Save Your Body, Use Your Forearms: The Research

Many people know I am passionate about using forearms as much as one can in a massage. But it's so important to understand that using the forearms while improving body awareness, can prevent physical burnout and physical injury. It’s about working smarter, not harder. So in this post I thought we'd could nerd out a bit and take a good look at some of the research on why physical preservation is so important in our practice.

According to Lauriann Greene, CIPI Program Director and one of the foremost experts on injury prevention for manual therapists, “Seventy seven percent of manual therapists and bodyworkers report symptoms or injury as a result of their work. There’s a great need to teach effective, proven methods and tips to prevent injury.

“For every pound of pressure that a massage therapist applies with their thumb, there can be 10 to 12 pounds concentrated on the carpometacarpal joint. So if a massage therapist uses their thumb to apply 10 pounds of pressure on a stubborn trigger point, the result could be as much as 120 pounds of force at the base of their thumb.” (SanGregorio, Save Your Hands a Guide to Injury Prevention) https://www.amazon.ca/Save-Your-Hands-Prevention-Ergonomics/dp/0967954916.

In study that tested the prevalence of osteoarthritic symptoms of hands amongst female massage therapists, the mean age of symptomatic presentation was 43 years. The AUSCAN ™ Index (Australian-Canadian Osteoarthritis Hand Index) found that more than half of the total sample reported osteoarthritic symptoms in their hands. Participants in the non-symptomatic group also indicated a positive response to symptoms on the AUSCAN ™ Index although they did not report a symptomatic onset age ( University of Johannesburg 2017).

In research sample noted above, the conclusion was not only did massage therapists experience osteoarthritic symptoms that cause pain and stiffness in their hands but it also seemed evident that the symptoms experienced were also responsible for placing strain on their ability to perform daily tasks.

According to Lee Kalpin’s article titled “Staying Ahead of the Storm”, Massage Therapy Canada (2010), statistics were shown that a great many therapists drop out of the profession in their first five years. Other articles place a massage therapists life span anywhere from 5-8 years but the sentiment is the same. Injury and overuse are the most common reasons why massage therapists leave the industry.

In the fall magazine of the RMTBC Review ( 2021), an article discusses research carried out by The Massage Therapy Foundation. MTF is a public charity supporting scientific research and education. It has invested in an Ergonomics Project with its sole purpose to develop recommendations for safer massage therapy work. “When you consider the time and knowledge invested into entering this profession, it is disheartening that so many have short-lived careers”, says Robin Anderson. Here are some key points made by the Massage Therapy Foundation after an 18 month ergonomics survey study:

• Massage therapy work has a moderate risk for developing repetitive stress injuries if no self-care or intervention is employed.

• Massage therapists have long duty cycles and the time spent at work is very long in comparison to other professions. This poses more opportunity for potential injury and risk.

• Due to the physical nature of massage therapy work, physical conditioning and maintaining specific health levels are key factors in career longevity.

• Improvements can be made in some of the preparation and setup of the massage work environment to promote the health and safety of massage therapists.

• Entry-level training and education can help mold future massage therapists and their workplaces to be proactive in implementing recommended practices for the profession.

A Survey was published of Canadian Massage Therapists Experiences of Work-Related Pain. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9401083/ It was based on the work-related pain (WRP) experienced by Massage Therapists (MTs) in Ontario, Canada was undertaken using voluntary completion of an online questionnaire following broad distribution of requests to take part in this study. Valid questionnaires were analyzed both quantitatively and qualitatively. Massage therapists ranged in age from 20 to 73 years, and 85% of respondents were female.

The overwhelming majority (85%) of Massage Therapists had experienced, or were experiencing, Work Related Pain at one or more of five pre-identified, primary locations with the hand/wrist, the most common site (65.5%); followed by the fingers/thumb (60.3%), shoulder (55.0%), lower back (50.1%), and neck (49.2%).

Now consider the average life span of a Massage Therapist is only 5-8 years. So how do you stay successful and lead a long an healthy life as a Massage Therapist? Use Your Forearms!

Using the forearms can be a helpful technique for massage therapists in several ways:

Pressure: Using the forearms allows the therapist to apply more pressure than they might be able to with their hands or fingers alone. This can be especially helpful when working with clients who have dense muscle tissue or who prefer deep tissue work.

Surface area: The forearms have a larger surface area, which can help the therapist to cover a larger area of the client's body more efficiently. This can be especially helpful when performing long, sweeping strokes, such as in Swedish massage.

Body mechanics: Using the forearms can also help the therapist to maintain proper body mechanics and reduce strain on their hands and wrists. By using the larger muscle groups of the forearms, the therapist can distribute the workload more evenly and reduce the risk of overuse injuries.

What we have learned from the research in these articles is that formal injury prevention courses for RMT’s are urgently needed. By focusing on improving joint mechanics and technique, attention to workload, careful selection of manual techniques, and managing expectations for manual therapy, we can live long fulfilling pain-free lives in our career. By incorporating the forearms into massage work it can provide a variety of benefits for both the therapist and the client, including increased pressure, efficiency, and reduced risk of injury.