Did you know that three out of four therapists have experienced work-related pain or discomfort in the past two years? It’s true, according to a survey on injury among 601 American massage therapists. The same survey found that 64% of LMTs have sought medical treatment for their injuries. To enjoy a long, successful massage therapy career, therapists must cultivate good self-care habits, including injury prevention. Today we’re examining workplace injuries for massage therapists. We also include a list of questions therapists can ask themselves to understand their risk.

Let’s begin with a review of injury in the massage profession. Massage Magazine reports that soft tissue injuries common to massage therapists tend to fall into two categories: muscle/tendon injuries and nerve impingement injuries. Overuse is the most common cause for both. Injuries may be categorized as cumulative trauma disorders (CTD), repetitive strain injuries (RSI) or overuse syndromes. An overarching term which includes all of these is “musculoskeletal disorders” (MSDs). MSDs can happen suddenly (ex: ligament strain) or over time (ex: tendonitis). MSDs are the second cause of missed work among LMTs, just behind colds and the flu. Four out of ten LMTs have already been diagnosed with a musculoskeletal disorder (MSD).

Frequently injured body parts among massage therapists include shoulders, thumbs, lower backs, necks, and wrists. The most common injury types tend to be overuse syndrome, tendonitis/tenosynovitis, and low back strain. What causes these injuries? Applying pressure, standing for long periods of time, and positioning clients’ limbs or head, among other workplace habits. In response to an injury, 19% of massage therapists cut back on the amount of massage work they do, and 18% have considered leaving the profession due to injury or fear of injury. Overall, more than two thirds of LMTs suffer ongoing symptoms stemming from injuries.

Self-awareness is a vital tool in the battle against LMT injury. Therapists can reflect on their own tendencies prevent injuries. To assess your risk of injury, ask yourself the following questions, grouped around the most common causes of injury for massage therapists.

What Repetitive Movements do I Perform Regularly? Repetition increases your risk of injury.

Is my massage table at the proper height? If not, you are making your job harder every day.

Am I using the same massage techniques every day, with every client? This is a recipe for injury. Variety is the key in avoiding repetitive strain injuries.

Can I vary my massage schedule more? Taking breaks and changing up techniques will keep you fresh and therefore delight clients.

What can I do to reduce repetition? Consider your work at home, at your massage practice, and doing hobbies or sports. Everything from computer work to doing laundry to talking on the phone to pumping gas to doing gardening will have an impact on your body.

When Do I Use a Significant Amount of Hand Force? Sudden and long-term injuries are more likely when you are pressing hard.

What duration are my massage sessions? Am I providing all back-to-back 90-minute massages? This may tire your muscles and put you at higher risk for injury.

How many clients will need deep tissue work this week? If all your clients demand deep-tissue work, you may consider adding other approaches to your repertoire, to reduce your chance of injury.

How can I vary light and deep force within the same massage session? This approach will give your muscles and joints a break.

When do I repetitively take or stay in Awkward Postures? Poor alignment increases the likelihood of injury.

Am I keeping my elbows close to my body? (To prevent rotator cuff injuries.)

Am I keeping my wrists straight? (To prevent carpal tunnel syndrome and wrist tendonitis.)

Is my body stacked in line with gravity? This will make your work more effective, in addition to protecting you against injury.

If I am leaning over the table, can I apply core strength and maintain a flat back? If not, consider building core strength.

Are my neck and head in a neutral position?

When do I hold positions that require Static Loading? (Applying pressure without movement)

When do I place Contact Stress on my soft tissues?

When do I regularly perform Awkward, Heavy, or Frequent Lifting? Consider movements such as adjusting a client’s limbs or head, as well as secondary tasks such as moving or transporting massage tables.

What Prior Injuries have I sustained? In addition to any therapy-related injuries, don’t forget to consider, car accidents, sports injuries, etc.

How often am I prioritizing my own overall fitness? The better your overall health, the less apt you are to injure yourself on the job.

Therapist self-preservation should be included in every massage class. A massage therapist certification or licensure program that doesn’t address the risk of therapist injury isn’t worth its salt. And therapists in all styles, from Swedish to sports therapy massage, must prioritize their own self-care in order to effectively care for their clients. If reading through our self-assessment questions put up some red flags in your mind, we encourage you to sign up for a CE class on self-preservation. For instance, Debbie DeNardo, LMT, has a class coming up this April on massage tools to help your hands. To sign up for this or any massage CE class at East West College’s downtown Portland location, call 503-223-6500, or visit us online at EastWestCollege.edu and select Continuing Education from the top.