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Protecting yourself against injury in massage therapy

“Your average massage therapist typically has six or seven years in the industry before they have to change careers due to injury,” says massage therapist of 20 years Kayleigh Purser, founder of The Purser Method – a method of deep tissue massage therapy with the main focus being the health and wellbeing of the practitioner.

Award-winning independent beauty therapist Anna Tsankova adds: “Therapists rarely do any sort of stretching exercise or preparation on the day before they start work, despite massage being a very physical job. Unfortunately, therapist wellness and injury prevention is not often included in curriculums, aside from ‘keep your back straight’.”

There are a number of ways in which therapists can cause harm to their own bodies – chiefly repetitive strain injury (RSI) and carpal tunnel syndrome.

“We suffer from a lot of swelling and pain in the wrist, which can get into the rotator cuffs or into the muscles surrounding the shoulder blade into the neck,” says Purser. “In spas, I’ve seen external trainers come in to address therapist posture and tell students to squat to alleviate pressure on the back, which technically works, but you’re then expected to basically do a sustained squat, unsupported, for the entirety of your treatment.”

Purser says that because of this she has begun to see a lot of sciatica in very young therapists as the glutes get so tight that they start pressing on the sciatic nerve. “The entirety of the spine can be compromised, as well as the knees; it can really affect the whole body. A lot of courses teach you to use your forearms more to take the strain and pressure off your hands, thumbs and wrists. That’s great, but nobody’s telling you about the impact that has on your rotator cuff. Everything I tried would just highlight a different bodily issue. It took me years of training, often very obscure training, to come up with the Purser Method.”

Breathing techniques

One day, while performing a couple’s massage on another therapist, Purser noticed that her co-worker was holding her breath during the massage and realised she was doing the same. She became a yoga instructor to learn breath work, better posture and flexibility.

Purser’s method is a combination of Swedish, sports and acupressure massage, yoga, forearm massage, Reiki, breathing techniques and, interestingly, Tai Chi, which is rooted in Asian martial arts and traditional Chinese medicine. It focuses on gentle, repetitive movements, which allows you to focus on integrating your breath, having bodily awareness and increasing mental focus through visualisation.

Lucie Allen, Professional Beauty UK Therapist of the Year 2023 and therapist and trainer at New Forest spa Chewton Glen, also credits techniques from Asian cultures for enabling her to avoid injury when performing a lot of massage treatments. In the East, people are more accustomed to the practices of intentional movement and the importance of breathing and mindfulness.

“I learned a lot from Thai therapists when working at a Thai-themed spa,” she says. “They are taught to breathe and use every part of their body rather than just the thumbs. They use the palms, knuckles, forearms and elbows, even the feet. There is a real remedial side to it – they find an injury or blockage and literally apply pressure to it. It’s a lot stronger than anything we do with Western massage.”

Thai therapists rely on their body weight to bend and stretch their clients into different positions, hence the reason that Thai massage is often referred to as ‘lazy man’s yoga’.

Mental wellbeing

As well as being highly physically demanding, massage therapy can also be emotionally taxing, as you take on your client’s energy, pains and often complaints. It’s common knowledge that, across the beauty industry, professionals take on the role of emotional therapist while also conducting the beauty or wellness therapy they specialise in.

Allen also thanks Thai practices for helping her take care of her mind, starting with the absence of shoes during massage to help stay grounded.

“Thai massage is focused on the Zen, or energy lines, which flow through the body. They teach you how to separate yourself from someone else’s energy with grounding rituals, affirmations and prayer before and after the treatment, and to push positive energy into the client.”

Thus, it is important to work for spas that understand the strain on the therapist and the benefits of providing a healthy work environment.