This article will identify a few techniques to help massage therapists minimize finger and thumb strain and fatigue. By integrating these principles to help alleviate hand pain, massage therapists can ensure sustained success and well-being in their profession.
Table of Contents
Key Takeaways
- Proper wrist angles and engagement of supporting muscles are crucial to prevent strain and injury over time.
- Avoid relying solely on hand strength for pressure. Use your legs to power movements, viewing your hands as extensions of your arms.
- Minimize fatigue and injury risk by utilizing safer techniques, such as keeping joints straight and leveraging external support, ensuring long-term hand health and success in massage practice.
Rule #1: Your Hands are Sandbags
Think of your hands as sandbags. When you lay them on the body, they shape and drape the area. Sandbags have weight to them but aren’t rigid and stiff. This shape-and-drape concept holds true for all muscles of the body you massage.
Can you see your hands as strong but relaxed? Solid but soft? Imagine shaping and draping the calf muscles during petrissage as well as the muscles down the back during effleurage. There is no tension in sandbag hands.
Rule #2: Your Joints Will be Stacked
All joints leading to the tool in use should be stacked in a straight line with bone supporting bone. For example, when you are at the beginning of a massage, starting with the client prone, you use effleurage down the back. With this effleurage, you are using an open hand, which, ideally, is a tension-free sandbag hand.
Your wrist should be at a comfortable angle, between 120 degrees and 130 degrees. The wrist angle is crucial, so you stay behind your work, never on top of it where stress on the hand and wrist is too great which could add to hand pain rather than alleviate hand pain. When the wrist is at an angle less than 120 degrees, strain is put on the carpal bones, leading to injury over time.
Now, let’s go through the joints up the arm. The elbow joint should be straight into the shoulder’s glenohumeral joint, supported by an engaged serratus anterior muscle. Engaging the serratus anterior prevents the scapula from retracting when pressure is applied. This supported shoulder joint is essential in all your massage strokes, especially when you need more pressure.
Rule #3: Your Strength Comes from Your Legs
When you need more pressure for a stroke, never rely on the strength of your hands. The muscles of the hand fatigue quickly and cannot sustain grasping movements massage after massage. Watch that your arms aren’t providing much power; instead, try bringing strength up from your legs.
Think of your hands as extensions of your arms, which you pour pressure into from your legs.
The larger lower-body muscles are perfect for recruiting power and do not fatigue as quickly as the upper-body musculature. (Remember, when you envision the hands as soft, receptive, sandbag-like tools, it’s easier to keep them relaxed even while doing deep compressions.)
You can pour pressure from your legs into the bone-supporting-bone structure, leading to your tool of choice. Using the bone-supporting-bone system, the areas leading to your tool and the tool itself can remain tension and pain-free.
Rule #4: Your Fingers Must be Respected
Using fingers and thumbs as tools during a massage is inevitable. Fingers are beneficial during assessment and specific work where a smaller tool is needed. Friction, trigger points and feeling for abnormalities in muscle tissue are ways your hands can help clients.
Improper use of the fingers and thumbs promotes overuse making them a leader in injury areas for massage therapists. There is a safe way to use fingers and thumbs with a bit of knowledge and attention to detail.
To use fingers and thumbs safely and alleviate hand pain, we need to be constantly aware of how often and how we are using them. When using fingers, notice which finger joints are bent during the stroke—and why. Three joints of the fingers are the metacarpophalangeal joint, the proximal interphalangeal joint and the distal interphalangeal joints. When you notice tension in the hands, look down and see which joints are bent.
Do the bent joints need to be bent, or is there another way to deliver that stroke?
Any bent joint means muscles are contracted, which doesn’t follow the tension-free hand rule. For example, when massaging the muscles at the base of the skull, many massage therapists cup their hands and fingers. Curling fingers to massage an area puts strain on the muscles of the hands.
Often, two of the three joints of the fingers are bent. The first is the metacarpophalangeal joint and the second is the proximal interphalangeal joint. The curled position of the fingers means there is tension in the flexors of the hands and fingers. Five minutes into a neck massage using your hands like this, you’ll realize how quickly hands fatigue.
There is a safer way for the fingers to accomplish the same goal: when only one joint is bent (the metacarpophalangeal joint), it reduces strain on the hands.
A technique to further save the hands is to use the table as a fulcrum for the wrist joint. By pushing the wrists into the table, the fingers press into the neck muscles, and no hand muscles are needed to do the stroke. Where else during your massage can you use the table as a fulcrum? The padding on the massage table allows an inch or two of downward space if you need to use it.
Ensure Long-Term Success
Another way we recommend alleviating hand pain is to simply use them less. Whenever possible, use your knuckles, elbows, fists or forearms to perform massage. Get creative with your massage work. There is always another way to achieve the desired outcome and give your hands a break.
Get in the habit of checking in with yourself during your massages. Do you feel any tension or strain in your hands? Notice what’s going on in your body and, if needed, adjust.
Follow these internal questions to determine if you need to adjust:
- Is the tool you are using relaxed? Do your hands feel like sandbags?
- Is the tool you are using relaxed? Do your hands feel like sandbags?
- Do you need to support or brace that tool?
- Are your joints straight, or stacked, leading to your tool, with bone supporting bone?
- Is your body lined up with your work?
- Are you behind your work vs. on top of it?
- Are you breathing?
About the Author
Angela Lehman is a massage therapist of 25 years turned online educator, promoting fitness and nutrition for massage therapists. She runs The Fit MT. With her kinesiology degree specializing in nutrition, she trains therapists in healthy eating, exercise and body mechanics to prolong their careers.
