Generally, body positions with “stacked” joints require the least energy and should be used when possible. For example, when applying an effleurage stroke with the heel of your hand, try to keep your fingers, wrist, elbow, and shoulder in as straight a line as possible to minimize muscular tension and joint stress. When these joints are stacked, like a straight stack of blocks, the form a more stable structure that can deliver a substantial amount of force.

— from Introduction to Massage Therapy by Mary Beth Braun and Stephanie J. Simonson, Lippincott Williams & Wilkins, 2007