1. Listen to your body and respond to symptoms. Don’t hesitate to seek medical treatment if you begin to have symptoms, particularly if they indicate a need for immediate medical attention.
Medical treatment received early on in the symptom progression is often simple, consisting of rest, ice and anti-inflammatory medications and sometimes combined with recommendations of activities to avoid. Early treatment is also more effective, less expensive and will allow you to return to work more quickly than if you delay treatment. Some musculoskeletal disorders can require extensive periods of rehabilitation, or even surgery, if they progress too far.
Symptoms that require immediate medical attention include:

• Intense pain
• Any pain that lasts more than five days in a row
• Inflammation that is moderate to severe or lasts more than five days in a row
• Unexplained clumsiness, weakness or loss of function
• Any numbness, tingling or burning sensations
• Pain that radiates down an arm or leg
• Symptoms that wake you up at night or prevent you from falling asleep
• Changes in skin color
• Symptoms that change or worsen rather than improve

2. Avoid fatigue while working. Leave enough time between massage sessions to take a short break, stretch, hydrate and breathe deeply. Avoid scheduling too many massages in one day or week, and avoid scheduling clients needing deep work back-to-back.
Build some recovery time from repetitive hand motions into your massage sessions by incorporating such techniques as active and passive stretching or positional release. Try to sit for at least 15 minutes out of each 60-minute session. For example, you can sit when working on the hands, feet, head and neck.

3. Practice good self-care. Exercise regularly, but avoid working the same muscles you use all day while doing massage. Stretch the muscles in the front of your body that may get shortened from your work, and strengthen the muscles in your back that may be stretched and weakened.
Include exercises to maintain or increase endurance, such as walking. Don’t smoke, since it impedes circulation and impairs your body’s ability to heal itself. Avoid foods with saturated fats or trans fats, since they can provoke an inflammatory response. Get plenty of sleep, since sleep is the time your body’s repair and self-regulation processes are the most active.

4. Plan for your future. Use continuing education as an opportunity to learn modalities that are less demanding, such as positional-release techniques, or that allow you to use your hands less, such as lomi lomi .
Invest in your well-being and peace of mind by getting good health insurance and long-term disability insurance. Think about where you want your massage career to take you 10 or 20 years from now. Will you still want to be doing full-time, hands-on treatment work, or would you rather be managing a clinic or spa? Start working toward your goals now, so that you can continue to work well beyond the eight-year average for massage careers.

and Richard W. Goggins