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Massage Therapist Self-Care: Creating an Ergonomic Treatment Room

Massage treatment room

The size of your treatment room and the height and width of your massage table have an impact on your body mechanics.

Because of the risks of chronic hand, wrist, forearm, and low back injuries that many massage therapists experience, ergonomics is important for saving your hands and saving your practice. Improper body mechanics can result in injuries that can end your career as a massage therapist. With the right ergonomic work area and body mechanics, however, you can look forward to a long and healthy career in massage and bodywork.

Work Area

In a best case scenario, your massage table should have at least 3 feet of open space on all sides. With adequate space on all sides of the table, you will be more likely to use proper body mechanics and natural alignment. The more cramped the room is, the more cramped your movements are likely to be.

Unfortunately, the size of your treatment room may not allow for adequate spacing. To make the most of the space that you have available, try angling the table to give yourself more room at the sides and ends of the massage table.

Massage Table Width

Although you can’t change the width of your current massage table, now is the time to evaluate the width of your table and how it affects your posture. A massage table that is too wide encourages reaching across the client and compromising your body mechanics. Although a wider table may be more comfortable for some of your clients, a narrower table provides better access for you as a therapist. Taller therapists can work on wide or narrow massage tables, while shorter therapists will find it easier to maintain proper body mechanics on a narrow table.

Side arm extenders

Side arm extenders make larger clients feel more secure on the table.

Consider a compromise on your next massage table purchase by choosing a narrower massage table and adding side arm extensions for your larger clients. You may also want to consider a massage table that is wider at the shoulders and feet and narrower at the center. This will give you better access to the hips and lower back while providing adequate support and width for your clients’ shoulder and arms.

Massage Table Height

Do you keep your massage table at the same height for every client and modality? Although changing the table height takes a few minutes between clients, the extra time is worth the effort. Don’t compromise your body mechanics by working on a table that is too tall or too short. If you are working on a “thick” client, lower the table even further than usual. Deep tissue massage is also easier with a lower table height.

Although the rule of thumb is to adjust the table height so that it just brushes your first set of knuckles, don’t be afraid to experiment with other table heights to find the right height for you. Your standard table height may change depending on the client, the type of treatment, and other factors.

How to Use a Massage Tool

Grip the massage tool gently.

Grip the massage tool gently with your
whole hand, not just your fingers.

Using a massage tool can be a great way to save your hands. Used properly, it can enhance your technique and gently loosen stubborn tissue. Here are some tips on getting the most out of a massage tool.

  1. Practice before using a tool on your clients. Practice on yourself and on a friend or therapist who can provide helpful feedback.
  2. Use tools in moderation. They should complement your technique, not take the place of your hands.
  3. When you’re not using a tool, put it down to prevent gripping the tool unconsciously.
  4. Don’t grip the tool harder than necessary, or you risk losing all the benefits of resting your hands.
  5. Keep your hands, wrists, and arms soft and relaxed. Tension in any part of the body can affect the entire body.
  6. Hold the massage tool comfortably with your whole hand, not just your fingertips.
  7. Try several different methods of holding the tool. There is not necessarily one correct way to use a tool.
  8. Be aware of ergonomics and posture as you use the tool. Keep your wrist straight.
  9. Ask for feedback from the client if you are unsure how much pressure you are exerting, particularly for deep tissue and trigger point. If in doubt, use gentler pressure.
  10. Do not force tissue to respond. Be gentle.
  11. Do not use massage tools on clients with fragile skin or on areas of the body where the bones or organs are close to the surface.

When Should I Use a Massage Tool?

Use a thumb helper tool to give your thumb and finger joints a rest.

Use a thumb helper tool to give your thumb and finger joints a rest.

Your fingertips are one of the most sensitive parts of the body, with numerous nerve endings close to the surface. It’s natural that you may want to use that sensitivity to its fullest extent by searching out the intricacies of a tight muscle or applying prolonged pressure to a hypersensitive trigger point.

But the truth is, the thumb and fingers are not only sensitive but they are more susceptible to overuse injuries than, say, the forearm or elbow. The more you rely on your fingers and thumbs to massage, the more likely you are to injure your hands over time.

Preventing Overuse Injury

No therapist can or should discount the importance of feeling the body with your own hands. But might there be a safer way to apply deep pressure without overstressing the thumbs and fingers?

A large number of therapists have found a way to balance the sensitivity of hands-on massage with the hand-saving technique of using massage tools. No massage tool can ever replace direct touch, but it can relieve pressure on the hands, allow you to massage deeper without compromising your body mechanics, and encourage resistant tissues to respond and heal.

Using a Massage Tool for Specific Types of Work

Some types of work are more appropriate for using massage tools than others. For example, if you need to apply sustained pressure to a muscle group or trigger point, use a hand tool or T-bar tool to give your thumb and finger joints a rest. If your technique requires a large amount of thumb and finger work or you are working on an obese client, massage tools also come in handy here. A sudden increase in the usual number of massages you give per week also calls for more massage tool usage to relieve the strain on your hands.

Use your best judgment for when to use a massage tool and when to lay it aside. The key is to use it as a tool and not as a replacement for the sensitivity of hands-on work.

Use a massage tool when your work includes…
  • A disproportionate amount of thumb work
  • Sustained pressure
  • Trigger point therapy
  • Working on obese clients
  • An increase in the usual number of massages per week

How to Use Massage Tools Effectively

Massage tools allow you to accomplish more with less effort.

Massage tools allow you to accomplish more with less effort.

The main benefit of massage tools is that they allow you to save your thumbs, fingers, and wrists from injury and apply deep, localized pressure to the tissue. Used correctly, a massage tool (such as a thumb helper, hand helper, or T-bar tool) will allow you to accomplish more with less effort.

Save Your Hands

Even with the best body mechanics and techniques, full-time massage can be hard on your hands. Massage tools take some of the pressure off of your hands and allow you to keep up with your massage schedule without making you vulnerable to overuse injuries.

Practice, Practice, Practice

Learning to use a massage tool effectively starts with practice. Before using massage tools on your clients, practice on a willing friend or therapist. Ask for feedback, adjust your technique, and then ask for feedback again. It’s also a good idea to ask another therapist to use the massage tool on you so that you know exactly how it feels for your clients. You may not even be able to tell the difference between the massage tool and the therapist’s hands.

Trigger Point Work

If you incorporate any type of trigger point work into your technique, the benefit of massage tools will immediately become transparent. Trigger point tools can reach places that your fingers can’t, and they do so with pinpoint accuracy.

Sensing the Tissue’s Response

Massage tools are not a substitute for human touch but rather an extension of the hand and a stabilizer. The more familiar you become with using a massage tool, the more effectively you will be able to sense the response of the tissue and convey the subtleties of human touch through this extension of your hands.

Using Massage Tools for Deeper Massage

Thumb Helper Massage Tool

Thumb Helper Massage Tool

Do you use massage tools in your therapy practice? Do you feel guilty—like you’re giving your client something less than a “real” massage? You shouldn’t!

Using massage tools is a smart way to save your hands, and the fact is that when you use these tools effectively, your clients won’t even know the difference between the feel of your fingers, your knuckles, and a hand helper or T-bar tool.

Massage tools help you to work more effectively. You can give a deeper tissue massage and apply firmer pressure to trigger points without working your fingers to the bone.

With practice, you will become more sensitive to the tissue’s response, even through the medium of the massage tool. The more skilled you become in using massage tools, the more they will become simply an extension of your own hands.

Your hands are your greatest asset as a massage therapist. If you work them too hard, you may just work yourself out of a job! Reduce the strain on your hands by using your elbows, knuckles, and massage tools for deeper strokes and trigger point work, or even for traditional Swedish massage techniques.

Full-time massage work places strenuous demands on your hands and body. Massage tools are just one way you can keep up with the pace of your work without compromising the health and strength of your body.

Save Your Back with an Adjustable Massage Stool

Pneumatic Rolling Massage Stool

Use a rolling massage stool
to rest your back and legs.

One of the best ways you can take care of yourself as a massage therapist is to invest in an adjustable massage stool. You spend hours on your feet each day, working on your clients. The stress on your body adds up, especially if you follow the same general stance and movements. Too much repetition can lead to injury, if you’re not careful.

A pneumatic massage stool helps cut down on repetitive movement by “mixing things up.” Instead of constantly using the same movements and positioning, you can give your body some variety by sitting down while you massage your client’s hands, feet, and head.

Your body reacts differently when you massage from a sitting position versus a standing position. Sitting allows your back and legs to rest while you continue to massage your clients. You may even find that you experience less soreness and have more energy at the end of a full workday when you use a combination of sitting and standing.

With a quick-adjust lever, you can easily raise or lower the pneumatic stool without breaking the momentum of the massage, and with the rollers on the bottom, you can move around the massage table with ease.

Give your body a break with an adjustable massage stool! Find one here.

Sick Over the Economy: How to Safeguard Your Health on a Tight Budget

Don’t let a struggling economy raise your stress level.

Over 20% of Americans are struggling to pay their medical bills, according to a poll released by Gallup and Healthways in March. With the cost of medical care on the rise and the pinch of today’s economy, preventative and ongoing medical care is becoming more and more difficult to afford. As a result, many Americans are cutting back on trips to the doctor, despite the risk of increased health risks in the long run. The knowledge of this increased risk can increase an individual’s stress level, which in turn can exacerbate or cause physical symptoms.

Relax at home with a variable-speed electronic massager.

Relax at home with a variable-speed electronic massager.

This struggle to cover medical bills and the anxiety over existing or potential health care has led to an increase in stress over the past months as the economy sours. A joint poll by Gallup and Healthways tracks the daily stress level of Americans as related to the economy. According to this cumulative poll, Americans’ stress levels increase as worry over the economy increases.

One way to cope with rising healthcare costs and skyrocketing stress levels is to place a greater emphasis on self-care to prevent health problems before they start and to keep existing health problems in check. Choosing a healthy, balanced lifestyle can reduce your need for medical visits and reduce your stress level.

There are countless options available for self-care at home, including do-it-yourself massage and electronic massagers. You may even find that you enjoy learning new self-care techniques and the freedom that comes from taking charge of your own health. Make self-care a family affair by involving the whole family in learning massage at home or relaxation techniques. Not only will you improve your overall wellness, but your family will get the chance to spend some quality time relaxing together.

3 Massage Accessories that Promote Self-Care for the Therapist

Promote your own self-care and increase the efficiency of your massage sessions with these 3 helpful accessories for massage therapists.

As a massage therapist, you’re on the go all day at your practice, giving massage, doing laundry, and dealing with paperwork. Fortunately, there are several accessories that make your day go a little smoother and promote your own self-care while you’re busy caring for your clients.

1. The Hand Helper

thumb_tool_smallYour hands are one of your most important assets. Reduce the amount of stress on your body and prevent overuse injuries with professional massage tools. With the right tool, most clients will never notice the difference between your fingers and your massage tool.

A massage tool allows you to apply greater pressure for modalities such as deep tissue massage and comes in handy for applying focused pressure on trigger points or bony areas of the body. Getting the feel for applying the right amount of pressure can take a little practice, so elicit feedback on your client’s comfort level throughout the massage, just as you normally would.

2. The Back Saver

You ask a lot from your body during each massage session. Give your back and legs a rest with a rolling massage stool. A pneumatic stool easily adjusts to your height and the height of your client to ensure that you continue to massage with proper body mechanics, even while seated.

A healthy combination of standing and sitting during massage prevents muscle fatigue and repetitive injury by varying your body position and balancing out the stress load on your muscles. A massage stool is perfect for massaging the head, feet, and hands.

3. The Lubricant Leash

You’re on your feet all day. Why not save yourself a few steps with a massage product holster? Forget the reaching and stretching or walking around the table to get to your lubricant, not to mention the days you’re so frazzled that you forget where you last set down your massage oil.

Those days are over when you strap your lubricant to your waist, keeping it within easy reach at all times. A product holster lets you keep the rhythm of the massage going and never lose contact with your client.

Injury Prevention for Massage and Bodywork Practitioners

Proper table height can help prevent common musculoskeletal injuries in massage therapy workers.

Adjusting the height of your massage table is a critical element in massage therapy injury prevention. Working on a table that is too high can lead to injuries in the wrists and hands; working on a table that is too low can cause injuries in the lower back. Most massage therapists tend to err on the side of setting the table too high.

Three key factors to consider when adjusting the height of your massage table:

1. Your own height in relation to the table height
One recommended method for determining table height is to adjust the height so that when you stand with your closed fist hanging straight down, your fist barely touches the top of the table. However, the best way to find the right massage table height for you is to experiment. What works best for you may not correspond to the standard method of finding the correct height.

2. The type of massage given
As a general rule of thumb, the deeper the massage or bodywork, the lower the table should be. For example, if the client requests a deep tissue massage, you may want to lower the table an extra notch. This allows you to focus on using your body weight for leverage rather than relying too heavily on the hands and wrists.

3. The position and size of the client
If the client will be lying on his or her side, the table should be set much lower than if the client is lying prone or supine. A client with a more solid build may also require a lower table height.


Working with proper posture helps to prevent injuries and prolongs the career of a massage therapist. Taking the time to adjust the table height before a massage is a simple way to prevent injuries and ensure that you can continue to provide for the well-being of your clients. Caring for yourself first allows you to provide the best care for others.

After adjusting the height of the massage table for a new client, simply jot down the table height for next time so that you can adjust the table height before the client arrives. You can use the time that you are adjusting the table for a new client to establish a relationship with the client through casual conversation.

If you find changing the massage table height for new clients a distraction or inconvenience, keep the table at your standard height and note down on the client’s chart if the table needs to be lowered or raised for the client’s next session.