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In school we were cautioned about the way we use our hands and fingers, but I never remember any specific exercises or ways to help with the development of our own low back problems as we move along in our massage careers.  I now have been massaging for 10 years.  I try to exchange massages with my co-workers for massage and regularly see a chiropractor for low back adjustments.  I  also see Egoscue clinic therapists to correct and strengthen my lumbar area.  But there seems to be a dirth of specific strengthening excersises from the massagers themselves. 

 

But alas, the same problems I see in my clients, like mild scoliosis and other spinal problems, have become my companion too. 

 

I am always eager to try modalities that might help me such as rolfing (too painful) and deep tissue and other new therapies, but what I help people with, I can't do for myself unless it is a strengthening regimen that helps correct the body imbalances that were there before I became a MT. 

Does anyone have a program? 

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Hello Jeanne and Samantha,
Thanks for your input on exercises and practices that promote good health and strength for LMTs.
As I stated before, there were things going on with my back that I know now were a precursor for continuing back problems such as a very hypertonic or hypotonic left back...all the erector spinae, quadratus lumborum and other spinal muscles from the illium/sacrum area up the back that makes a back look really lopsided. I see this in many of my clients...who have sciatica and or scoliosis beginning or in chronic stages with attendant nerve pain and numbness down the hips to the feet.
I have seen a chiropractor for over 5 years who has helped tremendously but keep feeling that somehow, somewhere there is a massage modality that would help those muscles return to their original status while getting adjustments.
And, YES, giving massage exacerbates the low back pain at times but I refuse to quit. So I am looking for the person or persons who could steer me toward therapy that is NOT painful but would in addition to exercises and stretching, help me to walk straight and keep working.
This is the stuff I see in my clients., the inability to stand straight to walk cuts down the life expectancy of people. So how can I NOT explore avenues that would also help people like me.
Does or has anyone taken the Therese Pfrimmer crossfiber classes from Janine Ray which I feel intuitively may the answer I am looking for?

Jeanne Riley said:
Hi Laura,

I had a very similar experience. In school we also talked quite a bit about being careful to protect ourselves from repetative strain issues with wrist, thumb and hands in general. I had previous experience with a low back injury myself so perhaps had already learned how to protect myself in that area. My problem area was shoulders pain. Part of my problem was that because I was new and had not built up much business yet, I would be very busy one week and then nothing the next. That was very hard on my body.

There were 3 things I did that eventually helped me get past that problem and become stronger. The first was strengthening my own body with excercise, stretching and massage. I did see a physical therapist to help me figure out where I was imbalanced and I started going to the gym to strengthen.

The next thing I did was to work with another more experienced LMT who mentored me. First of all she gave me treatments which helped make my own tissue healthier. Then, she had me give her some treatments and when she saw or felt me using techniques that were hard on shoulders in general she told me to throw them out either altogether, or temporarily and she showed me other options.

The third thing I did was take a few classes to learn other types of massage so that I could vary the work I do. I had been doing almost exclusively deep tissue modalities. Learning to vary my treatments meant less repetative stress on my own body. I took classes that at first I didn't think I was going to like, but I ended up really appreciating the addition of these new modalities I had to offer my clients and they did too. And I had some aha moments in learning that sometimes a very gentle touch can create significant change.

So I do not have a program, but I thought my experience with this might give you some ideas as you work through your back pain. Good luck.
Laura - Find a good Active Isolated Stretching therapist. Start with the folks endorsed by Aaron Mattes in the "A.I.S. Therapists" lists on www.stretchingusa.com.

AIS includes a strengthening component that is essential to your needs. I have never seen anything else work so well for scoliosis and large-scale postural issues with so little discomfort... and it will improve your strength, body awareness, balance, and coordination while your ROM increases.
Fortunately, I've been able to keep my back relaxed after my sessions, just from stretching everyday.Plus, I am almost always moving around during my sessions, which seems to help me stay in proper form. I am finding though, that my hands and fingers get a bit tired after work. I have discovered that the rowing machine and/or dumbbells really help strengthen the flexor/extensors of the hands/wrist/arm.
I have always used things I've picked up in various professions or have been shown.

Hands:
1. Buy 5gal paint buckett fill w/ rice and take tennis ball twist it until you reach the bottom of buckett.
2. Same buckett simply knead and squeeze the rice in your hands.

Body:
There isn't anything better for a Therapist than both Pilates and Yoga both build on your flexabilty while increasing core
strenght.


Laura K Dylla said:
Jason, I most likely should not have become a LMT without learning about my body more, that I already had signs of problems of structure and pain with the same problems that my clients have when they now come to see me. I wished that I had gotten an honest evaluation of my body when I was in massage school, where I needed to focus on myself to keep working at massage; what to strengthen and correct my illium imbalance and scolotic curvature of the lumbar.
The instructor was a great teacher but the statistics bear this out that the average work-life of an LMT is 2-3 years at most. Could that statistic go up if more care was given when training the therapists about their own lifetime care.

But I am glad that I stuck with massage these 10 years. I am a survivor and have learned more about how our bodies get to the conditions I was in. I am much better for questioning and seeking new therapies. Someone usually has the correct answer. Thanks for your input. I think I will order the program you suggested.
Jason Erickson said:
Massage schools are horribly remiss in not requiring student MTs to engage in guided strength and conditioning training. In the early 1800s, Per Henrik Ling wouldn't even accept a student if they were not in decent physical condition. Now we hear a little talk about body mechanics and some stretching, and hope that the student will eventually "find a way" to not become injured.

As a personal trainer prior to becoming a massage therapist, I was distressed to see so many classmates suffering needlessly. I even started a free student club and conducted group training sessions in preventative and corrective exercises to help them. A secondary goal of the club was to help them understand movement in a meaningful way that would help them better grasp the functional aspects of A&P. This knowledge is critical to efficiently evaluating a client's health history, particularly when musculoskeletal injuries are involved.

For basic maintenance, I recomment the Intu-Flow program from RMAX International. It helps improve pain-free ROM, balance, coordination, breathing, and overall body awareness, and is ideal for a quick warmup before strenuous exercise, and for active recovery on your off days. Info here: http://cstminnesota.com/4.html#IntuFlow

For strengthening, I like dynamic free weights like clubbells and kettlebells, though barbells and dumbells can be fun too. Bodyweight calisthenics, yoga, pilates, etc. can also be great overall strength conditioning. IMO, the key is using a moderate variety of compound movements that require efficient coordination of many areas at once. Some movements should be strenuous, others quick, some light and easy, etc. Exercises that require extension of the body are critical, and should not be overlooked.

Cardio is okay for general health and conditioning, but of limited use in bodywork. Do it after your strength work. 10-20 minutes of intervals is plenty unless you are training for a long endurance event.

Active stretching such as AIS, PNF, yoga, CRAC, should be part of your cooldown and recovery strategy. Passive static stretching is pretty much a waste of time, so pick an active approach and become skilled with it. Active stretching has the added benefit of being very useful in therapeutic applications, and clients can learn how to perform it if you are competent to teach it (self-practice is a prerequisite).

These are very general recommendations, but they will give you a place to start. Hope that helps!
Jason
I see lots of good and helpful replies.
The only piece that seems to be missing is ---- BODY MECHANICS while you are working! It is extremely important to understand and observe good body mechanics while you are doing massage. I agree, you do have to be in good shape in order to maintain good positioning, but you also have to understand correct positioning of your whole body, not just hands and arms. Strength in doing massage should not come primarily from the hands, but from the ground up, using legs to provide the strength.br /> I have been doing massage for 26 years now without any injuries or down-time (well, I've had occasional down-time from other causes but not as a result of doing massage). I used to do 7 massages per day, for years. Now I am down to 3 - 4 per day on most days, but still working!
Great comments posted here.

Schools are getting better at preparing therapists, but I know when I went to school I didn't get trained enough in self care and injury prevention. Legs are definitely important to performing massage. It is essential that we strengthen and stretch the legs as part of our daily routine. Yoga, Wall squats, and lunges are great for the legs. Stretch your hamstrings everyday before and after you do massage. Back extension exercises can help and strengthening your core can help stabilize your back. It is essential to get the Transverse abdominis to activate. The TA attach to the lumbar fascia and help the multifidi fire which help to stabilize the lumbar spine.

I suggest for you to get someone to watch your mechanics as you massage. Make sure you are not bending at your back instead bending at your hip joints? Are you using your legs to transfer power through your core to your arms?

Congenital problems with the spine can be more challenging. I have been there with back pain and most of the time with stretching, strengthening, and proper usage and alignment of the body, low back pain can subside. PT has helped me a lot to stabilize my spine and correct muscle imbalances.

Please check out my book, Creating Peace with Your Hands, for more information on this subject.
Karina Braun
I have been doing massage for 14 years now. Did not have anything major wrong with me in the beginning. Still am doing good. Had little stuff here and there over the years but was able to correct them. For restorative and health purposes I combine yoga and pure strength exercises (push ups, pull ups, lunges). I also play soccer - but that is mostly for fun, although I find that running does me good as well. I also utilize a nice buckwheat heat pack for my low back on the days when I feel drained, tired and the low back is a bit uncomfortable: 2-3 minutes in a microwave, and then put it on a low back kidney area as you are resting on your tummy - if it is right for you, it should feel really pleasant.... keep it on for 15 - 20 minutes, (I often fall asleep for half an hour) and then take it off. A wonderful selfcare method that works on my low back wonders and restores my sense of vitality every time.

All the best,

Roman
Los Angeles, CA
Does this missing piece of body mechanics need to be more stressed at school? I also had the back problem when at massage school and did not hear of any interventions I could take or which modalities could help me. I have had many massages and none have ever addressed the hip imbalance or the uneveness of the lumbar area vs the back! In the 10 years since going to Massage School, I learned and sought out help, first with a chiropractor and now with a core strengthening regimen. The illium/hip imbalance is mostly corrected but the deep core muscles got rather lax and do not support the changes made by the chiro until now. I am trying Super Slo Zone to help my core shape up much faster. Unbelievable results and thanks to an LMT for suggesting one type of therapy that led me to this. I don't want to stop massaging ever so all your replies are very important to me and to other LMTS.
Are there any CEUS that help LMTs with body mechanics if you didn't have this in school?


lee kalpin said:
I see lots of good and helpful replies.
The only piece that seems to be missing is ---- BODY MECHANICS while you are working! It is extremely important to understand and observe good body mechanics while you are doing massage. I agree, you do have to be in good shape in order to maintain good positioning, but you also have to understand correct positioning of your whole body, not just hands and arms. Strength in doing massage should not come primarily from the hands, but from the ground up, using legs to provide the strength.br /> I have been doing massage for 26 years now without any injuries or down-time (well, I've had occasional down-time from other causes but not as a result of doing massage). I used to do 7 massages per day, for years. Now I am down to 3 - 4 per day on most days, but still working!
Karina Braun teaches "Creating Peace With Your Hands" and it is all about Self Care. She offers a free 1 CE hour on a mini course. I had 3 hours with her at the World Massage Festival in June and she is awesome.
I have always used weights (free weights, machine) to keep me strong in all area of my body, not just the low back. Any weight bearing exercise is good for all of your joints, plus muscles and stamina.. I also practice AIS stretching. I hike and snowshoe. The point is...my workout schedule is one that doing massage for a number of hours seems easy. It's not that hard, imo, to stay diligent on your body mechanics too....after awhile it becomes 2nd nature. I've been in the biz for 10 years,will be 55 next month and have 2 illnesses that require extreme diligence to stay healthy....at least by my definition.
I saw her post and the book is being shipped today. I am looking forward to reading it.



Darcy Neibaur said:
Karina Braun teaches "Creating Peace With Your Hands" and it is all about Self Care. She offers a free 1 CE hour on a mini course. I had 3 hours with her at the World Massage Festival in June and she is awesome.

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