It’s great that therapists are trying new ways to do massage. In online forums and social media, we see therapists talking about, for example, how using the knuckles instead of the fingertips is the most risk-free way to do massage. Another swears by the forearms, and yet another by avoiding the upper extremity altogether and using the feet to do massage.
The reality is that each “tool” we use to do massage, be it hands, thumbs, knuckles, forearms, etc., has its own set of risk factors. Some have fewer risks than others. Thumbs and fingertips are inherently unstable and therefore carry the most risk for most people: first, because their structures are inherently unstable, and their delicate ligaments, tendons and cartilage can be easily damaged; second, because the instability forces you to contract the forearm flexors and extensors quite a bit to keep them from buckling, and this increases pressure in the carpal tunnel (which can lead to CTS) and can cause tendonosis in the forearm muscles.
But there are risks associated with use of any part of the body to apply pressure. To use the knuckles (which aren’t all that stable, either, if you use only 2-3 of them), you have to stabilize with the forearm flexors and extensors, too, and if you’re not stabilizing your scapulae at the same time and using the larger muscles of the shoulders and back to create the force, your shoulders can be at risk for injury. In our 2006 study of injury among massage therapists, shoulders were the body part most often injured. Same goes for use of the forearms – the shoulders are still vulnerable, although certainly the large, flat surface of the forearm offers much more stability than the fingers, thumbs or knuckles. No matter what body part you use, transferring pressure through the bones of that body part causes wear and tear to the joints which can lead to osteoarthritis over time.
And as for using the feet: not only do they also have small bones and other soft tissues that can get injured, but you have to hang on with your hands and arms to overhead bars as you massage. We recently had a CIPI candidate tell us that she was starting to have shoulder symptoms from hanging on to the bars, and I have heard of another therapist who injured her feet by massaging with them.
So am I saying that it’s not good to look for alternatives to using the hands to do massage? No, it’s actually a really good idea to do that. Just bear in mind that there is no one part of the body that is magically free of risk factors for injury. Being aware of the risks of using a particular body part to do massage is very important. For choosing which body parts to use for your massage techniques, the approach that seems to work best involves frequently changing the part of the hand or arm (or even feet) you use to do massage, so that no one part becomes overused. Using real tools (IndexKnobber, Massage Star, etc.) when possible can also be very helpful. Do you use a certain part of the body to do massage more than another? Share your experiences with us here.
Lauriann Greene post “Knuckles, Forearms...Which Body Part is Best to Use to Do Massage? Thanks to Lauriann for her thought on this issue. I'd like to add some thoughts here. Having had an active massage practice for 21 years and having taught massage therapy for 14 years with my own pre-existing conditions and risk factors, I am unrelenting in making sure our students use their bodies in ways that minimize their risk of injury over time. I aim to make sure that they develop sound and habitual optimal patterns of body use from the very beginning of their programs. It's absolutely true that use of any part of the body can result in injury if used to long, too hard and with less than optimal body mechanics.
We start all classes with yoga and other movement arts activities to establish increased strength, aerobic fitness, and strong muscles of scapular stabilization. Even with this students come in with all manner of hand, arm and shoulder anomalies that could result in injury; so far we have a pretty good record of finding ways to accommodate those so they can have long, fulfilling and comfortable careers.
That said, I dislike the use of "knuckles," which many students are inclined toward, and which has a feel that is aggressive and unpleasant for many clients. "Soft fist" is a little better, but "dorsal fingers" or "backs of the fingers" both expresses and describes what I believe is a softer and more reasoned approach. With knuckles or dorsal fingers many students want to lead with the knuckles, and for those with weak extensors the metacarpal-phalangeal joint "folds" way too much, a serious risk to wrist and hand health. Making sure not to exceed a 90 degree angle at that joint and leading with the radial (ie: indicis) side of the fingers while maintaining the body in a position that facilitates neutrality of the wrist and elbow seems to be a good solution.
Massaging from the whole body, for instance, in a wide lunge with weight in the back heel grounded for stability, with a lifted sternum helps eliminate some of the hazards of forearm use. Not all use of feet on the client's body requires supporting one's weight with bars. There are numerous ways of working on clients on the table or on the mat that require little or no use of the hands, and are especially suitable for work on large, dense, tight-muscled clients in particular.
In the past I thought that tools were artificial and hindered sensitivity. I've come to believe that certain tools used in ways that facilitate sensitivity can be a great boon to the busy massage therapist. I personally dislike any tool made of plastic, but have enjoyed (as my clients have!) the use of hot stones as hand-held tools and placed stones. Holding the stones can still create some strain on the hands, but when balanced with other techniques, creates a balanced repertoire of upper extremity actions. More recently I have begun using rosewood and bamboo tools (Mu-Xing therapy) and they create yet another set of "holds" that helps balance the musculature. So, part of the key to healthy massage practice is variety, and clients appreciate it.
Another key element in injury prevention is avoiding overuse. I know it can be difficult in uncertain times to limit the number of massages one gives in a week, all MTs should find a limit that their bodies tell them is reasonable and stick to it. We should never be so hungry for clients that we work on people who demand intense pressure (not the same at all as intense depth, which may not require undue pressure) or who are simply too large, dense, and athletic for our own frames. Maintaining a regular yoga or other movement art practice that keeps the therapist in touch with her body and it's conversation with her is a key element to assessing the body parts, tools and techniques that will allow her to have a long and healthy career.
Victoria Jordan Stone, MA, NCMT
Author - The World's Best Massage Techniques (2010) Fairwinds Press Partner -
Blue Ridge School of Massage & Yoga, Blacksburg, VA
From Massage Magazine Blog http://massagemag.com/massage-blog/injury-prevention-ergonomics-manual-therapists/2011/10/24/knuckles-forearms-which-body-part-is-best-to-use-to-do-massage/
Tuesday, October 25, 2011
Tuesday, October 18, 2011
Upcoming Continuing Education at BRSMY
Hot Stones
Instructor: Victoria Stone, CMT
Sunday, November 6, 10am-6pm
7 CE Credits
Cost: $165 (or $150 if registered and paid in full by October 6)
You will also receive a list of supplies that need to be purchased before attending. These will allow you to continue practicing what you have learned.
call 540.552.2177 to register.
Hot Stones: This course includes explanation of the use of hot stones, cautions, benefits and care of the stones. During the workshop you will give and receive a full-body sequence. You will be able to incorporate hot stones safely, effectively, and therapeutically in any massage session, or use it as a stand-alone spa technique. Prerequisite: at least 120 hrs. Swedish massage training.
Victoria Stone, CMT is director and co-owner of Blue Ridge School of Massage and Yoga. She has been in practice for 20 years. She has 13 years of teaching experience in various massage modalities, massage theory and practice, anatomy and medical massage, as well as certifications in Pregnancy massage, Hot Stone Therapy, Basic Cranial Therapy, and Thai Yoga Massage, Watsu, and is a registered Yoga Instructor.
Monday, October 17, 2011
A Green and Sustainable Profession: Massage Therapy
Over the past twenty years the massage therapy profession has grown and changed rapidly, moved into a more cooperative and integrative position with traditional medical care. Certifications and licensure have aided in quality assurance by maintaining standards and requiring continuing education for massage therapist. But under the more overt changes a sea change has swelled and is increasingly affecting the field in its relation to the environment.
The suppliers of products for massage therapists' use have responded to this quiet revolution by providing ever-increasing variety in massage products: massage lotions, oils and creams are now available in natural, unscented and organic forms, often with the addition of anti-oxidant or homeopathic essential oils. Organic cotton massage table linens are available. Some massage therapists choose to line dry (a great use of solar energy!) their massage linens, utilizing the sterilizing effects of the sun, rather than Tools from natural sources are used increasingly such as natural basalt stone for hot stone therapy, and basalt or rosewood tools for Mu-xing or bamboo massage.
Even massage tables made from sustainably produced wood and upholstery materials that do not outgas or create damaging byproducts in their production are now available.
Although the massage room environment has often become more in line with mainstream health care, we do continue to use re-usable linens rather than paper disposables. Some massage therapists do still use candles in their spaces, but increasingly these are soy candles, which have lass of an environmental impact than the old petroleum-based ones, and which are less likely to negatively affect clients.
Massage is by its very nature low tech and high touch. Most therapists do not use vibrating electrical massage tools, though there are requirements for the use of electricity to heat packs, cool cold packs, and heat stone, bamboo or rosewood implements, but the use is not high. Low light is the rule rather than the exception, unlike most brightly lit medical offices - another reduction in energy demand.
Many massage therapists have offices within walking distance or on public transportation lines, which can minimize the gas cost to clients; others may be further afield in day spa, destination spa, or other locations. Almost all massage therapists will recommend simple stretching and strengthening exercises to clients which can be done in their own homes with minimal or no equipment.
Those seeking to be part of a profession that has minimal damaging effects on the environment might do well to consider massage therapy as a rewarding and environmentally conscious occupation.
The author, Victoria Jordan Stone is a nationally and state certified massage therapist and co-owner and primary instructor at Blue Ridge School of Massage & Yoga in Blacksburg, VA. See www.blueridgemassage.org
The suppliers of products for massage therapists' use have responded to this quiet revolution by providing ever-increasing variety in massage products: massage lotions, oils and creams are now available in natural, unscented and organic forms, often with the addition of anti-oxidant or homeopathic essential oils. Organic cotton massage table linens are available. Some massage therapists choose to line dry (a great use of solar energy!) their massage linens, utilizing the sterilizing effects of the sun, rather than Tools from natural sources are used increasingly such as natural basalt stone for hot stone therapy, and basalt or rosewood tools for Mu-xing or bamboo massage.
Even massage tables made from sustainably produced wood and upholstery materials that do not outgas or create damaging byproducts in their production are now available.
Although the massage room environment has often become more in line with mainstream health care, we do continue to use re-usable linens rather than paper disposables. Some massage therapists do still use candles in their spaces, but increasingly these are soy candles, which have lass of an environmental impact than the old petroleum-based ones, and which are less likely to negatively affect clients.
Massage is by its very nature low tech and high touch. Most therapists do not use vibrating electrical massage tools, though there are requirements for the use of electricity to heat packs, cool cold packs, and heat stone, bamboo or rosewood implements, but the use is not high. Low light is the rule rather than the exception, unlike most brightly lit medical offices - another reduction in energy demand.
Many massage therapists have offices within walking distance or on public transportation lines, which can minimize the gas cost to clients; others may be further afield in day spa, destination spa, or other locations. Almost all massage therapists will recommend simple stretching and strengthening exercises to clients which can be done in their own homes with minimal or no equipment.
Those seeking to be part of a profession that has minimal damaging effects on the environment might do well to consider massage therapy as a rewarding and environmentally conscious occupation.
The author, Victoria Jordan Stone is a nationally and state certified massage therapist and co-owner and primary instructor at Blue Ridge School of Massage & Yoga in Blacksburg, VA. See www.blueridgemassage.org
Tuesday, October 11, 2011
Blue Ridge School of Massage and Yoga Upcoming Classes and Events
Upcoming Continuing Education:
Hot Stones
Instructor: Victoria Stone, CMT
Sunday, November 6, 10am-6pm
7 CE Credits
Cost: $165 (or $150 if registered and paid in full by October 6)
You will also receive a list of supplies that need to be purchased before attending. These will allow you to continue practicing what you have learned.
This course includes explanation of the use of hot stones, cautions, benefits and care of the stones. During the workshop you will give and receive a full-body sequence. You will be able to incorporate hot stones safely, effectively, and therapeutically in any massage session, or use it as a stand-alone spa technique. Prerequisite: at least 120 hrs. Swedish massage training.
Victoria Stone, CMT is director and co-owner of Blue Ridge School of Massage and Yoga. She has been in practice for 20 years. She has 13 years of teaching experience in various massage modalities, massage theory and practice, anatomy and medical massage, as well as certifications in Pregnancy massage, Hot Stone Therapy, Basic Cranial Therapy, and Thai Yoga Massage, Watsu, and is a registered Yoga Instructor.
Continuing Education for certified massage therapists. To learn more, click on the course's name above. NCBTMB Approved Provider: #450101-06
Registration is required - 540-552-2177
Upcoming Yoga Teacher Training :
Join us this Fall for Ashtanga Vinyasa Krama Yoga teacher training starting November 11, 2011 at the Blue Ridge school of Massage and Yoga. In this program we'll develop the foundation of personal practice. From this strong foundation our practice of teaching will grow.
We'll explore western anatomy and physiology, eastern energetic anatomy and how yoga practice effects both. We will also focus on alignment principles; safe, effective assisting and hands on adjustments following these principles.
We'll explore the many cycles of asanas in classic asana practice diving deep into how and why the Ashtanga practice weaves it's way through them. Understanding this opens the door to many levels of teaching. We will have the opportunity to play with working with individual conditions to organizing larger classes.
In addition to practice, we'll read and discuss the Yoga Sutras of Patanjali - in order to ground us in the universal underlining philosophy of what yoga is. Meditation will be introduced so the concepts of movement and stillness can be integrated in practice and teaching. Yoga can be defined many ways. Ultimately it's a path of transformation - Of diving into the sea of divinity and fully encompassing, being, who we truly are.
For registration and more information contact Jeff Tiebout at the Blue Ridge School of Massage and Yoga -
Address: Colony Park 2001 S Main St Suite 106 Blacksburg, Va 24060. phone: 540.552.2177 Email: info@blueridgemassage.org
Check us out on Facebook - Blue Ridge School of Massage and Yoga or Follow us on Twitter @BRS_MassageYoga
Ongoing yoga sessions:
Mysore Style Yoga with Jeff Tiebout
Thursdays, 6-8pm - $5 for students, $10 for non students Call to check on cancellations - 540-552-2177
Gentle Yoga with Thea Vincenti
working breathe alignment and yamas/niyamas.
Sundays, 6-7:30pm - $15 open to the public
Call to check on cancellations - 540-552-2177
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