Manual Therapists: Training Tips to Stay Healthy on the Job

In my experience of training this special population, certain considerations must be taken into account in the weight room.

rack position, rack carry

Massage therapists and other professionals who practice bodywork do wonderful things for people. However, it is estimated that as high as 80% of professionals in this field dropout after two years. This is in part due to common ailments like finger, wrist, neck, shoulder, elbow, and back injuries. Also, according to the Bureau of Labor Statistics, the average salary for these practitioners was $35,970 in 2012.

This leaves massage therapists with a tough choice – work more hours in order to pay the bills, but risk injury and burnout in doing so.

Given my strong affinity for massage and my experience training several therapists, I felt I must help. It would seem the basic goals of getting stronger and increasing work capacity would be the primary ones of a practitioner looking to take more clients and survive more years. However, in my experience of training this special population, certain considerations must be taken into account in the weight room.

“Bodyworkers should pair together grip-friendly exercises and get an elevated heart rate while still putting the body under tension.”

If you are a bodyworker concerned with the health of your own body, in addition to that of your career, then read on. (These would also be good for anyone else who works with their hands and on their feet all day.)

Avoid Grip Work

Farmers carries, barbell complexes, and high-volume kettlebell swings are great for increasing capacity and strength. Unfortunately, these methods tax the grip. A massage therapist absolutely cannot burn the grip and expect to handle a client load. Instead, bodyworkers should pair together grip-friendly exercises and get an elevated heart rate while still putting the body under tension.


5 rounds:

  • 10 kettlebell swings
  • Walking lunges with weight vest or backpack

3 rounds:

  • Plank on elbows for 1 min
  • Rack carry, switching from right to left halfway

3 rounds:

  • 15 goblet squats
  • 10 push ups

The rack carry simply means keeping a neutral wrist on the kettlebell, squeezing your armpit, and locking your elbow down. Walk for a distance and switch arms. It should be heavy enough to make your arms, lats, and midsection work hard.

rack position, rack carry

Protect Your Wrists

Wrist extension, like what happens in a push up, can be an aggravating position. The last thing a massage therapist or bodyworker needs is irritated wrists. Instead, try using push-up bars or suspension straps to limit wrist extension in pushing movements.

Watch Your Shoulder Position

Giving a massage tends to force you into a hunched over, downward-pushing position. This imbalance can lead to a locked-up thoracic spine and increase the risk for a shoulder injury in overhead movements. I love a good thoracic-spine opener and batwing planks are quick and easy ways to get the shoulder blades moving in different planes. In addition, batwing planks are not taxing on the grip when compared to rowing movements.

To do the batwing plank:

  • Make sure your body is tight like in a regular plank.
  • Constantly think “thumbs to armpits.”
  • Hold for thirty seconds to a minute.
  • You can increase difficulty by moving your feet further from the wall.

plank, batwing plank

Take Advantage of Active Rest

Your warm up and the time between sets will be valuable for doing the little corrective exercises nobody wants to do. Think of these periods as useful rest and take advantage of all your workout time. Drills like the T-spine opener and a cross-pattern movement below will be great choices between sets. They help with posture and the up and down off the floor adds a heart rate benefit.

  • T-Spine Opener – Take your time with these and think of opening your chest toward the sky. Push your stance arm through the ground.

  • Dead Bug – Has similar benefits to a birddog movement, but without putting the wrist in that push up position. Do this in a position comfortable for your level of flexibility and make sure your lower back doesn’t arch too much.

Remember to Eat

Increasing your hours worked often means less time for nutritious food. You also always have lotion on your hands, and due to the proximity of your profession, you cannot afford to have bad breath. So, always keep these foods on hand:

  • Bananas
  • Nuts in a tube bag so you don’t need to put them in your hands
  • High-quality nut and fruit bars
  • Mint dark chocolate bar

Control Inflammation

Regardless of how well prepared you are, a demanding job will still have the risk of causing inflammation and anything with “-itis” at the end. Curcumin plays a role in controlling inflammation, and is relatively safe compared to NSAID drugs such as aspirin. You can try a supplement or cook with the spice turmeric as often as you can.

Optimizing Work Performance

Keep in mind: these suggestions aren’t regressions. They are just different ways to get the desired result. I want you to know that you can still look great and feel great at the same time.

As a bodyworker, you just need to be mindful of certain exercises and add in the ones that increase your ability to work, rather than detract from it. With some nutritional planning and tweaks, you should be able to optimize your work performance and make more money without pain.

Check out these related articles:


1. Blau, Phd Gary, Phd Christopher Monos, Phd Ed Boyer, Jd Kathleen Davis, Phd Richard Flanagan, Phd Andrea Lopez, and Phd Donna S. Tatum. “Correlates of Injury-forced Work Reduction for Massage Therapists and Bodywork Practitioners†.” IJTMB International Journal of Therapeutic Massage & Bodywork: Research, Education, & Practice 6, no. 3 (2013).

2. He, Yan, Yuan Yue, Xi Zheng, Kun Zhang, Shaohua Chen, and Zhiyun Du. “Curcumin, Inflammation, and Chronic Diseases: How Are They Linked?” Molecules 20, no. 5, 9183-213.

3. “Summary.” U.S. Bureau of Labor Statistics. January 8, 2014. Accessed August 8, 2015.

Photo 1 courtesy of Shutterstock.

Photos 2 and 3 courtesy of Marc Halpern.