Body Mechanics & Safety

Proper body mechanics are essential for career longevity in massage therapy. The average career of a massage therapist can be cut short by repetitive strain injuries to the wrists, thumbs, shoulders, and low back. Using efficient body mechanics prevents injury and allows you to deliver effective treatment throughout a long career.

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Principles of Proper Body Mechanics

1. Use Body Weight, Not Muscle Strength

• Lean into the stroke rather than pushing with arm muscles
• Position your center of gravity over the point of contact
• Let gravity do the work — drop your weight through relaxed arms
• If you're using muscular effort, your body mechanics need adjustment

2. Maintain a Stable Stance

• Knees should be slightly bent — never locked
• Keep feet at least shoulder-width apart for stability
• Shift weight through your legs and hips, not your arms

3. Keep Wrists Neutral

• The wrist should be in a straight line with the forearm
• Avoid excessive flexion, extension, or deviation
• Use a stacked hand position when applying pressure
• Switch to forearms and elbows when possible to protect the wrists
• Common injury from poor wrist mechanics: carpal tunnel syndrome

4. Protect Small Joints

• Avoid overuse of thumbs — the CMC joint is highly vulnerable to overuse injury
• Use forearms, elbows, knuckles, and fists for deep pressure
• When using thumbs, stack them or support them with the fingers
• Alternate tools throughout the session to distribute stress

5. Use Your Core

• Engage abdominal muscles to support your lower back
• Keep your spine relatively straight — avoid rounding or hyperextending
• Power should come from the legs and core, not the upper body

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Table Height

Proper table height is essential for good body mechanics:

• General rule: Stand next to the table with arms hanging naturally. Make a fist — your knuckles should just touch the table surface.
• For lighter work (Swedish, relaxation): Table may be slightly higher
• For deeper work (deep tissue, sports): Table should be slightly lower to allow body weight leverage
• Adjustable tables are ideal for accommodating different client sizes and techniques

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Draping

Purpose of Draping

1. Client modesty and comfort — protects the client's sense of security
2. Warmth — maintains body temperature during the session
3. Legal requirement — most states require draping by law
4. Professional boundaries — reinforces the therapeutic nature of the session

Draping Rules

Draping Techniques

• Top sheet method: Client lies between sheets; the top sheet is folded to expose the treatment area
• Towel draping: Towels used as covers (more common in spa settings)
• Diaper draping: For gluteal work — sheet is positioned to cover genitals while exposing gluteals
• Breast draping: Secure draping that allows chest work while maintaining breast coverage

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Therapist Self-Care

Preventing Common Injuries

Self-Care Practices

• Stretch before and after each session — focus on forearms, hands, shoulders, and low back
• Stay hydrated — drink water throughout the day
• Exercise regularly — maintain overall fitness and strength
• Schedule breaks — avoid back-to-back sessions when possible
• Receive regular massage — practice what you preach
• Maintain good nutrition — support energy levels throughout the day
• Know your limits — reduce your schedule if experiencing pain or fatigue

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Ergonomic Equipment Setup

Massage Table Considerations

Room Setup

• Temperature: 72-76F (22-24C) — slightly warm for client comfort
• Lighting: Dimmable — soft lighting promotes relaxation
• Music: Optional — ask client preference; volume low enough for conversation
• Ventilation: Adequate air circulation without drafts on the client
• Cleanliness: Spotless appearance — first impression matters
• Accessibility: Clear path to treatment room, accessible entrance if required by ADA