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Raise Your Hands

25 August 2009
Massage therapy is still one of the most lucrative and popular treatments on the salon and spa menu today. Estimated at $4-billion per year globally*, the art of massage has become an industry in itself. It is ironic though that from an ergonomic point of view, the workplace can be a hostile environment to the therapists performing these treatments.  

In an 60-90 minute session, the average massage practitioner puts huge amounts of pressure through their wrists, so much pressure in fact that a startling 80% of therapists specializing in body massage drop out after the first two years due to injury to the hands, wrists and arms.

As Lauriann Greene, author of the book Save Your Hands! Injury Prevention for Massage Therapists puts it: “Too often, there is a tendency to be more interested in the financial bottom line than in the health of the people who are doing the work.”

Cramped massage rooms, uncomfortable table heights, too many massages in one day (viewed as more than two hours of repetitive hand movements a day), as well as awkward postures and poor techniques, all contribute towards a host of injuries including Repetitive Strain Injury (RSI), Carpel Tunnel Syndrome and back strain. Some injuries can even reveal themselves in later years such as Osteoarthritis.

Mariet Smal Head of Short Learning Programs at Isa Carstens Health and Skin Care Academy, and an expert in the field of massage and injury prevention, explains: “When such high strain, high stress movements are repeated over and over, we have all the necessary pre-conditions for overuse injury.”

Swedish massage techniques for example see constant pressure applied to the smallest joints, muscles, nerves and tendons of the body.

This leads to therapists 'losing their touch' so to speak! The therapist becomes depleted, fatigued, impersonal and mechanistic. “Poor body use causes the therapist's touch to feel invasive, pokey and even smothering, whereas dynamic body use allows the massage to become a dialogue of sensations between therapist and client,” Smal explains, adding that effective bodywork can only be successfully practiced if correct postural mechanics and correct postural dynamics “sing their song” together.

Startling reality

According to the U.S. Bureau of Labor Statistics Occupational Outlook Handbook (2008-2009 Edition), employment for massage therapists is expected to increase by 20% from 2006 to 2016, faster than the average for all occupations. Massage therapists find themselves accepted as medical tools, particularly by the medical provider and insurance industries, a fact that will have the greatest impact on new job growth for massage therapists.

It is worrying then that a UK survey (2000) to study the demographic incidence of wrist and finger damage, in which some 1684 practitioners were questioned, identified a great weakness in the profession. The survey revealed that nearly 88% of massage therapists, who have been giving five or more sessions per week for more than two years, suffer from injury. It showed that 78% of therapists have experienced wrist pain and that every day at least six workers left their jobs in the UK forever because of Repetitive Strain Injury (RSI). These figures show a potential pandemic within the massage industry and indicate a very worrying global trend.

Healing hands

Isa Carstens Health and Skin Care Academy has taken a pro-active approach by instituting injury prevention as part of its curriculum. Says Smal: “If the injury rate continues to climb, then a large percentage of graduates will last no more than two years in their careers. This puts the very future of the massage profession at risk and has large cost implications for employers in the salon and spa environments. Schools need to take action and prepare students by teaching them to prevent injury by adjusting traditional techniques and also by exercising good body mechanics.”

Thus, training institutions play an essential role in training a skilled therapist to operate efficiently and competently in today's challenging market.

“It is no longer enough to teach Swedish relaxation massage sequences,” says Smal. “It is in the best interest of any school to graduate students who are equipped with the knowledge necessary to prevent injury.”

She suggests creating a separate course to present injury prevention and body mechanics. “By providing students with comprehensive information and conscientious guidance on ergonomics and injury prevention, students will leave school armed with the knowledge to protect their health and the investment they have made in their training.”

Hands Free

So how can massage therapists safeguard themselves against possible injury?

Says Smal: “injury prevention massage and hands-free massage philosophies combine to induce balanced movement, enhance posture, reduce pressure on spinal vertebrae and the diaphragm, relieve tension, improve breathing capacity and increase alertness, producing a genuine sense of poise and equilibrium.”


Smal's tips for taking charge include:


·         Increase your knowledge

·         Avoid other hand-intensive activities

·         Work with your body characteristics

·         Correct postural dynamics and mechanics

·         Vary your massage techniques

·         Become fluid in your techniques

·         Don't use massage techniques that cause you pain

·         Use the principle: less is more

·         Use thumbs only for soft touch

·         Breathe correctly

·         Learn to massage from your heart

·         Treat personal injuries immediately


In addition employers can assist by ensuring proper working conditions and by providing ongoing training in different modalities. This also means that the working stations or rooms need to be ergonomically sound for massage therapists. Proper scheduling and breaks form an essential part of the program to avoid fatigue and over-use.

By taking these factors into consideration, salon and spa owners will realize that it is more efficient to set up effective rosters and systems and to build ergonomically suitable treatment and spa facilities from the beginning of a new project.

 * Source: Massage & Bodywork magazine. Media Kit 2004.   

Injury Prevention Course

Injury Prevention Massage principles and techniques are now the “new hot trend” in massage. These principles and techniques teach the therapist to “DANCE” their massage and to become the “GIVER”. We believe that these principles and techniques are the only guarantee for longevity in the career of a therapist. This will transform the massage experience and give the therapist the required confidence to work with passion, power, creativity and fluidity. Furthermore excellent treatments will lead to repeat bookings, full columns and increased revenue.

Please contact the SA Spa Association or Isa Carstens Academy for further discussion and input on a specific and achievable plan of action for your therapists.

Course duration: 2 days
Course cost: R 1530.00  SA Spa Association Members or R1 700.00 Non-Members

Course content: Injury Prevention Principles
 Body Mechanics
 Body Dynamics
 Repetitive Strain Injury prevention
 Safe use of forearms
 New fluid, soul techniques to work deeper with awareness

 For further information contact:Mariet SmalTel:      021      883 9777Fax:      021      886 6061e-mail:             headslp@isacarstens.co.za
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For more information contact the SA Spa Association on 011 447 9959 or e-mail: info@saspaassociation.co.za


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