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Why You Get Hurt in the Massage Room


"Why didn't they teach me how to care for my body in school?"

The stabbing pain in my upper-back seemed to be connected to the electrical feeling in my elbow and the constant tingling in my hands. The orthopedist diagnosed me with cervical radiculopathy, cubital tunnel syndrome and unstable left shoulder. Before I could tell him about my achy fingers, he said: If I were you, I’d find a new job.

It was practical advice, what I would expect a doctor to say, but here’s the thing: I had worked through aches and pains in the massage room before, why couldn’t I do it now? Granted, these were bigger issues than before, but what if I ran an “experiment” in my massage room where everything was on the table (no pun intended)? In other words, I wouldn’t assume what I knew about body mechanics was correct. Anything goes; winner takes all.

I went with the experiment. I gave myself a year to figure out how to massage without being in pain, and at the end of the day, I was able to do massage without hurting myself or triggering old problems.

I usually tell this story before I teach my body mechanic classes to help participants understand the rationale behind my classes. I’m telling you this story because if you have or are massaging in pain, there’s a reason why: The massage industry does not have your back.

Massage is Physical

Here are two facts about massage: It’s a physical job that stresses joints, and your income as a massage therapist is dependent on how many massages your body can handle in a day. That’s a recipe for pain and injury.

With a job so “body” dependent, it’s still alarming to me when massage therapists, after reading my book, The Pain-Free Massage Therapist, ask me, “Why didn’t they teach me how take care of my body in school?”

It’s a question I have asked massage teachers. Here are their answers: I would like to teach more body mechanics but I have to cover so much material I don’t have time to cover body mechanics thoroughly and I have to teach for passing the licensing exam.

Massage teachers are in a tough spot, right? Their hands are tied, and it’s not their fault that you didn’t walk out of massage school knowing how to take care of your body in the massage room. The blame goes to the massage industry.

The Massage Industry

By massage industry, I’m talking about massage schools, licensing boards, regulatory agencies, professional groups, massage businesses, massage product suppliers, massage CE providers and media outlets. These entities are connected to each other through relationships and are dependent on each other through transactions. That’s not a bad thing for the health of the massage industry, but not always a great thing for the health of the massage therapist.

As it pertains to this article, no entity that I know in the massage industry opposes teaching a massage therapist how to massage without being in pain. That said, no entity in the massage industry is rushing to the frontline to make the therapist’s physical health in the massage room the most important topic of 2023. Why? It’s not profitable enough, relationship-smart or transaction-wise.

Massage schools don’t fill seats by highlighting how physically demanding massage can be when they don’t have an answer to the body, wear-and-tear problem because they haven’t sunk time, money and resources into developing a program that mitigates on-the-job injuries and pain conditions.

Professional groups stay funded or make money by straddling the line between looking out for the massage therapist and keeping massage employers, massage schools, sponsors, donors and advertisers happy. They’re not going to risk losing revenue by pushing massage schools or massage businesses to truly put the massage therapist first.

Media outlets publish articles to get views and sell subscriptions. An article like “How to Release Fascia Using Cupping” is hot. “How to Use Your Body Weight to Apply Force” is not. Also, media outlets have to be concerned if an article could upset an advertiser, which means the magazine may withhold information or not pursue a topic that is important to massage therapists but potentially disruptive to the massage industry. (Massage Therapy Media is an exception to the rule or you wouldn’t be reading this article).

All this means that your physical well-being in the massage room is being addressed at a snail’s pace. Don’t take it personally. It’s business.

Look Out For Yourself

So, for now, until the massage industry changes, you have to look out for “you” in the massage room. Here’s what you do:

1. Trust yourself. You know when a technique is hurting you. Stop doing it and find a replacement that doesn’t hurt your body. This is easier said than done, especially when you think a technique is helping a client get out of pain or you’re entrenched in a methodology.

I am a certified neuromuscular massage (NMT) therapist. When NMT started to beat up my body, I continued to do it exactly as I was taught because I thought it was the only way I could get the job done.

But eventually I realized that massage was not like hip surgery where the surgeon had to do a specific task in a specific way to produce a specific outcome. For a relaxation or a pain relief effect, I discovered I had a lot of options.

2. Experiment. If you want to look out for your body in the massage room, you need to think about your body during the massage. I’m not saying to prioritize your body over the quality of the massage. I’m saying be aware of massage techniques and body mechanic strategies that are causing you pain. Once you are aware, you can experiment with making adjustments

By the way, the two, a good massage and a safe massage for your body, are not mutually exclusive. In fact, once I started to look out for my body in the massage room, I became more attentive to what strokes and techniques my clients liked and I was then able to provide a massage that was even more customized than before.

Here’s what you do to change the massage industry:

3. Buy courses and study modalities that have the massage-therapist’s body in mind.

Massage schools are not motivated to put our bodies first until market forces push them to do so. That said, we can start this process by demanding that modalities and CE courses are designed with massage therapists’ bodies in mind.

Don’t think: I am paying a course provider to teach me a new technique. Think: I am paying a course provider to teach me a new technique AND to NOT hurt my body. The provider should have or be able to create workarounds for any of their techniques that may cause you pain because of your body type, massage style or a pre-existing pain condition. Period.

Change From the Top Down

Ultimately, the massage industry is selling us what we are willing to accept. Right now, we accept the next shiny massage-technique because it will make us more money or help our clients feel better no matter the toll it takes on our bodies. But the reality is you don’t make more money and help more clients by doing less massage because your body hurts from doing techniques that were not designed with your body in mind.

So, buy classes that are body-friendly. To protect your body in the massage room, trust yourself to know when a technique causes you pain. Then experiment to figure out workarounds or to find substitutes. If you need more help, I’m here.


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