From quality of life to diversity of choice in the modalities you practice, now is a great time to be a massage and bodywork professional. I’m sure you’ve heard it said that being a massage therapist is the best job in town.

To help ensure our prosperity and longevity, we will spend the next few columns focusing on the tools of our trade—our hands. The percentage of work-related injuries for massage therapists is still extremely high, with the hands incurring the most damage. Given the ever-growing potential of the massage and bodywork profession, we need to stay proactive in taking good care of our hands. The following points will bring more awareness to how you use your hands and will help you to apply mindfulness when you do.

Use Different Parts of Your Hands

Mindfully using different parts of both hands throughout a session prevents

overuse of any one part. Try to become more ambidextrous (using both hands with equal skill). Typically, injuries occur when one or two parts of the same hand are overused. Become comfortable with switching between both hands to decrease the chance of overuse. Take time to practice using your less dominant hand for applying techniques.

Consciously Use Your Less Active Hand

Bring awareness to how you use your less dominant hand. Without conscious awareness, this hand may endure considerable stress. For example, using one hand to apply deep pressure and unconsciously bracing the other hand against the client or table can put the wrist joint in a compromised position—typically overextension. A healthier approach is to consciously use the less active hand as a reinforcement hand. It can support the dominant hand by reinforcing a neutral (straight) positioning of your wrist joint, or it can support your client by touching another part of the body.

Rethink Your Body Position

When working in a certain position, be aware if it creates hand discomfort. For example, standing at a certain angle while applying pressure to your client’s back may cause pain in your wrists. If so, change your position. Find a standing or sitting position that allows your wrists to maintain neutral alignment.

Adjust the Client’s Position

Prone, supine, side-lying, and sitting are all viable options for the client throughout your session. Your client’s position, however, should be comfortable for both of you. For example, if your portable table is set too low for a supine or prone position, turn your client to a side-lying position. This changes the height of the body, making it much more comfortable for you to work. Thinking about your work from an ergonomic perspective can help you alleviate this situation. Ask yourself: how can I bring my work to me, rather than conforming to the work?

Change Your Tools

Mindfully choose the right tools from the start. However, if you use a certain part of your hand, and it starts to feel uncomfortable, change to a different tool. For example, discomfort commonly arises when the fingers and thumbs are used for applying deep pressure. If this happens, immediately change to your knuckles, fists, forearms, elbows, or a handheld tool. If you lack experience in using other types of tools, you might be tempted to work with pain, rather than changing to another option. Don’t let yourself fall into this pattern. Anytime you feel uncomfortable, find a way to change your working tool.

Modify Your Technique

Manual therapy is an organic and dynamic process in which you and your client work closely together to create the best possible outcome. Thinking about your session this way can help you realize there are many different ways to work with a client. If a certain technique causes your hands discomfort or pain, chances are it’s not the best choice for your client either. Be mindful of the wide range of possible solutions. With so many modalities to choose from, there is a good chance you will find at least a few that are comfortable for you and that benefit your client as well.

Use Your Body to Help Your Hands

We help facilitate the healing process of our clients with our hands. It is important to remember that the most effective tool is your entire body moving in synchrony. The next time you begin a session, become aware of how your lower body (pelvis, legs, and feet) moves to support your work and how your upper body (back, head, arms, and hands) moves to facilitate it. Practicing this kind of global body awareness allows you to spread your attention fully throughout your body and specifically to your hands. In this moment, your entire body moves in synchrony, becoming your greatest tool.

 Barb Frye has been a massage educator and therapist since 1990. She coordinated IBM’s body mechanics program and authored Body Mechanics for Manual Therapists: A Functional Approach to Self-Care (Lippincott Williams & Wilkins, 2010), now in its third edition. She has a massage and Feldenkrais practice at the Pluspunkt Center for Therapy and Advanced Studies near Zurich, Switzerland. Contact her at barbfrye@hotmail.com.