Ergonomic Considerations for Practicing Massage Therapists.

The physical demands and repetitive movements performed by massage therapists during a treatment increase the risk for work-related musculoskeletal disorders. While massage therapy meets the level of heavy physical demand, the ergonomic risk of performing a massage was previously unknown. The Massage Therapy Foundation undertook a job task analysis to be used by educators, employers, and clinicians to create an optimal work environment. Data collected via survey were used to create the protocol for an onsite data collection where massage therapists were evaluated on the ergonomic risk factors by trained ergonomists. The results of the job task analysis found the highest variability in movement when the massage therapist was treating the neck prone, neck supine, and leg prone. When the massage therapists did not change positions during a stroke, there was increased forward flexion of the trunk which increased postural stress on the extensors of the back and neck. Strokes such as effleurage which can span the entire length of the body part had the highest cumulative load, requiring postures that put mild biomechanical stress on the shoulders (90% of the time), neck (70% of the time), and trunk (60% of the time). The forward-bending posture of the massage therapist increases the eccentric demands of the therapist's neck and back musculature, thereby increasing fatigue and leading to an increase in the chance of overuse injury. The job task analysis recommends the massage therapist monitor the duration of application in an unsupported position, take more time between sessions, work in an optimum environment, including correct table height, and have a healthy, active lifestyle to maintain career longevity.