reminds us that the work we do can feel sharp and painful, or too light or frivolous; that we have to respond with good touch, good awareness and correct pressure to an individual's particular needs; and that it is important to allow time for clients to just breathe or rest, and not to over--or under-do your work. Being a massage therapy client is also educational in that it develops your own therapy. Try different therapists for variety--it will teach you new things.

Tense Versus Relaxed

There's another observation you may have made. Let's say I have a 55kg client having massage who is unconsciously rigid, tense and unbending, and a 105kg client who is relaxed, nimble and loose. One is 50kg heavier and larger framed yet is easier to work with. One client's shoulders present as weighing lightly; the other's, heavily. Yet the heavier client's shoulders move more freely than the lighter client's. This demonstrates that it's not all about the weight or size of the client but more about how a person can or cannot relax. Rigidity in clients, whether they are male or female, large or small, can take its toll on the therapist's body. Be aware of this and take steps to counter it.

My suggestion is to let go of your pressure or stretch immediately, then gently ask the client to focus on relaxing and breathing with your work. Ask them to be aware of how they are reacting to that move or pressure. They may become defensive at the suggestion of more cooperation --it happens, but reassurance that you will work together will build your client's trust and confidence in you. I have found that if I notice the client not breathing again, I take a deep breath myself and they naturally hear it and do the same. I compliment that with a simple, 'well done--breathe and relax the best you can'. It's gentle suggestion, not a command, that a client responds to best.

You may have to do this time and time again. A client will respond eventually. You are re-teaching them how to relax, which has unfortunately become a lost art for so many. When you encounter unconscious or conscious resistance, you need the co-operation of your client for them to relax. Clients want to cooperate --after all they have come to you for your help. Remember that at the end of the therapy a client does not want to feel 'beat up' but up beat'. The request to relax through focusing on the breath helps to achieve this outcome. It also it greatly reduces the risk of your bruising a client

Stance and postural do's and don't's

I am six feet tall in the old scale. Every kitchen sink I have ever had to do the dishes in seems to have been built for a person who is five feet two. I have to spread my feet, over a metre apart so that my body lowers and my back stays straight, or else I get back fatigue. Sure, it looks ridiculous but it works.

This same logic applies to massage therapists. Do whatever you have to do to achieve a good postural position. Sitting on the edge of the table to perform some leg stretches on your client is not unreasonable if it helps you get into a good posture and breathing pattern. As long as you do not encroach on the client's personal comfort and use correct drapin they won't be inconvenienced. I was taught many years back that using a chair or stool is remiss or rude: I've found this advice a fast way to burn out' through bad posture. A stool or chair is a tool like any other, so have them at your disposal when they're needed to maintain good posture, throughout your career.

The above points are intended as basic guidelines to surviving injury and burnout in massage therapy while fulfilling the varied and sometimes difficult requirements of your clients. As a massage therapist you have a duty, to your own personal health and wellbeing, to look after your own body. You are also in a unique situation where leading by example is how you can confidently advise your clients on their own health requirements.

Occasionally a client comments that I must get sore hands. My answer is, 'No. I get massage'.


(1,) Kessler HS, Sisson SB, Short KR. The potential for high-intensity interval training to reduce cardiometabolic disease risk. Sports Medicine. 2012,42(6): 489-509

David P Hughes | Remedial Therapist, Caloundra Queensland
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Author:Hughes, David P.
Publication:Journal of the Australian Traditional-Medicine Society
Geographic Code:8AUST
Date:Dec 1, 2016
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