To prevent injuries and increase the odds for a long and successful career, it is essential for massage therapists to develop and implement a self-care strategy. Resistance exercises are one aspect of this plan.

Massage therapy is a physically demanding profession that can cause a lot of wear and tear on the body of the therapist unprepared for its rigors.

To prevent injuries and increase the odds for a long and successful career, it is essential for massage therapists to develop and implement a self-care strategy.

Resistance-exercise training is one aspect of this plan.

Don’t Lose It

The old adage use it or lose it truly applies to our musculature, because if you don’t overload the muscles while working, training or in a sports or recreational activity, they may grow weak and atrophy.

Massage therapists need a resistance-exercise program that ensures their muscles are toned, flexible and balanced, so normal posture is maintained.

The type of resistance training recommended here will not bulk you up like the Incredible Hulk or prepare you to be an NFL lineman.

Moving light resistance through the full range of motion of each major muscle group will add muscular strength, endurance and some muscle mass, but will not turn you into a muscle-bound bodybuilder.

Gently and progressively overloading the muscles with resistance will stabilize lax joints; prevent injuries by making the tendons, ligaments and cartilage cells stronger; increase muscle mass; improve muscle tone; increase capacity to perform more treatments; and may even improve one’s confidence and self-image due to the improvement of the body’s composition.

Increased muscle mass is important for those challenged with being above their ideal weight, because larger, more toned muscles act like a furnace, burning more calories even when at rest.

If you have access to a fitness center, you can use weight machines or free weights to develop a base of tone, strength and a sense of proper body positioning.

Unfortunately, many therapists don’t have the time or money to go to the gym.

Fortunately, a highly effective resistance-training routine can be done easily and quickly at home using inexpensive exercise bands, tubing and loops, or even old-fashioned calisthenics activities.

Getting Started

Resistance exercises should be performed three days a week, followed by a day of rest.

If possible, complete a warm-up and stretching program on the off days.

The beauty of exercising at home is you can perform these activities dressed in comfortable clothes, while watching television or listening to music, without the hassle of competing for a piece of equipment or the interruption of individuals invading your space at a gym.

To prepare your muscles for resistance exercises, perform a 10-minute warm-up to get a light sweat going before each session.

Riding an exercise bicycle or moving each joint through its range 10 to 20 times while listening to fast-paced music works well to achieve this.

Remember to start slowly with resistance training, even though you may feel great the first day.

The true test comes 48 hours later when delayed muscle soreness kicks in.

You will probably experience some soreness when you start a resistance-exercise program, but don’t let this discourage you.

On your first day of training, select a resistance level of bands or tubing that allows you to comfortably perform eight full-range-of-motion moves or repetitions (reps).

Moving through the full range of motion is important because you want to train yourself to have long, functional musculature rather than short, inflexible muscles.

As strength is gained, increase the number of reps to 12 and/or add more sets.

When you can easily perform 12 reps, move to a heavier resistance band or tubing.

Breathing and speed of movement are important aspects of a proper progressive, resistance-exercise program.

Never hold your breath while performing resistance activities, because this will raise your blood pressure and can even make you pass out.

Instead, try to breathe normally. Some people prefer to exhale during the shortening contraction (concentric), and inhale and control the movement on the return (eccentric contraction).

Concentric and Eccentric Contractions

A rep is comprised of a concentric, or shortening, muscle contraction, where the distal attachment moves closer to the proximal attachment; and an eccentric contraction occurs when a muscle lengthens as you return to the starting position.

Take two seconds to perform the concentric contraction and three to five seconds to return, in order to get the full benefit of the exercise.

Always maintain proper posture: Keep your head balanced over the spine, your eyes level and your wrists in a neutral position, and use a band that allows you to move through the full range of motion.

Also be sure to isolate the muscles involved in each exercise and avoid substituting other muscles or using momentum to complete an activity.

Perform eight to 10 exercises that train the muscles of the upper and lower body and their opposing muscle groups.

For example, if you train the chest, you must also perform activities to train the upper back and scapula adductors so body balance is maintained.

As your strength improves, you can do more sets or increase the amount of resistance. Be sure to stretch after resistance training to maintain full range of motion.

Program Guidelines

  • Select activities for all the major muscle groups.
  • Specificity is an important concept in resistance exercise. Pick activities that mimic massage movements and train the muscles used during massage.
  • For general conditioning and to maintain or improve body balance, also choose exercises that strengthen and tone muscles that are not used when performing treatments.
  • Always warm up before resistance activities and stretch afterward.
  • Build up slowly and gradually, and progressively increase the amount of resistance, number of reps and sets, and number of exercises performed.
  • Take at least one day off between workouts to give your muscles a chance to heal and restore.
  • Avoid resistance exercises if you are recovering from an injury.
  • If you have chronic pain, check with a doctor and/or physical therapist to determine if resistance work is indicated and for appropriate guidelines.
  • Stay properly hydrated and eat a balanced diet.
  • In addition to traditional resistance exercises, such as bicep curls, reverse curls and leg press, add the following exercises to your program:

Table Tops

This exercise strengthens the gluteus maximus, wrist extensors, triceps, rhomboids and middle and lower trapezius, while stretching the wrist flexors, anterior deltoids and the pectoralis major.


  • While seated on a massage table or mat, bend your knees while keeping your feet flat on the table or floor.
  • Place your hands, palms down, next to you. Squeeze the glutes together and raise your hips and torso until the front of your body is as flat as the top of a table.
  • After elevating, squeeze the scapulae together to stretch your chest and anterior deltoids, as well as strengthen the scapula adductors.
  • Hold the elevated position for two to five seconds, then slowly lower down and repeat for a whole set.
  • To add resistance, hold onto the ends of an exercise band and place the center of the band across your waist before raising your hips and torso.

The Wall Squat

This exercise strengthens the glutes, quadriceps, hamstrings and abdominals and can also help you maintain proper neck and shoulder posture.

  • Place your head and back against a wall with your feet roughly 2 feet from the wall and knees comfortably apart.
  • Tighten your abdominals, press your lower back against the wall, and keep the back of your head against the wall and your eyes level while you bend your knees and slide down the wall until you approximate a seated position.
  • While in this squat position, try to keep your knees directly over your ankles. Adjust the feet if you experience knee pain. Hold the squat position for five to 10 seconds, and then slowly slide back up to the starting position.
  • If you like, tape two tennis balls together and place them behind your back, one on each side of the spine, to massage your back while you slide up and down the wall.
  • To increase resistance, hold onto the ends of an exercise band and place the center of the band under your feet while sliding up the wall from the squatting position.
  • Arm and shoulder exercises can also be performed using the bands in this same position.

Side-Lying Hip Abduction

The gluteus medius and minimus are important pelvis stabilization muscles that should be trained on a routine basis.

  • Lie on your side and keep your hip extended, so your trunk and legs are in a straight line. Keep the lower arm straight out in front of you and cross the other in front for stability.
  • From the hip, raise the top leg up to contract the target muscles, but do not attempt to kick toward the ceiling. (You want to keep the quadratus lumborum relaxed.)
  • If you have weakness in the gluteus medius and minimus, your body will try to substitute other muscles (commonly the tensor fasciae latae) and allow the hip to flex while performing this activity. No cheating is allowed, so don’t allow the hip to flex during this exercise; keep it in line with the trunk.
  • After raising the leg, hold it elevated for five seconds and then lower it slowly.
  • As you get stronger, you can progressively add resistance by using a resistance band or loop around your knees.

Upper Back Exercises

Massage therapists need upper-back and posterior shoulder-strengthening exercises to counteract the overload placed on the chest and anterior shoulder musculature during the course of their work.

  • To strengthen the upper back and posterior shoulder, the middle and lower trapezius and the rhomboids, plus stretch out the pectoralis major and the serratus anterior, securely loop a band in your hands directly in front of the chest, then squeeze the scapulae together as you horizontally abduct the shoulders.
  • Hold this activity for two to five seconds then return to the start. After performing a whole set of this exercise, vary it by adding a diagonal option.
  • From the same starting position in front of the chest, bring one shoulder into flexion while bringing the other shoulder into extension.

A Real Insurance Policy

The time you spend training is like a free insurance policy for your career—it will keep you off the injury list and keep you earning more income. Remember: Use it, move it or lose it.

About the Author
Jeffrey Forman PhD., CMTC, is a tenured professor and the massage therapy program coordinator at De Anza College in Cupertino, California. He is a member of the Scientific Advisory Board for Performance Health Inc.  He is also the author of Managing Physical Stress with Therapeutic Massage (Cengage Learning, 2007).


  1. Fahey, Thomas, Paul Insel and Walton Roth, Fit and Well: Core Concepts and Labs in Physical Fitness and Wellness, 9th Edition, Brief Edition, McGraw Hill New York, New York ©2011 ISBN 978-0-07-734969-1
  2. Forman, Jeffrey, Managing Physical Stress with Therapeutic Massage ©2007 Cengage Learning ISBN 1-4180-1489-3.