Issue link: https://www.massageandbodyworkdigital.com/i/790815
I DID IT MY WAY (FOR A WHILE …) Remember the famous Frank Sinatra song "My Way"? Well, that's how I did massage for the first 15 years of my career. I used my upper body to generate pressure, and I did a lot of forearm work even though my shoulder was iffy. Eventually, however, doing it my way caught up with me. My massage injuries accrued (cubital tunnel syndrome, cervical radiculopathy) and suddenly I was forced to figure out different ways to get the job done. It took me some time, but eventually I devised strategies and adopted techniques that didn't trigger my conditions. At one point, I realized that most everything I was doing in the massage room to take care of my body had a common element: a neutral (not flexed, extended, or rotated) back. WHY A NEUTRAL BACK? When I think of the importance of a neutral back, I think of my client Doug who hurt his lower back while brushing his teeth. Doug was leaning over the sink with his back slightly arched, and that's when his lower back locked. Doug's story is not uncommon. In fact, over the past 25 years, I've heard many stories from back-pain clients who have tweaked their backs doing simple, everyday actions, like turning in the shower to reach for the soap. I've found the same to be true when doing massage. I discovered there was a strong association between my back pain and the position my back was in at the time of the pain. When I could find the neutral position for my back, the pain often went away. Though the root cause of back pain can be complex, can vary from person to person, and sometimes is never known, it's reasonable to speculate that a trigger for a back-pain episode could occur when back neutrality is compromised. The questions then become: How can I establish back neutrality? How can I maintain back neutrality throughout the massage? THE MASSAGE TABLE FACTOR The foundation for keeping back neutrality and maintaining good posture when doing a massage hinges on the relationship of your legs to the massage table. If you can lean into the table with one or both legs, the table will help support your body weight and you'll be in a perfect position to establish and maintain a neutral back. Picture my client Doug brushing his teeth when he injured his back. His legs are straight and his lower back is rounded as he bends over at the sink. (This is the same flexed lower-back position I want to avoid when I'm doing a massage.) 78 m a s s a g e & b o d y w o r k m a r c h / a p r i l 2 0 1 7 Now, imagine Doug brushing his teeth with his legs apart, knees bent, the front of his thighs leaning into the vanity, and his back neutral, not flexed. In this scenario, Doug is using the vanity as a support to help him stay upright. Instead of flexing his lumbar spine, he has shifted his weight to the balls of his feet, causing his hips and back to move forward. That means he doesn't need to flex his back to be over the sink because he has moved his whole body closer to the sink. From this supported position, it's easy to maintain a neutral back. The same is true when I'm at my massage table: the more I can use the massage table to support my weight by leaning a thigh or both thighs into it, the easier it will be for me to maintain a neutral back. Now, let's look at four ways to practice good posture while doing a massage.