Pain-Free Massage Therapist Classes
I've designed three classes to help you massage pain-free. Delivering Pressure Without Hurting Yourself covers the important strategies for massaging pain-free. Once you learn these strategies doing deep work, you will easily be able to make adjustments for medium and light pressure. How to Use Massage Tools is an introductory course to massage tools. You will learn how to hold a massage tool without hurting your hand and how to apply precise pressure that feels great and is easy on your body. Advanced Massage Tools gets you competent with massage tools so that you will actually use them in the massage room to save your hands, arms, shoulders and neck. In addition, you'll learn how to transition from massage tool to "using a body part to massage". The classes are NCBTMB provider approved (#451308-10). That means they are accepted as approved CE classes in most US states. Check with your state if you're not sure they accept NCBTMB approved-providers. The classes are accepted in Ireland as continuing education and fall within the STRiVE guidelines for RMTs practicing in Ontario, Canada. Click here for the 3 online classes that can help you become a pain-free massage therapist. I'll continue to expand the CE courses accreditation into other countries. Stay tuned.
NOW Worksheet to Prioritize Pain Issues
How do you start to massage pain-free? You start by identifying and prioritizing your pain/injury issues.
First, list your pain issues in the massage room. Next, list your pain issues outside the massage room. Then look for cross-overs (pain issues that occur both in the massage room and in daily life). These are you highest priority areas to work on. Below you can download an easy one-page worksheet that will help you prioritize your pain issues.
New Videos, Next Event and Specials (not spammy)
Massage Tables That Go Low
If you’re finding that you prefer a low table to apply force, but your table won’t go low enough, just take off the extendable legs:-)
If that doesn’t get you low enough, here are two tables that go lower than normal tables:
(1) Earthlite Yosemite 30 Treatment Table
(2) Earthlite Medi Sport Therapy Table
If you’re doing a search for tables that adjust low, use the search terms “sport” and “treatment” with “massage table”. The lower-adjusting tables seem to be marketed towards sports trainers, personal trainers and chiropractors.
Make A Massage Tool
My friend, Matt Johnson, makes all my wooden massage tools for me. In this video he shows you how to make a basic T-bar.
How to Make a T-bar for Small, Medium and Large Hands
As I taught MTs how to use massage tools, and as Matt and I continued to work on massage tool designs, we quickly realized that a one-size massage tool does not fit all hands. In this video I show you what to do to customize your T-bar to fit your hand.
7 Questions to Massage Pain-Free
I wrote this article for Massage World Magazine (Summer, 2022).
Do you view body mechanics as a system of rules to be applied universally? I once did. Then injuries and pain conditions nearly ended my massage career. I did a year-long experiment in my massage room and found out that simply following body-mechanics rules didn’t work. To massage effectively, efficiently and pain-free, I had to find the body-mechanics strategies and techniques that worked for my specific needs. I did that through asking myself a series of questions that I’m going to share with you now.
Reprogramming Your Autopilot
After enough years of doing massage, the process of massage becomes automatic. You don’t think about the next move you’re going to do, you just do it. Flying on autopilot in the massage room is not a bad thing unless your autopilot is on course of pain and injury, like mine was.
One issue I had was persistent shoulder pain when I using my forearm. But here’s the thing: I was in textbook form when I was doing my forearm work. My back was neutral, and I was pushing from my back leg and using my body to generate force. Why was I in pain?
I was in pain because I had a shoulder issue that pre-dated my massage career. I got away with using my forearm for twenty years of my massage career, but it was now catching up with me. My autopilot wasn’t programmed to take into consideration my pre-existing condition. He was programmed to execute a body-mechanics technique for a person with good shoulders.
I needed to reprogram my autopilot with strategies and techniques that worked specifically for my body if I were going to make it to my 30 year mark in massage. So I started asking myself these questions before the client got on the table.
Questions to Ask Before the Client Gets on the Table
• Does this body-mechanics strategy/technique work for my body type?
• Does this body-mechanics strategy/technique work for my massage style?
• Does this body-mechanics strategy/technique work for my pre-existing injury/pain condition?
So which body-mechanics strategy/technique was going to work for my shoulder condition? I tried fists even though I was worried about overusing my hands. My first attempt at fists didn’t go well. With my massage table set at my forearm work height, I couldn’t generate enough force using my body weight to apply firm pressure. I needed to lower my table.
Why lower? Picture a couch. Make loose fists, put your arms straight out and lean onto the top of the back of the couch. Now try to increase your pressure. Not easy, right? The top of the couch is too high for you to lean all your body weight into it. To generate more force, you need to press with your upper-body. That’s hard work.
Now walk to the front of the couch. Do the same thing with your arms, but now lean into the seat cushions of the couch. You’re basically in a push-up position with most of your body weight leaning into the cushions with minimal strain in your upper-body. The key to leaning with fists is to have enough “leaning distance” to transfer your body weight onto the client. In the massage room, you increase your leaning distance by lowering your table. That worked for me, and I learned if I relaxed my fists when I leaned, my hands were fine.
By using my fists on a low table, I basically changed my massage style. Now, I worked over top the massage table instead of to the side of the massage table. My body responded well to this, but there was still more questions to consider with table height.
More Massage Table Height Questions
• What’s my client’s body type?
• What’s my client’s pressure request?
• Does my client have an area of focus?
For my leaning-with-fists style, large clients, body parts that stuck up off the table (like glutes and thoracic back) and firm pressure requests required a lower table so that I had enough leaning distance. Light pressure and body parts that didn’t stick up off the table, like calves and arms, didn’t require a lower table.
At this point, you may be wondering if I change my table height for each massage? I did, but not anymore. Now, I set my table at the lowest setting and adapt to light and medium pressure requests by broadening my stance and using the table for support.
Different Strokes for Different Folks
It’s important to make it clear that the body-mechanics strategies/techniques that work best for me, may not be the ones that work best for you. Tara, who came to me for help, is a perfect example of that.
Tara is a forearm therapist when applying firm pressure and works on a high table. She has pain in her left wrist and arm from a congenital, wrist issue that can only be temporarily corrected by surgery. Her lower-back acts up if she’s not careful about how she works, but she hadn’t had any episodes for a long time. She struggles to deliver firm pressure when working on backs.
Immediately it was apparent to me that Tara shouldn’t lower her table and use her fists. Any compression in her wrist would aggravate her condition. In fact, the less she can use her left wrist, the better.
When I watched Tara work, I noticed that she switched to palms and fingers when applying light to medium pressure. Though natural to do, it was potentially aggravating her compromised wrist. My suggestion was for her to use more forearms for light and medium pressure.
I also noticed that Tara would switch from forearms to fingers, knuckles and fists in hard to access areas, like between the scapula and spine. Again, it was natural to do, but not good for her wrist. I suggested a round-tip L-bar because it was a good substitute for fingers and thumbs.
She could hold the round-tip L-bar in her right hand (dominant hand) and just use the left hand (compromised-wrist hand) to help support the massage tool without putting any pressure in her left wrist.
The last suggestion I had for her to protect her left wrist was to never use her left hand for detail work.
Her table height for her back seemed to be spot on since she hadn’t had any recent back pain episodes. So to do firm pressure, she just needed to be able to generate more force at her current table height. Tara uses an asymmetrical stance when working with her forearm. I noticed that she didn’t fully use her leg power in that stance. I recommended that she practiced driving from her back leg to generate additional force.
Another technique for Tara to make firm pressure easier is to shorten long strokes. Making a stroke shorter will allow Tara to reposition her feet so that she is not overextending and diminishing her capability to push from her back leg. Lastly, when doing short-stroke, focus work, like in the lower-back, Tara could experiment with stroke direction. Is it easier to do a forearm stroke from L5 to L1 or from L1 to L5? Go with the winner.
So far I talked about questions that I ask myself before the client gets on my table. I showed you how those questions led me to finding a substitute for my forearm. Then with Tara I showed you how those questions led to different body-mechanics solutions than mine. We have one more question to ask in our pursuit to massage pain-free.
The Question to Ask During the Massage
As you’re doing the massage, it’s important to ask yourself this question: How is my body feeling?
If the answer is not good, then you’ll need to make an adjustment.
Here’s an example of how I make adjustments to my body mechanics on the fly. Roberto wants a 60 minute massage with focus work on his mid- and upper-back. If you’re not using your forearm (like me) or are using your forearm on a limited basis, you can see that his request could be tough on fingers and thumbs. But it’s an easy request to fulfill if you have a variety of options to deliver pressure.
I start the massage using my fists and knuckles to make exploratory strokes up and down Roberto’s back, looking for the specific areas he wants me to work. I find an area around T6 on his left side that I palpate with my thumb. Then I lift my thumb and use a massage tool to apply ischemic compression. Once I’m done my work with the massage tool, I continue the stroke up his back until I find the next area that I want to work at the top of his scapula. As I start to palpate with my thumb, I feel that it’s fatiguing. So I switch to a middle knuckle.
Once I finish scoping out the area I want to work with my middle knuckle, I use a massage tool again. But this time, my hand that is holding the massage tool is feeling a little overworked from the three massages before Roberto, so I use my non-dominant hand to hold the massage tool.
Next I glide into the upper-trap with the massage tool, but the angle I’m at now makes the massage tool feel awkward in my hand so I switch to a two-handed hold.
During one, long back stroke, I may make three or more transitions between fists, massage tools and combined body parts (e.g., knuckle and a thumb). The point is not to set a PR with transitions; it’s to do a massage that feels good to the client without causing you pain.
If this sounds like way too much thinking for you during a massage, I have some good news. The thinking happens as you’re experimenting and finding new ways to do massage that don’t hurt your body. The additional benefit of practicing these new ways is that you’re reprogramming your autopilot with the body-mechanics strategies and techniques that work for you body.
Time to Rethink Body Mechanics
We all make body-mechanics decisions with each massage whether we know it or not. When we don’t know it, we’re operating on autopilot. My autopilot did what he was programmed to do. He followed general body-mechanics rules. It’s not his fault that my body fell apart and my massage career almost ended.
Once I asked myself questions about my pre-existing injuries/pain conditions and other important considerations, I was able to figure out ways to do massage without being in pain. Now I’m at thirty years of massage and counting.
Ultimately, body mechanics is not a picture in a textbook with an objective of achieving perfect form. Body mechanics is about figuring what works for you and making adjustments as you go along. Once you do, then the objective of body mechanics becomes clear—to have a long, prosperous and pain-free massage career.