There are many reasons why people choose to become massage therapists, including the opportunity to help people, flexible working hours and relaxing work environments, often in some fairly exotic locations. In fact, for many people, it’s the absolute dream job!
Unfortunately though, it’s not all fun and games. Due to the nature of their work, massage therapists face the risk of a range of musculoskeletal injuries, particularly in the hands and wrists.
In a survey of more than 500 registered massage therapists, the number one flashpoints for pain after giving a massage were in the wrists and thumbs. And according to massage therapist Kathy Reitsch, this pain is likely the result of improper techniques. She suggests using gravity and the weight of the body to accomplish some of the work, rather than just the wrists, fingers and shoulders.
But administering massage using proper techniques isn’t always enough. You should also work on strengthening your hands, wrists and arms through exercise, in a bid to prevent injury.
With that in mind, here are some of the most common hand and wrist injuries that massage therapists can suffer, along with some practical exercises for not only relieving symptoms, but preventing injury in the first place.
Common hand and wrist complaints
The most common hand and wrist injuries in the massage therapy industry include:
- Tenosynovitis – inflammation of the lining of the sheath covering the tendons, most often in the hands and wrists and caused by strain and overuse.
- Saddle joint injury – pain in the saddle-shaped joint between the wrist and thumb due to overuse.
- Carpal Tunnel Syndrome (CTS) – one of the most common injuries, where the median nerve becomes compressed at the wrist, causing burning, tingling, itching, pain and numbness in the hand.
- Trigger thumb or trigger finger – pain and stiffness in the thumb or finger due to irritation in the tendon sheath, which becomes inflamed because of overuse.
Exercising the hands
Maintaining good physical condition is a big part of being a massage therapist, and should be an integral part of your personal injury prevention strategy. As the hands and arms are overtaxed by the work you do as a massage therapist, the hands are a great area in which to start your conditioning.
To reduce fatigue of the fingers and hands, it’s recommended that you always perform warming, stretching and strength building exercises before every massage.
Hold your hands at chest level and shake them vigorously for about 10 seconds. This will warm and limber the muscles in your hands.
Massage each finger from the knuckles of the hands to the fingertips for 5 to 10 seconds. This will stimulate circulation and help keep your hands supple.
Bunch your hands into fists at chest level. Rotate both hands clockwise for ten seconds. Relax, then rotate the other way.
Press one fist into the hand of the other, with each hand resisting. Alternate 10 times.
Hold a semi-soft foam rubber ball between the thumb and first finger. Squeeze as hard as you can for ten reps. Repeat with other fingers, then vigorously shake your hands.
Clasp your hands and interlace your fingers just below the waistline at the back of your body. Pull your arms upward while holding the tension for 10 counts. This will strengthen the muscles of your arms, shoulders and hands.
Exercising the wrists
The wrist is a highly complex mechanism with a lot of moving parts in one small area, so it is highly vulnerable to injury. Tendons on the extensor side can become irritated by tight muscles rubbing across them and the median nerve can be damaged where it exits the carpal tunnel at the base of the palm.
Performing these simple exercises several times a day between massage sessions will help strengthen your wrists and make them less susceptible to injuries.
Place your palms together at chest level. Press one hand against the other, moving back and forth. Repeat the presses ten times for supple and strong wrists.
Hold your hands at chest level. Grasp a small bar, or clinch your hands into tight fists. Squeeze the bar or your fists as hard as you can while counting to ten. Repeat three times to strengthen the hands and wrists.
Place one arm flat on a table and roll a small semi-soft foam rubber ball over the wrist and forearm with pressing and circular movements, exploring between the radius and ulna and applying moderate pressure to the wrist extensor mass. Repeat on the other arm.
Kneel down and extend both your hands in front of you on the floor, ensuring they are shoulder-width apart. Place the back of your palms on the floor with your fingers facing inwards towards your knees. Apply gentle pressure and hold this pose for 30 seconds. Release and shake your hands.
Place your arm straight out in front of your body with your wrist stretched and your palm facing the ground. Use your other hand to put a small amount of pressure on the back of your downward-facing hand, extending your fingers and wrist as far as you can. Hold for 20 seconds, then change hands and repeat.
Put your hands together in a position of prayer, then spread your fingers as far as you can while pushing them together, so that your palms are pushed away from each other. Do this two to three times per side and perform every hour or so.
Performing these simple exercises several times throughout the day will help keep your hands and wrists in peak physical condition. You may also benefit from soaking your hands in warm water for ten minutes or so before performing these exercises – this can warm them up and increase your flexibility. For a real treat, indulge in a warm paraffin wax bath – you’ll quickly feel the difference this can make to your hands and wrists!
While exercising with massage in mind is vital, so is avoiding exercises that could be damaging or painful. As a general rule, you should avoid any exercises that:
- Place a great deal of pressure on the hands, wrists and forearms.
- Require repetitive movements using the hands, wrists or forearm muscles.
- Put your hands or wrists into awkward postures.
Push-ups are a good example. They are a great core strengthening exercise, but when you perform a push-up, the weight of your upper body is transferred to your hands. Wrist curls are another activity to be cautious about – they’re great for building forearm strength, but play havoc with the wrists.
It’s important when conditioning your body to look for exercises that suit your needs as a massage therapist. There are plenty of core strengthening exercises out there that don’t strain the hands or wrists, including knee folds, forearm planks and oblique reaches. To work your forearms, try exercises like the Farmer’s Walk, which don’t involve moving your wrists back and forth.
Whatever exercise you do, keep your wrists as straight as possible and maintain a neutral posture. Remember to also be careful of your back, neck and shoulders, which are also overused in massage.
Other preventative measures
As well as having a regular exercise regime to keep your hands and wrists as strong and supple as possible, there are other simple precautions you can take as a massage therapist to reduce your likelihood of injury.
- Take at least a 15-minute break between massage treatments to allow your body to stretch and shake off any tension that may have built up.
- Know how many massage treatments you can effectively perform in a day and in a week, and try not to exceed this number.
- Warm up and stretch before you begin work for the day to get fluids into your joints and to loosen up muscles, tendons and ligaments.
- Consider using effort-saving tools where possible, such as an electric massage table that changes positions, or hand-held tools that can deliver the required therapy with less stress on your thumbs, forearms and wrists.
- Trade services with colleagues to ensure your own massage therapy needs are being attended to.
- Make sure you get enough sleep, eat healthy nutritious food and hydrate your body throughout the day.
Take care of yourself
In the massage profession, you need to take care of yourself before you can take care of others. Your hands are the tools of your trade and you must do everything you can to make sure they remain in top-notch condition.
Sore hands and wrists don’t have to be the result of giving massage when the right care is given to them and if you put a little time and effort into their conditioning, you’ll hopefully be rewarded with a fulfilling career that’s free from pain.
Are you looking to become a massage therapist, or a qualified therapist wanting to learn new techniques and improve your repertoire? Sign up today with Discover Massage Australia’s industry-recognised courses and learn new massage therapy skills today. Or, take a look at our online massage course.