Massage is a physically demanding, hand-intensive activity. As massage practitioners, it’s important for us to look after our hands (and bodies) in order to maintain our careers.
So today, we wanted to highlight some aspects of the common massage repertoire that puts pressure on your thumbs - the most vulnerable parts of your hands. We also look at four ways of reducing strain on them.
In daily life, half of the actions around using our hands, involves our thumbs, and it’s similar when we massage.
We use the thumbs a lot to apply pressure. Why do we do this? They are firm (the bone) with a padding cover (flesh), so they are perfect for applying focused pressure on small areas. And they have a concentration of sensory nerves in the pads, which enables us to identify the client’s tissues and tensions, and to monitor their responses to the massage.
So how can we protect our thumbs to help us sustain our careers?
The thumbs are the area that we most often fatigue or strain in our work. The sensations generally occur in the base of the thumb (the carpo-metacarpal joint - CMC joint) where the thumb joins the hand. This usually develops from regularly applying pressure with the thumb bent back (hyper-extended).
So, in massage sessions, it’s important to avoid letting our thumb(s) bend backward when we apply pressure. This can be quite a challenge if it’s a familiar habit, but it’s important to look after your thumbs and sustain your career.
If you feel that you need to press with your thumb you, can support it from both sides by:
This is one simple way of looking after your thumbs in action. There are many others, so search them out.
Note: If you have small, slender or hypermobile thumbs, you need to be EXTRA CAREFUL about how you use them, as you are more at risk of straining them than people with bigger, stronger thumbs.
Hypermobile thumbs - more vulnerable to problems.
Save your thumbs whenever you can. For example:
Wringing with thumbs next to fingers.
Next time you’re massaging, try to;
1. spot just one opportunity where you can reduce the use of your thumbs
2. have a shot at figuring out how you can take your thumb out of the picture for that particular technique you’re doing
3. Imprint the result in your mind for next time
Then apply those 3 steps again during each massage. This way, you will slowly but surely bring more awareness to reducing the amount you use your thumbs and discover ways to work differently.
And if you forget to do this during sessions and you find yourself unconsciously rubbing your thumbs to relieve pain/strain, take your mind back to your massage sessions for a quick ’self reflection’ session, to see if you can think of what you did that could have contributed to your pain or strain.
You can also save your thumbs by using larger parts of your hand e.g. knuckles or fist, to apply pressure. Be careful though as you can create other wear and tear if you don’t use those ‘tools’ with consideration.
Using side of fist.
As per the suggestions above, try to experiment with this during your massage sessions.
And the ultimate way to save your hands altogether, is by learning ‘Hands Free Massage’. In a nutshell, the principle of Hands Free Massage (HFM) is using your forearms and elbows skilfully and sensitively. This makes it easier to apply firm pressure, when appropriate, with less effort and helps you to replace the use of your hands for much of your massage repertoire.
Using elbow (carefully).
Note: It’s very easy to use your forearm in a clumsy, awkward or insensitive way. For you, this may result in straining your own shoulders and back.
Using the forearms or elbows in an insensitive and ‘gung-ho’ manner, can also result in pain for your clients.
So, if this is new territory for you, it’s important to get good training in Hands Free Massage with experienced tutors, so you can learn to work with your forearms and elbows in a skilful and sensitive manner.
Of course it’s important to receive regular massages as part of your self care regime. And if you’re starting to experience strain in your thumbs, it's important to seek out a physiotherapist, remedial therapist or sports injuries expert to give you specific treatments and remedial exercises.
However, regular self-massage will help look after your thumbs. First, let's look at the anatomy of the thumb. There are two groups of muscles that control the thumb;
It’s easy to use a small rubber ball (e.g. a squash ball) to massage the thenar eminence;
Ball under thenar eminence (base of thumb).
A simple way to work on the thumb muscles in the forearm, is to squeeze them;
And of course, once you have had some Hands Free Training, you can progress to using your forearm or elbow to massage the other hand.
Squeezing thumb muscles of forearm while moving thumb.
Please look after your thumbs, they’re the only thumbs you have.
We hope we’ve highlighted the importance of paying attention to how you use your thumbs and given you some useful suggestions for looking after them. Please don’t strain them, or your other fingers for that matter. Work consciously to save your thumbs, hands and wrists so you can have a long and rewarding career in massage.
About the Authors
Darien Pritchard from Dynamic Massage and Hands Free Massage Training, has been a massage trainer since 1982, and has served on the General Council for Massage Therapy (UK). He wrote the career-maintenance book Dynamic Bodyuse for Effective Strain-Free Massage (2008), and the student text Anatomy, Physiology and Pathology for Massage (2nd ed, 2023). For three decades, Darien has pioneered a focus on how massage practitioners can protect their hands and body whilst using them most effectively, including developing Hands Free Massage - the skilful, sensitive use of the forearm and elbow to save the hands.
