Giving massage all day is a physically demanding job—and as working massage therapists, we all face a daily physical challenge that can be met with ease or dread, depending on how we feel, emotionally and physically, that day.

Burnout in our profession is notoriously high for a variety of reasons. As someone who has previously employed massage therapists, I know massage therapists commonly leave our profession because they develop pain problems themselves.

Self-Care Strategies

As a full-time massage therapist for more than 31 years, I understand these challenges firsthand. In this article, I would like to share some of the strategies I have used to stay healthy and pain-free.

I use the Active Isolated Stretching method of stretching to keep my whole body flexible and to reduce any fatigue or soreness I might feel at the end of my workday. I have stretched my way out of out of acute pain situations such as neck pain and spasm, as well as to relieve minor low-back achiness and fatigue, with the AIS method of stretching more times than I can count.

When your neck or low back hurts, or even if what you feel is stiffness, spending 10 to 15 minutes doing these routines can be completely restorative. The breathing component of AIS facilitates the effectiveness of the stretching and acts on the nervous system like a sedative, leaving one feeling calm and relaxed.

Before I go into the how-to of these stretches, I would like to speak more generally about other strategies for ensuring your longevity as a massage therapist.

Neck Side Flexion

Neck side flexion: Anchor your left hand to the bottom of a chair. With your gaze forward, move your right ear toward your right shoulder. Place your right hand on the left side of your head above your ear and apply a gentle stretch.

Neck-Side Flexion

Release the stretch and move your head back to neutral. Do 10 repetitions and then repeat to the left side. On the left side, your right hand is anchored to the chair bottom and your left hand does the stretch.

You are an Athlete

Look at yourself as an athlete preparing for an event or race. If you are giving massages for four, five or even six hours a day, that’s a lot of energy output. If your energy reserves are low, your body will be more quickly depleted and susceptible to breakdown than if you have trained for the event—the event being your workday.

Exercise of any kind increases your energy reserves and will give you more stamina. I am not here to promote one type of exercise over another, but rather to emphasize how important it is that you do something to increase your strength and endurance on a regular basis.

This can be as simple as a 45-minute walk three or four times a week. Pilates, yoga, weight-training, running, cycling, swimming or water aerobics—any of these activities are good options.

When I am working with my health-coaching clients, I suggest they look for an activity they love and look forward to with anticipation. If it’s drudgery, you won’t stick with it.

If you hadn’t considered that the work you do every day as a massage therapist is akin to an athletic event, I hope this discussion will spur you to action if you need to build up your energy bank. If you adopt just a little of the athlete mentality, I guarantee you will not be as fatigued at the end of your workday.

Neck Flexion with 45-Degree Rotation: Grasp the bottom of a chair with your left hand. With your chin in a tucked position, rotate your head 45 degrees to the right and actively move your chin toward the right side of your chest.

Neck Side Flexion with 45 degree rotation

 Place your right hand on the back of your head between your left ear and the center back of your head—fingers pointing toward your neck—and pull your head gently toward your chest to give your neck a gentle stretch. Go back to the starting position and repeat. Do 10 repetitions and then repeat with your head turned to the left.

Prevent Pain

The beauty of this system is these stretches can be done no matter how limited or painful the neck or low back may be.

Of course, as massage therapists, we know it is better to prevent the onslaught of pain, and using AIS stretching can help you do just that. AIS is a unique approach to stretching because, unlike traditional stretching, one only holds each stretch for two seconds. In this way, you never trigger the stretch reflex, and most importantly, stretching doesn’t hurt.

Another feature is you move in and out of the stretch. That’s the active part, meaning there is a starting point and an ending point at the end range of motion where you go two to three degrees past your active end-range to apply the stretch. This active motion helps move blood and lymph, which increases oxygen and nutrition.

The other feature of AIS that assists this detoxifying effect is breathing. As you do each stretch, you exhale during the stretching phase and inhale as you move back to the starting position between each stretch. Each stretch is typically repeated 10 times during a stretching session.

Neck Anterior Oblique—Flexion

Neck Anterior Oblique—Flexion: Rotate your neck 45 degrees to the right, and take your left ear toward the left side of your chest. Place your left hand above your right ear and apply the stretch using your left hand, then release your hand and return your head to neutral between every stretch. 

Do 10 repetitions and then do the left side. For the left side, rotate your head to the left and take your right ear toward the right side of your chest. Use your right hand to apply the stretch.

Gentle Assist

Even if you have pain or very little range of motion in your neck, you can still do these stretches. Because you repeat the stretches, there is no need to push yourself to achieve your deepest stretch on the first one. Especially if you have a tender, sensitive neck, you can actively move to a place where you feel a little pulling sensation then apply a gentle assist with your hands to increase the range of motion, counting 1, 2, 3 as you exhale, then releasing the stretch and moving back to the starting position.

With each repetition of a stretch, you will feel your active end range of motion increase. To incorporate some AIS stretching into your day, I would recommend warming up before seeing clients using a few of the photos and instructions in this article. You can easily do one or two stretches between clients, and it also feels lovely to decompress before bed with stretching.

If you find yourself reading this article and thinking, “What’s the big deal? It’s just stretching,” here is what I must say to you: You will probably be familiar with most of these stretches but just try doing them the way I describe: with short duration, moving in and out of the stretch, for 10 repetitions. You have to feel it to understand the benefit, just like someone does with massage.

Neck Rotation:

Neck Rotation: With the left side of your chin tucked, turn your head to the right side. Place your right hand over your left jaw and left hand above right ear. (The fingers on your left hand are pointing toward your face.) Give yourself a gentle stretch.

Turn your head back to neutral between every stretch. Do 10 reps, then repeat to the left side. Left-side hand placement: Your left hand over your right jaw, and your right hand is above your left ear. (The fingers on your right hand are pointing toward your face.)

5 AIS Steps

1. Move the body part being stretched to the starting position for the stretch.

2. Gently stretch the body part two to three degrees past the end point and hold the stretch for two seconds (count 1, 2, 3).

3. Inhale during the movement phase of the stretch and exhale during the stretch.

4. Move the body part being stretched back to the starting position between stretches.

5. Repeat each stretch 10 times.

AIS will enhance the health of your muscles, tendons, ligaments, fascia and joints, and decrease your vulnerability to injury. I hope you will find it easy to make these stretches part of your daily routine. 

Spinal Rotation: Rotate your spine to the left. Place your right hand on the outside of your left thigh, while reaching your left hand behind your back as far to right as possible to pull yourself into the stretch. Reverse directions to stretch to the right.

Spinal Rotation


About the Author:

Lois Orth-Zitoli, LMT, CHHC, s a public speaker, teacher, massage therapist and health coach. Lois owns Full Circle Health in Chicago, Illinois, and teaches workshops in the Benjamin method of orthopedic massage and injury assessment, as well as stretching workshops. She wrote “Active Isolated Stretching: A Revolutionary Approach to Self-Care” for MASSAGE Magazine’s October 2016 issue.