With high levels of consumer demand for massage therapy and an industry-wide shortage of trained, qualified massage practitioners, the profession needs to help current practitioners stay as healthy as possible in order to safely maintain caseloads.

With high levels of consumer demand for massage therapy and an industry-wide shortage of trained, qualified massage practitioners, the profession needs to help current practitioners stay as healthy as possible in order to safely maintain caseloads.

Some massage therapists are leaving the profession, often because of repetitive stress injuries (RSIs). Vital steps to self-care and maintaining longevity in the profession are to be mindful of your body mechanics and adhere to evidence-based ergonomics recommendations.

Empirical procedures and technology have evolved to enable the assessment of massage therapy procedures and practices, helping to guide and enhance long-term health and stamina of practitioners and, by extension, your career.

The Massage Therapy Foundation’s (MTF) Ergonomics Project was developed with the purpose of strengthening the profession via creating a job task analysis to develop recommendations for safer massage therapy work and conditions.

The extensive, 18-month-long project brought in the experience and perspectives of professional ergonomists from Briotix Health of Centennial, Colorado, which shares MTF’s vision to support delivery of results through effective, science-based, practical injury prevention services and technology.

[Watch a video of MTF President Robin Anderson and Stefan Shulz from Briotix as they discuss the fundamentals of ergonomics, and how ergonomic principles were studied in MTs over the course of Phase One of the MTF Ergonomics Project, here.]

Why Ergonomics?

A pragmatic method to assess massage therapy work is through ergonomics, the combination of science and art that adapts work tasks to the worker as well as factors in both physical and emotional health and safety of the workers.

An-depth analysis of MTF’s project results may significantly impact the profession in many positive ways. We are excited to share this information so therapists from a variety of common workplace environments and massage therapy education programs may become advocates and demonstrators of career longevity.

MTF President Robin Anderson, MEd, LMT, BCTMB, CEAS, who has experience with ergonomics herself, explained how this project evolved. “As an organization, MTF supports the massage therapy profession through research, education and community service. The Ergonomics Project, in all its phases of discovery, has provided support in all areas of our mission.

“The data collection and technology are the research aspect,” Anderson continued. “The reports and results are content we learn about our own profession in how to perform it safely and efficiently to support a longer career span.”

The Ergonomics Project was set to establish baseline workplace risk data for analysis. Once identified by ergonomic experts, the behaviors and risks provided discovery that will allow practitioners and educators to make adjustments to the workplace environment, body mechanics and workload. The better understanding of work tasks and physical activity of therapists will optimize the productivity and impact on not only the therapists but the clients as well. When therapists experience less physical fatigue or discomfort, they may continue to work—and for a longer career span—in the industry in a healthy capacity and ideally, they will continue to produce positive results and experiences for clients.

“The Ergonomics Project can certainly have an impact on the career longevity of massage therapists, [and] identified recommendations for changes in how massage methods are applied will need to be integrated into entry-level education,” said Sandy Fritz, BCTMB, an MTF workgroup member.

The main objectives for the investigative phase one were:

• Observe, identify and evaluate the ergonomic risk profile of typical work environments for massage therapists;

• Determine items contributing to the risk; and

• Provide recommended guidelines that can contribute to the general education and practice methods in order to reach all practitioners, current and new.

This phase of the Ergonomics Project took place in spring of 2019 with the help of 755 massage therapists nationwide via an expansive survey and included 30-plus massage therapist volunteers from the Baltimore, Maryland, and Portland, Oregon, areas.

The volunteers allowed video observation by ergonomic data experts performing massage using the same parameters of tasks in a controlled setting, and then thorough evaluation of workplace settings such as a franchise site, a day spa and multi-therapist wellness centers.

Survey & Data Findings

The comprehensive workplace survey findings provided insights into therapists of a vast age range of demographics:

• Common musculoskeletal discomforts reported were the neck (most prevalent), lower back and shoulder areas; and 25% of respondents indicated they have decreased client load due to their recurring discomforts.

• Therapists indicated the preferences for pressure application when performing massage were mostly in the “medium” to “deep” ranges.

• A telling and concerning finding was that the vast majority of therapists personally knew a colleague “who left the profession due to a musculoskeletal, work-related injury.”

In addition to the survey, over 600 data points were collected and examined by professional ergonomists while observing therapists performing required (typical and common) workplace activities. Data analysis shows a moderate risk for developing repetitive strain injuries if no self-care or intervention is used. This, in aggregation with the long duty or work cycles most therapists have, indicates there are greater opportunities for risk. Taking these ergonomic observations into consideration, the massage practitioners’ work environments may be enhanced for improved health and safety.

“This is a distinctive assessment since there are all different types and sizes of workplaces for massage therapy practitioners,” said Briotix Lead Ergonomist and Team Manager Stefan Schulz. “We’re trying to make workplaces better for each and every therapist out there and provide information on how they can remain safer at work. Data is the basis for our assessments; and now that Phase One is collected, we have created thresholds for ergonomic risks that are easy to implement on a personal basis.”

By utilizing the results of phase one, the MTF’s staff is proud to provide the profession with guidelines to increase physical health and career longevity. The MTF is in the process of creating an in-depth e-book to help guide practitioners and workplaces to establish an environment that promotes self-care and safety. These recommendations include guidelines for physical conditioning, table height adjustments, positioning, stroke, force exposures and stance.

8 Self-Care Adjustments to Make Now

Here are some phase-one highlighted recommendations and interventions:

• Use softer floor surfaces;

• Wear supportive footwear;

• Rotate and shift work postures from sitting to standing to leaning throughout workday;

• Limit prolonged standing;

• Adopt height-adjustable massage tables and stools to vary work postures;

• Implement stretches during the workday with a focus on low back, lower extremity and foot flexibility;

• Maintain core and lower extremity strength and flexibility through targeted physical fitness activities and exercise; and

• Use compression stockings to reduce subjective complaints of leg fatigue, pain and swelling.

Further Study

Phase two of the Ergonomics Project is planned for study with the use of wearable sensor systems to enable the ability to capture objective task-specific metrics in combination with ergonomic exposure data for an entire workday, all with minimal disruption of the therapist’s workflow. The focus will be on understanding fatigue as a factor of musculoskeletal risk within the massage therapy profession.

There is a possibility of a Phase Three, which would consider psychosocial fatigue that is commonplace with careers in a caregiving role, of which massage therapy is one. These elements are currently being explored to expand the project further and create more depth and expanded outcomes to its findings.

The MTF’s staff is optimistic that our discoveries will provide valuable recommendations for current and future massage therapists to enjoy long and healthy careers.

Download the complimentary ergonomics graphic below here.

About the Authors

Marla M. Gamze is the development & marketing manager for the Massage Therapy Foundation. Geri Anne Nelson is program manager for the Massage Therapy Foundation.

ergonomics infographic
Download this complimentary ergonomics graphic here.