As we begin to perfect different techniques and learn new skills, we may develop habits along the way that will start to produce less than desirable body postures. In the long-term, this will produce work-related injuries that can eventually lead to the end of a career if the source of the problem is not found. When looking at the work habits of massage therapists and aestheticians, there are many similarities throughout treatment procedures such as sitting, standing, and working with both hands in order to provide clients with the best experience. The pressure applied to clients will vary from massage therapists to aestheticians based on the treatment and the goals they are looking to achieve. The pressure will also vary from one practitioner to another in the same field. When a modality does not require firm or deep pressure, the effect on joints, muscles, ligaments and tendons will be less stressful. The body’s joints are made up of soft tissue and are designed to wear out over time. No matter the body’s position while working, there will be muscles that are over-contracted and over-stretched, which may eventually produce an imbalance. Being aware of how we work and our body align-ment becomes paramount. It is important to work out of choice, not out of habit, and to practice using good positions during professional treatments.
As a result, it is necessary for massage therapists and aestheticians to be aware of their body positioning while they work. I personally did this by putting a massage table in front of a mirror and observing my body mechanics; what I found was very eye-opening. Ultimately, I needed to tweak or change many of my learned ways. Bad habits are not a quick fix but from greater body awareness and better proprioception, good practices can develop.
Take sitting, for instance. While seated, an individual puts seven times more pressure on their lower back than while standing. Many individuals will sit leaning forward, arms in front of them with their head forward and shoulders rounded anteriorly. Every inch of their head comes forward from being aligned with the center of their shoulders (acromial process) doubling the weight of their head on their cervical vertebrae (C7). This added pressure on the disks puts them in a compromised state which can produce a numbness and tingling sensation in the neck, arms and hands with a possible lack of function. On a day-to-day basis, much of their discomfort comes from fighting gravity and trying to prevent themself from being pushed forward. Furthermore, sitting for long periods of time can worsen existing conditions; a stagnant position can produce a lack of blood flow and oxygen to compromised tissue (for example, over-contracted or over- stretched muscles).

"Being aware of how the body works and aligns is paramount to an aesthetician and/or massage therapist’s well-being. It is important to work out of choice, not out of habit, and to practice using good positions during professional treatments."

Therefore, massage therapist and aestheticians can begin by paying attention to how they sit and the small changes they can make to not stay stuck in any one position for a long period of time. For instance, sit with the back straight; bring shoulders back; sometimes stand to vary the body’s position. They might also want to adjust the height of their chair in order to change the angle of their arms.
While standing, there are a few things a massage therapist and/or aesthetician should be mindful of: table height, body alignment, and the power coming from the core of their body. The second two are extremely important to massage therapists due to the pressure they use and the time they spend standing. Moreover, they need to work with both hands equally; meaning they will no longer have a dominant hand. If their arm does not cross the midline of their body, it will help in keeping better alignment, thereby assisting the professional in working with less effort and subsequently minimizing work related injuries.
Many issues come from the professional not keeping their wrist in line with their hand and overworking smaller joints when larger muscle groups could be used. For example, when doing cross fiber-friction, oftentimes the thumbs are used, resulting in the saddle joints being stressed. I would recommend having the movement come from the shoulder in order to use the largest muscle group possible. When performing gliding strokes, the wrist should be kept in line with the hand and both knees should be bent while the back is flat. Then, the professional should lean into the stroke with the power coming from their core. By working out of choice as a massage therapist and/or aesthetician – moving around the table will prevent many overuse problems thereby prolonging the use of their hands throug- hout their career.
Other key components in self-care are the products used and how much is applied to the client. There are four common choices: lotions, creams, oils and gels. Lotions are water-based products which absorb the fastest into the skin; depending on the formula, varying glides from one lotion to another can be found. Creams are made to work like oil but are also water-based and typically have a longer lasting glide to the comparable lotion. The thicker the cream, the more control of the glide. Oils represent the original massage lubricant, giving a greater glide than a cream or lotion. Oils should not contain any preservatives but they might have the tendency to stain sheets if a dispersing agent is not part of the formula. Gels made their appearances in the early 1990s and give the maximum amount of glide, using a blend of wax and oil.
Many will choose products based on touch and what it feels like in their hands. Often, aestheticians will not consider the viscosity and glide of the products they choose. The overuse of product can have a direct effect on your body mechanics, as well as leave a negative impression on your client, such as feeling greasy. This unfavorable result happens when too much product is used, especially oil- and gel-based products which provides greater glide. Overusing product of any type is a waste of money and compromises your control along with your sense of touch. I would much rather reapply than wipe off excess product. I have seen service providers switch from a lotion to a gel with their choice being based on viscosity, not knowing that they are going from the least to the highest amount of glide and not being aware of the product’s attributes.
There are additional concerns for massage therapists who overuse a product and like to apply medium to deep pressure. With too much glide, their pressure will have to have a greater downward force, preventing them from leaning into their stroke. In this position, there could be greater force on their wrist, elbow, and/or shoulder. By reducing the amount of gel, oil, cream and lotion, they will be able to change the angle of their arm and lean into their stroke with a controlled glide, thereby harnessing the power coming from their core as opposed to their arm.

"For the professional, the products used and how much is applied to the client are two key components in their self-care."

If a client is lying in a prone position as their leg is being worked on, the massage therapist should be standing by their knee facing the head of the table. The therapist will find better wrist alignment by using their outside hand when working on the client’s gluteus and lateral upper leg and their inside hand on the hamstrings and adductors. It is important to note that the effleurage strokes can be done with arm power but after the therapist’s muscles have warmed up, the firm and deeper strokes should come from their core. This power can be achieved by the massage therapist bending their knees and changing the angle of their wrist by decreasing the angle of their arm, locking their elbow and letting their body lean into each stroke. When decreasing the amount of product used, the therapist will not have to hold back on leaning in; they need to remember to keep their back flat and to not bend from the waist. When repeated on the other side, the opposite hand will be used, so they will be working with both hands equally.
As a massage therapist and/or aesthetician monitors the amount of gel, oil, cream and lotion used; the height of their treatment table; makes sure to work with both hands equally; bends their knees, making sure to keep their back flat and arms straight; utilizes the power from their core; stays aware of their posture while seated; and changes the height of their chair, they will be working out of choice and not out of habit. Fundamentally, this choice will increase their longevity and help them in solving physical discomfort problems due to work-related overuse.

Bruce Baltz is vice president of education and business development for Bon Vital, Inc. He is coordinating an in-house continuing education program focusing on product awareness and the science behind ingredients. Baltz is an internationally recognized educator with over 28 years experience in the fitness and bodywork industry, a licensed massage therapist in New York and Florida and nationally certified by NCBTMB. In 2010, Baltz was elected to a three-year term as a Board Member of NCBTMB. He developed Deep Tissue Healing; “The Art of Stone Massage” in 1999 and in 2003 founded SpiriPhysical, Inc. In 2004, he brought Active Isolated Stretching (AIS): The Spa Method to the spa community.