UpClose & Personal - Ralph Stephens

Ever pay attention to the safety briefing they give before a commercial airliner takes off? Do you remember how they talk about the use of the drop down oxygen masks? They always tell you to put on your mask first before assisting others with theirs. In the case of airline oxygen masks, parents naturally tend to help their children first without thought of themselves. Unfortunately, if you do not get your mask on quickly, you would pass out before you are able to help your children.

The same principle holds true when caring for others by providing massage. If you do not take care of yourself first, you soon will be unable to help your clients.

So many therapists suffer from burn out and/or job related injury. I am often asked to provide information and recommendations regarding preventative injury care for massage therapists. These questions come both from individual therapists and from clinic or spa operators.

Unfortunately, there are no hard fast rules. Every individual has different capacities and needs. Some types of therapy are more stressful than others and therefore require more therapist care. Chair massage and table massage are equally problematic.

The massage and bodywork profession has a very high dropout rate. The average professional career is around three years. Of course, some last longer but some don’t survive that long. One reason is injury and/or “burn-out.” This usually occurs about six months to a year after the therapist develops a busy practice. Typically, these therapists admit they did not do anything to take care of themselves. They gave and gave until they were physically and energetically unable to give any more.

This is such a sad situation. Massage therapists report the highest job satisfaction of any profession surveyed, yet the highest dropout rate. Therapists become successful in doing what they love to do and shortly thereafter, many cannot continue.

Giving massage is a physically demanding task involving repetitive activity of many muscle groups throughout the body. Any repetitive activity presents the opportunity for overuse injury. Overuse injuries are generally slow to heal. It is much easier to prevent them than to recover from them!

To begin with, therapists must be “broken in” gradually and physically build up to their maximum patient load. This maximum load will vary from person to person and must be respected. Some people will never be able to sustain a patient load of 6 people per day. Others will be able to do 10 forever. Do not push yourself or your therapists beyond their capacity or injury and burnout will result.

Beyond the physical demands on the body of the massage therapist, there is a significant energy demand. This is beyond the energy to contract muscles. It takes a great deal of mental energy to concentrate on the patient and the procedures for the entire period of the massage. Further, there is an energy transference that occurs during massage. This is one of the reasons massage is such a powerful healing modality. In a sense, the therapist is like a jumper battery to the patient. Working in the patient’s energy field (aura) often elicits subconscious reactions and energy flows. This involves a multitude of things we do not understand..

This energy transference can be more demanding on some therapists than others. It can be a major factor in “burn-out”, which is a form of energy depletion. Once depleted energetically, the therapist is more likely to sustain a physical injury. Developing correct breathing habits is the best way to prevent energetic depletion.

Learn to breath deeply, into your abdomen. Keep your breathing regular, smooth and full when working. Exhale as you push forward or into the patient, inhale as you move back or release pressure. It is a great idea to do deep breathing exercises before and after massage. Just a minute or two of full deep breaths a few times a day makes a huge difference in energetic levels. Try this simple method for a few days and see what differences you notice. A great reference text for proper breathing and breathing exercises is The Science of Breath by Swami Rama, Rudolph Ballentine, MD and Alan Hymes, MD.

Most injured therapists admit that they did not receive regular massage. Most of them also admit they did not do anything to “train” for or counterbalance their activity. By this I mean they did not do strengthening and stretching exercises to maintain themselves physically. They just "did the work."

It has therefore become my strong recommendation that therapists who are working multiple appointments per day and multiple days per week should receive an hour massage every week. They should also participate in a regular strengthening and stretching program three to five times per week. Ideally, they should stretch every day.

Once a therapist has become injured, I recommend they receive massage until they recover, at the same frequency that they would ideally recommend to one of their patients with a similar condition.

Regarding stretching, special attention needs to be paid to the forearms, wrists, hands and fingers, especially the flexor muscles. More than normal attention needs to be paid to stretching the anterior cervical region (sternocleidomastoid, hyoids, scaleni and longus coli) and the upper chest (pectoralis major, pectoralis minor, and subscapularis).

The best system of stretching I have found for this is the Active Isolated Stretching© (AIS) system developed by Aaron Mattes. (Note: Aaron Mattes has excellent books and videos on his system. AIS - Mattes method stretches are also included in the my videos Seated Therapeutic Massage, Vol. 2 - Shoulder and Vol. 3 Forearm, Wrist & Hand videos as well as the Stretching That Works video by Ralph R. Stephens)

Remember that each individual therapist has different capacities. It is not possible to expect every therapist to do eight hours of massage each day, or even six. Each individual's limits must be respected and scheduled accordingly. As a therapist, you must find your own limit that you can sustain over time, respect it and not push beyond it.

Therapists require care in order to give care. Take care of yourself so you can continue to take care of others.

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