When you find yourself in a situation where your body mechanics feel uncomfortable or painful, you need to be able to immediately identify and solve the problem. Overuse is the primary reason for work-related injuries among massage therapists. If you repeatedly use the same positions, sequences, and techniques, you run the risk of developing dysfunctional patterns of movement: from habitually using the same part of your hand for performing techniques, to the way you position yourself when working. The sad truth is, many therapists continue to follow the same routine again and again, despite the fact that it causes them pain.

Changing the way you work (i.e., a position, part of the hand you use, and/or a technique) is the best strategy for solving uncomfortable body mechanics during a treatment. In other words, you must stay constantly aware of all your options. This awareness of choice allows you to develop a wide range of comfortable and effective alternatives for any given situation. If your treatment plan is flowing smoothly and your body feels comfortable and pain-free, well done. But when something doesn’t feel right for your body—for example, your back starts to ache or your hands start to hurt—it’s time to start problem solving.

Massage therapy is an organic, dynamic process in which you and your client work closely together to create the best possible outcome. Thinking about your process like this will help you realize there are many different ways to work. If a certain technique is causing you discomfort or pain, chances are it is not the best choice for your client, either. Keep an open mind to a wide range of possible solutions, remembering that if you are working comfortably and pain-free, your body, and ultimately your career, will remain healthy. Whenever you feel discomfort arise during a session, or when something creative is called for, use one or more of the following options.

Change Your Position
If working in a certain position doesn’t feel comfortable to you, change it. For example, working with a client’s neck from a standing position may cause tension in your shoulders or back. In this case, consider sitting while working with the head and neck. In general, sitting is always a good option, no matter the situation.

Change Your Client’s Position
Expanding your options for client positioning will greatly improve your comfort level when working. Often therapists opt to work in pain rather than ask a client to change his or her position. This is counterproductive; never compromise your body mechanics. Remember: prone, supine, side-lying, and sitting are all viable options. If you find that your table is too low when working with a client in a supine or prone position, and you do not have an electric lift table, turn your client onto his or her side. Think about your work from an ergonomic standpoint and ask yourself, “How can I bring my work to me, rather than conforming myself to the work?”

Change Your Tool
If you are using a certain part of your hand and it starts to feel uncomfortable, change to a different part. For example, discomfort commonly arises when fingers and thumbs are used to apply deep pressure. If this happens, immediately change to your knuckles, fist, or elbow. If you lack confidence, you might be tempted to work with the discomfort rather than change to another option. Don’t let yourself fall into this pattern. Any time you feel uncomfortable, no matter the level, find a way to change your working tool. This will better serve not only you, but also your client.

Change Your Technique
If you have tried all of the above options and you still feel uncomfortable in your body, the next step is to change your technique. For example, if you feel uncomfortable while applying deep pressure to facilitate muscle release, try switching to a passive or active range of motion. The bottom line is: don’t become a victim to your pain or discomfort; rather, be self-reliant and use your knowledge and creativity to find the best solution.

Finally, one last but important point: using your entire body to support and facilitate the movements of your hands will reduce effort in your back, neck, shoulders, arms, wrist joints, and hands—in other words, you will prevent overuse. You will also dramatically increase your quality of touch and your effectiveness. Keep in mind that when your lower body (pelvis, legs, and feet) is moving to support your work, and your upper body (head, shoulders, rib cage, and arms) is moving to facilitate it, your entire body moves in synchrony, becoming your greatest tool.

Barb Frye has been a massage educator and therapist since 1990. She coordinated IBM’s body mechanics program and authored Body Mechanics for Manual Therapists: A Functional Approach to Self-Care (Lippincott Williams & Wilkins, 2010), now in its third edition. She has a massage and Feldenkrais practice at the Pluspunkt Center for Therapy and Advanced Studies near Zurich, Switzerland. Contact her at barbfrye@hotmail.com.

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