Feature image for an article about seated body mechanics for massage therapists. Image of man correcting his posture while sitting.

Proper body mechanics are essential for massage therapists, even when seated. Key principles include proper stool height, balanced weight distribution, an elongated spine, and neutral head positioning to prevent strain and injury. By maintaining good posture and using weight shifts effectively, therapists can reduce stress on their hands and back. A quick self-check before seated work ensures longevity and comfort in a massage career.

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Key Takeaways

  • Use an adjustable stool to maintain proper body alignment, with hips at a 90-degree angle and elbows bent at a comfortable angle.
  • Keep both feet flat on the floor to support a balanced posture and avoid uneven stress on the body.
  • Maintain an elongated spine and engage your core to support proper posture and reduce back strain.
  • Keep your head aligned with your cervical spine to prevent forward head posture and unnecessary strain.
  • Shift your body weight rather than relying on hand strength to reduce stress on your hands and wrists during seated massage.

Massage therapists know they need good body mechanics to sustain a massage career without causing pain to their bodies.  All the guidelines for working around the table apply, with a few additional points to add while seated. Yes, you need good body mechanics while performing seated massage.

Regardless of how long you sit during your massage sessions, keeping your body mechanics in mind is important.  Let’s look at how your body mechanics change while seated and the best practices to avoid painful overuse injuries.  Good body mechanics are the key to staying healthy.

Remember, seated massage is still work.  The stool is not there to take a break or sit on because you’re tired or your back hurts.  The seated position is only used when a massage therapist can’t perform the massage stroke standing safely.  In other words, a seated position should be taken if the body mechanics are better seated than standing.

What you sit on

The chair or stool you use to perform seated massage should be height adjustable and easily moveable.  Although each massage therapist adjusts their table height to an appropriate height for them, the stool available for seated work should be adjustable too.

A hydraulic stool or chair is desired to place the massage therapist at a height where they can work with their shoulders relaxed. While massaging the neck, for example, it is best to be seated high enough to have the elbows bent at a comfortable 90-degree angle.

A general rule for stool height is to get the hips at a 90-degree angle.  A stool on wheels allows adjustments around the table easily without distracting the client on the table with unwanted noise or the need to remove your hands to move your chair.  

Body mechanics from feet upward

Just as in standing massage, where your feet are placed makes a difference in your seated posture and even the feel of your work. Two feet planted flat on the floor is the base of the seated posture. As a grounding exercise, practice lifting and spreading your toes (inside your shoes), and feel the ball of the foot as well as where the heel is connected to the floor.

All pieces of seated posture during massage build from the feet upward.  Get the feet right and build from there.  Therapists commonly stretch one leg out while seated, back, or tucked behind the other leg.  If one foot is not flat, it will affect the sit bone on that side, which in turn throws the seated posture off.

Ischial Tuberosity

After your feet are flat on the floor, the ischial tuberosities are the next piece to get right. The ischial tuberosities or sit bones need to be equally weighted.  To find your ischial tuberosities, sit on your hands. You will feel the bones at the bottom of your pelvis on your hands. These are the ischial tuberosity bones. You want to place equal weight on each ischial tuberosity for seated massage.  Sitting a bit off to one side may feel natural, but with awareness, you can sit equally.

Another important point before moving to the next piece is sitting at the front of your stool or chair. This will help you find balanced weight on the sit bones as well as good core engagement for a lengthened spine.  

Elongated Spine

To lengthen your spine upward, think of a string attached to the top of your head that pulls you towards the sky.  At the same time, lift the chest or sternum. This elongates the spine and helps to avoid slouching.

As the spine lengthens, the core muscles engage to support the spine softly. Core engagement is good during all massage work, so sitting is no different. A stronger core helps prevent back pain in massage therapists and is the key to overall better posture.

Remember, seated massage isn’t break time, it still requires good body mechanics. The seated position is only used when a massage therapist can’t perform the massage stroke standing safely.  In other words, if your body mechanics are better seated than standing, a seated position should be taken for that portion of the massage.

For example, a client supine, needing sub-occipital work, would require you to bend at the waist while standing, putting your lower back at risk.  A seated position is safer for the massage therapist in this instance.

Balanced Head

Just as in a standing massage, your cervical spine should be straight, and your head should be balanced on top.  Practice drawing your head back a bit so your ears are in line with the center of your deltoid.  This is an excellent postural practice in general, but I mention it here as a reminder that neutral head placement is just as important while seated as standing.

This prevents the forward head posture in massage therapists, which is unwanted but happens over time due to our repetitive work.  Try this exercise at home to feel where your head should be placed over your cervical vertebrae.

Stand with your back against a wall. Place your heels against or slightly away from the wall. Now, draw your chin back until your head is against the wall. Keep your head in that position as you step away from the wall and try walking around the room.  It feels a little foreign, but it is a balanced head. Avoid looking at your work with a tilted head as you massage in a seated position. Keep the “chin-back” ear alignment and head placement as much as possible.  Massage therapists will look at their work, but minor adjustments in posture will avoid pain caused by unnecessarily straining muscles.

Save your hands

A quick note about using your body while seated. Just as you should massage standing with a weight shift, use your weight shift while seated. 

Examples are when you are seated at the head of the table with the client supine. Think of leaning back with the client’s head in your hands to apply gentle traction.  Or during an effleurage from scapulas to occiput. Reduce strain on your hands by keeping them relaxed and leaning back with your upper body.

Reduce gripping with fingers to save your hands and wrists. Curing fingers during strokes should be kept to a minimum and not used while using pressure.

Summary

You’ll need to work from the floor upward to get your best body mechanics while seated. Foot placement, weight distribution, an elongated spine, chest up, and head in a balanced position are all important for a healthy massage therapist. Next time you take a seat, do a quick body mechanics self-check and make adjustments. Your body and your client will thank you. 

Image of headshot of the author Angela Lehman

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 specialized in nutrition, she trains therapists in healthy eating, exercise and body mechanics to prolong their careers.

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