Lauriann Greene gives advice for preventing work-related injuries

Dear Lauriann,
As a professional massage practitioner, I give between 15 and 30 massages per week. I’ve been practicing for about two years. The muscles in my forearms have become hypertonic, and there are spots in my neck and scapular region that are always sore. Every once in a while, when a friend of mine who is also a massage practitioner gives me a massage, she works on those spots and they feel less sore afterward. But then the soreness comes back. I’m not sure what I can do about this - do you have any advice?
Janene P.
Los Angeles, California

Dear Janene,
You were on the right track in asking your friend to give you a massage. You just need to get your massages regularly, rather than every once in a while. When we attend massage school, we are required to exchange massages with our fellow students. The main purpose is to get experience doing massage, but the side benefit is receiving massage on a regular basis. Once we get out of school, most massage practitioners are so concentrated on giving massages to others that they don’t think about getting massaged themselves. They may feel that they can’t find the time in their hectic schedule, or that it’s a luxury that they can’t afford.

Receiving massage or other types of bodywork is a very important part of your injury prevention strategy. The many benefits of receiving massage are so vital to maintaining your health as a massage practitioner that you cannot afford to leave them out of your weekly schedule.

The benefit for which massage and bodywork is most widely known is relaxation. Massage therapists tend to have hypertonic hand, arm, neck and shoulder muscles, often as a result of poor posture or body mechanics, or emotional tension. These hypertonic muscles never relax—they are in a constant working state. In this state, they do not get the rest they need to recover and heal so that injury can be avoided. Muscular tension also decreases circulation, impeding healing and increasing your injury risk. By lengthening your muscle tissue, massage helps your muscles return to a relaxed state with improved circulation. Massage also has a calming effect on the sympathetic nervous system. The physical and emotional relaxation that results will help prevent tension from creeping back into your muscles as you massage.

Trigger-point work is a particularly effective massage technique for many of the pain symptoms experienced by massage therapists. Trigger points are spots of hard, ropy tissue that are sore when touched. It is believed they are caused by emotional stress, injury due to overuse or trauma. If you carry tension in your shoulders, for example, the constant tension in those muscles may cause small areas of injury that result in scar tissue adhesions and trigger points. These points cause pain, both local and referred, and decreased circulation. Your massage therapist treats these points by applying pressure to them. This technique, followed by deep-tissue massage to the area, releases the point and allows the muscle to relax so that normal blood flow can be reestablished.

To prevent injury, massage practitioners need to be in touch with their bodies. Being aware that your shoulders have become tense, or that your thumb hurts, allows you to change what you’re doing so you don’t become injured. While you are receiving a massage, you have the time and space to tune in to your body, to feel how it reacts when touched by the therapist. Your once-a-week massage brings you back in touch with your body, so you will be more likely to notice its warnings and signals as you work.

There are several types of bodywork that address body alignment and posture, most notably the Alexander Technique and the Feldenkrais Method. I strongly advise massage therapists to work with a practitioner of one of these techniques at the start of their professional careers, to help them work with more freedom and ease. By increasing attentiveness to your body mechanics and alignment, these types of bodywork will help you to not overstress your body in your massage work.

To stay healthy, massage therapists need to remember the old adage, "Physician, heal thyself." Apply the lessons of massage as much to yourself as to your clients. Your reward will be a long, healthy massage career.

More Helping the Healers

Lauriann Greene is a massage therapist and the author of Save Your Hands! Injury Prevention for Massage Therapists which is used by massage schools in North America and in five other countries; and by physical therapists, chiropractors, and other manual therapists to help prevent injury.  She has also taught "Save Your Hands" workshops in numerous locations across America.

Please note: This column is edited by a medical doctor to make every attempt to ensure medical accuracy of the answers given; however, the recommendations and techniques described in this column are meant as suggestions only, and are not intended to be a substitute for appropriate medical advice and treatment from your own qualified health care provider. Readers who experience any signs or symptoms of injury have the responsibility to seek professional medical advice and treatment.