Self care for massage therapists: are you seriously fit and healthy?

“One of the most important – if not the most important subjects therapists avoid addressing, is their own health and well-being. This should be an area of huge concern for the industry and, unfortunately, it is not going away anytime soon”

The subject of injuries sustained by the manual therapist is quite overwhelming and absolutely needs to start within the very early stages of education, because this is the environment where bad habits are formed and the focus on self-care should be cemented.

I have seen countless numbers of fantastic, passionate and truly gifted therapists/students walk away from this amazing career all because of the physical and mental toll on their bodies. It’s not rocket science to work out the reason why the injuries occur: this is a physically and mentally demanding job, and for those who love it, it is one of the most rewarding and fulfilling careers that you can have. It’s almost hypocritical to think that we help others and keep them out of pain, when in some instances we actually put ourselves into that position, and that we overuse or overload the structures that we use to help others.

But, as much as I still have a passion after 30 years for helping clients break the barriers of pain and dysfunction and restriction, I can’t help but feel that it has also taken its toll on my body, and what the years to come will mean for me in my physical world is unknown. I have had an amazing career thus far, and I’m not ready to give it up either, but I have done one thing to make sure I continue – I invested in my body early on after sustaining injuries. I did this out of necessity and survival.

I shudder when I see YouTube clips of practitioners demonstrating techniques that are not sustainable or are highly harmful. Unfortunately, there was very little tangible information out there on self-care, let alone a course dedicated to it. So, it was up to me to traverse a self-care journey of my own, so that I could keep enjoying this amazing, rewarding career.

What did I discover was important? The balance between acute and chronic workloads, the understanding of what tools you need to use, the understanding of how you should progressively load yourself to steer away from harmful damaging techniques. This is the tip of the iceberg: there are so many factors that need to be addressed in order to sustain longevity in this career. Mental fatigue is a big part of it.

“The greatest environment for injury is when you step or you spike your workloads to something that your body has not experienced before.”

Understanding your workload journey

The cornerstone of becoming a strong, efficient, successful therapist physically all depends on where you start your journey and on understanding your journey from a workload point of view. I talk about workload because I’ve been working with athletes for years and years, and the one thing that makes all the difference in therapists or athletes in regard to getting injured is that the greatest environment for injury is when you step or you spike your workloads to something that your body has not experienced before.

There’s a great Australian sport scientist who I’ve been following named Dr Tim Gabbett, and for those of you who are not familiar with him, I urge you to go and have a look at some of his work. He speaks about how athletes can put themselves in the highest risk of injury. He equates it to two simple processes, How can I avoid injuries? and How can I prevent injuries?

Well, you can’t prevent injuries. You can help provide an environment where it’s least likely to happen. Okay? The nature of athletes, and in some cases even for therapists as well, is that you push your boundaries, your physical boundaries. So, depending on what you do about training and strength and conditioning, you try to get your body to a point where it can adapt and can withstand those boundaries that you put it through. One of the first things to consider is acute workload and chronic workload

Acute or chronic workload?

When we talk about acute workload, it’s what you’ve been doing in the last week or two. Chronic is about what you’ve been doing in the last six months. The balance between your acute and your chronic is the environment for injury. For instance, if we apply this rationale to the massage therapist who’s doing hands on, if over the last six to eight months you’ve been doing three, maybe four massages a day, and then in the last week you get a new job, and all of a sudden you have an increase in your acute workload, from three to four massages, you’re now doing maybe seven to 10 massages a day.

Now, that is a huge spike and increase, so your chronic workload and your acute workload are out of balance. Therefore, you are putting yourself at the highest risk of injury: you should have a slow progression. It’s like any athlete who has trained to do their chosen sport. Massage Therapists are no different. Your hands can’t cope with huge increases like that – it`s too great an adaption for the body. Therefore, unless you have sufficient strength and conditioning in the right acute and chronic workload ratios, you put yourself at the highest risk of injury.

There are other factors too – especially when you’re working at sporting groups or with sporting teams. Even at the elite level, and I’ve been there myself, I’ve been in peril of that when I was doing a lot of hours on larger athletes on non-adjustable tables. That threw my chronic and my acute workload out of balance because, firstly, I wasn’t used to working on a non-adjustable table with athletes who were a lot bigger and a lot more physically demanding to work on, and secondly, I was doing a lot more of it. Something would have to give, so was it going to be the wrist, was it going to be the elbow, was it going to be the shoulder, or was it going to be the neck? For me, a lot of the time I ended up having a series of acute torticollis every three to four weeks, which is not ideal. Touch wood, I was lucky to avoid a nasty over-used tendon injury.

So, your acute and your chronic workload ratios are highly important, and if you don’t have them in balance, then you are putting yourself at risk of the greatest amount of injury. Do not substitute success in terms of the number of clients that you’re seeing per week, plus the income, at the jeopardy of your body and the balance between that acute and chronic workloads.