Reddit reviews Save Your Hands!: The Complete Guide to Injury Prevention and Ergonomics for Manual Therapists

When I was fresh out of school, still working a full time job and doing massage on the side, I ended up here. I went to a local therapist who had been practicing massage alongside her husband for over 20 years. While she did amazing neuromuscular work on me I asked how they had been able to practice for so long. Did they trade with each other often or what? Her answer surprised me, and honestly changed my life. She said they actually hardly ever worked on each other and both depended on daily yoga practice to keep them in good condition. She said 2 hr a day would be her ideal but anything on a daily basis helps.

I took her words to heart, found Yoga With Adriene on YouTube and never looked back. Personally I find a mix of strength training using the Stronglift 5x5 program and yoga to be very effective. I work at one of the best paying, busy places in my area, yet I cannot afford to get massage and bodywork except when I absolutely need it, maybe 4x per year. So I really do depend on staying healthy on my own. However it take a lot of time and dedication and sometimes life gets in the way. So here's what I've found for crisis times when I'm not able to do my regular self care:

1. Expanding modalities and techniques makes a huge difference. Hot Stones are soothing to tired hands and soften the tissue making our job easier. Ashiatsu uses the feet, only requiring hands and arms for balance. It's also great for people who like very firm pressure. Thai, or table thai, is extremely effective and when mixed in with other techniques will really make deep tissue a lot easier on her. Any type of myofascia work will be much easier and more effective and will change how she approaches the body and teating pain. If her school didn't train her well in the big difference between deep tissue versus very firm pressure it's time for her to educate herself and perhaps take some neuromuscular classes, or a continuing education course that teaches specifically addressing, say, cervical issues.
   
   
   
2. Massage Schools or continuing education are her best non-hands massage options. Personally, due to my almost unlivable wages, despite a great workplace and generous clients, I am planning to pursue IT as even entry jobs start around 50k.
   
   
   
3. See if she can tolerate very gentle massage from you. Book her a massage with someone she likes. If you have any skills like working on cars or home repairs see if any of her coworkers or peers would be willing to trade with you for working on your partner. You could also get some CBD oil. It should be legally accessible in all states and provides a lot of benefits and relief for most people. In a topical application it helps with inflammation and pain relief by reaching local endocannabinoid receptors in the skin. You need to use a strong product so it is effective, as skin isn't the most effective means of delivery as it never reaches the bloodstream. I personally highly reccomend taking it internally as well, but not everyone is comfortable starting out there and topical is a great option for relief. Also pay attention to whether or not she is burnt out. Burn out can cause severe pain levels that have more to do with the stress the individual is under than what they are actually doing, and massage therapists are at high risk for burn out.
   
   
   
4. Your partner should also be saving her thumbs for when they are absolutely necessary and get comfortable using her forearms a lot. Remind her to check her body mechanics and maybe read Save Your Hands. She could try some hot/cold contrast baths in the kitchen sink with hot water on one side and ice water on the other. Fully submerge her hands, wrists, and as much of her forearms as possible. I like to do 90 seconds cold and 30 seconds hot. Get some carpal tunnel wrist wraps as well as elbow compression sleeves. She should throw these on immediately after work and whenever possible otherwise, but don't allow them to cut off circulation. She also should be trying to sleep on her back as much as possible so more irritation isn't occurring at night. Ultimately she needs a break and should take off as much time as you can afford. But it's quite likely that with proper care if she wishes to continue as a therapist she will be able to. And as always, seek proper professional medical advice from your primary care physician if your concerns continue.
   
   Edit) apologies for formatting as I'm on mobile. If anyone can tell me how to add breaks between bullet points I'd be grateful.

I use a hot-cold contrast bath at the end of a day where I'm feeling like my hands have been stressed, and that's been effective for me to avoid injury. It sounds like you've already incurred some injury to your fingers/hands from the work you've been doing. Long term rest might be what you really need for the injuries to heal.

Deep tissue work is hard work. And it's way too easy to find yourself in the territory of overuse and repetitive stress injury. Practicing multiple deep tissue sessions with no break between is a recipe for injury. And it sounds like you've got some injury, especially with the sharp pain in the knuckles.

"Save Your Hands!" by Laurianne Green is a pretty good book about dealing with injury and injury prevention for massage therapists. I've been reading the original 1995 edition, but it's since been updated.

Treat this pain seriously. It's a signal that you've used your body too much and you need to rest and heal. In the long term, you might need to change the way you practice so that you can continue deep tissue work in a sustainable way (e.g. take some damn breaks).

The protocol I use for hot-cold contrast bath:

• Fill two basins with water. One hot (at least 105, but experiment with getting as hot as you can stand without burning yourself). The other cold (at least 50, but colder if you can manage it). Adjust the temp as you go as necessary.
  
• Start with the hot basin. Submerge your hands for 1 minute.
  
• Pull your hands from the hot basin and immediately plunge into the cold basin. Submerge for 30 seconds. Move your hands gently around in the water; the water immediately surrounding your hot hands will have heated up, so moving them around keeps you in contact with the coldest water.
  
• Switch back to the hot basin, submerging for 1 minute, moving your hands gently around to keep in contact with the hottest water.
  
• Repeat the hot-cold cycle 3x (1 minute in hot, 30 seconds in cold), ending with your hands in the cold basin.
  
• After your last pull from the cold basin, dry off and let your hands return to normal body temp on their own.
  
  The hot-cold contrast bath has worked for me pretty effectively. That said, I've done it as soon as I feel any stress in my hands, and so far haven't experienced any long term pain issues. Your mileage may vary. Void where prohibited. Ask your doctor if hot-cold contrasts baths are right for you.
  

In that case I implore you to take body mechanics very seriously and take responsibility for figuring it out on your own. In my 14 years of doing this I've watched a lot of people crash and burn. With poor body mechanics, a good chunk of therapists only last 2-5 years.

Save Your Hands is a great book. It's a little pricey, but well worth the info. If you buy it used just be aware that the 2nd edition is 333 pages vs 159 pages for the first edition (I only have the 1st ed so I can't really comment on the updated content)

If you're a member of ABMP there are a few free courses dealing with body mechanics (not sure about AMTA)

Having a full length mirror where you can see yourself while working can be helpful as well as asking a experienced therapist to observe you while working on someone.

Don't overuse your thumbs! It's easy to do and will become an issue faster than a lot of other body parts. Use your leverage and body weight to your advantage (try leaning your fingers into your table while raising your front leg off the ground and see just how much pressure you can get with little effort)

Make sure your table is the proper height! For me a good rule of thumb is when making a fist with my arms straight down, my knuckles are at table level.

It's ok to jump out of good body mechanics from time to time, but you need to be aware of what you're doing.

If something is painful while doing it, Stop! Find a different way of doing it or accept that that particular move is not good for you.

Be well rested and well nourished before your sessions and have quick, healthy snacks on hand. If you're tired or hung over, your body mechanics are the first thing to go out the window. It's normal to feel a bit tired after doing a bunch of sessions, but if you're feeling completely wiped/energetically drained you probably need to work on your grounding and centering. It's normal to be a little tired/sore at first as your massage muscles start to develop. Hope this helps!