Listen to the Messenger

Use Pain to Self-Assess Your Body Mechanics

By Cindy Williams
[Essential Skills]

Key Point

• Returning to proper body positioning during your client’s massage sessions can relieve your pain. 

Tension and pain happen to all practitioners at some point, either because of overgiving, forgetting to keep a broad focus that includes your own body during a session, or both. These sensations and signals are your body talking. It’s important not to ignore this communication; instead, listen, investigate, and make shifts with authentic, mindful self-awareness so you make your health and well-being as important to you as your client’s.  

A big part of this awareness process is perpetually returning to the basics of body mechanics. These core skills of effective massage application can never be revisited too many times. After this reflection, you can self-assess any tension or pain you are experiencing and lovingly offer your body what it needs to stay healthy, strong, and pain-free. 

So, let’s review. We’ll start with appreciating pain as a messenger, then review body alignment and movement from the ground up so you can take part in the conversation your body is trying to have with you.

Pain as a Messenger

Thank goodness for the messenger of pain. I see pain as a tap on the shoulder, saying, “Hey, you! Look at how you’re holding your body.” Without that helpful reminder, none of us would likely make it past a few years in this profession. It’s a gift. 

Even after 23 years of being a massage therapist and instructor of body mechanics, I still find myself in sporadic periods of pain. Each time, I know the root cause is inattentiveness. In other words, forgetting to stay present with my body, typically because I’m hyperfocused on the person on my table. Pain then becomes the messenger that something is off-balance and offers the opportunity to ask, “Why does this hurt, and what can I shift to be in alignment and flow?”

Listen, Investigate, Shift


It’s common to ignore pain and hope it goes away. But stonewalling your body’s efforts to communicate will only cause it to speak louder until you listen. Take the first warning signs seriously and address the problem immediately.


Even though your body might feel stressed or strained in one specific area, it’s wise to do a full body scan to see the big picture and possibly illuminate any other areas that are part of the stress/strain pattern. When you first start as a massage therapist, it can be challenging to expand your focus to your body and investigate the origin of pain—but it is necessary. And, with practice, it becomes more natural. Slow your strokes, tune in, and ask yourself the following questions. 

Feet, Knees, Hips1

Are my feet aligned with my knees and hips? If the toes are turned inward or outward at an angle that is not aligned with the direction the knee is tracking, then alignment is off and you could experience knee, hip, or low-back pain.

Is my stance wide enough to allow freedom of movement back and forth or side to side? When lower-body movement is restricted, your upper body is doing most of the work, causing strain. You should initiate the movement of your strokes from your feet pressing into the ground, carrying your hips and core in a balanced and stable range between your feet.

Are my hips and core facing the direction of the stroke? While feet and legs initiate the movement, your primary source of power comes from your hips and core. So, if you want a stroke to go healthfully in a particular direction, this region of the body must be directly behind your hands and face the direction you push or pull. Any twisting at the waist will create low-back pain that can expand into the shoulders and arms.


• Is my spine lengthened and straight?

• Are my abdominal muscles engaged?

Shoulders and Arms

• Are my scapulae pulled back and down?

• Is there a slight bend to my elbows when in a lengthened position?

• Are my wrists relaxed and mostly straight (not hyperextended) when applying pressure with the thumbs, fists, or palms?

Neck and Head

• Am I looking down at my work or tilting my head?

• Am I clenching my jaw?


Once you recognize the misalignment or movement pattern that is causing pain, shift your body immediately. You must also shift your perspective so every session thereafter involves expanding your awareness and taking moments to tune in and listen to your body, especially if you are already experiencing work-related stress, strain, or pain.

Have a Loving Conversation

I’ve repeatedly witnessed clients and colleagues scold their bodies when in pain. Phrases like “My stupid neck!” and “My weak low back!” and “My %#&! shoulder!” become the communication one has with their body. This only reinforces the stress being placed on the body; healing can’t occur from this perspective.

The next time you find you’re talking down to yourself or being frustrated by pain, make friends with it instead and have a loving conversation. Ask your body what it needs and reassure it that you are committed to a team effort. It’s a much gentler approach to supporting a pain-free experience. 


1. Author’s note: Explanation is provided for the feet, knees, and hips/core because these are foundational concepts that ultimately affect the upper body.

Since 2000, Cindy Williams, LMT, has been actively involved in the massage profession as a practitioner, school administrator, instructor, curriculum developer, and mentor. In addition to maintaining a part-time massage and bodywork practice and teaching yoga, she is a freelance content writer and educational consultant. Contact her at