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Keeping healing hands from harm: Prevention is better than cure

by Lisa Rose August 14, 2015

Close up of a massage therapist's hands whilst they massage a client's feet

As massage therapists, we can end up working our bodies exceptionally hard. We become so familiar with the routines and techniques that we do develop a certain level of resilience with time. However, this resilience isn’t always our friend, as it can disguise the onset of injuries. We tend to power on through aches and pains in the name of doing a good job. But if we care about our own health and wellbeing as much as we do about our customers’, it would pay to give a little extra attention to our own wear and tear. The length of our careers could depend on it. Injury is probably one of the worst things that can happen to a massage therapist, if massage is your bread and butter, so for that among other obvious reasons, self-neglect should not really be an option.

Even the most proactive of therapists can’t say for sure that they won’t suffer an injury at some point. The most common of these injuries seem to be those sustained by our hands and arms. So what are the most common of these, and what are the best ways to protect our hands from lasting damage?

Carpal Tunnel Syndrome

Most people have heard of Carpal Tunnel Syndrome, or know somebody who has had it. It’s fairly common even in those who don’t massage. I have experience of this in my own family, though thankfully haven’t had to deal with it myself. My father had a painful operation on his hand thanks to this one, so I know it’s one you’d want to avoid; the operation left his hand scarred and misshapen, and it doesn’t function quite the same way as it used to. Carpal Tunnel Syndrome occurs within the Carpal tunnel in the wrist, where nine tendons operate the finger flexors and median nerve. Therapists who have taken an in depth Diploma or something more thorough may be aware of the biology affected by this condition. It causes motor sensory or dysfunction by compressing the median nerve. It is down full extension of the wrist joint and finger flexion, so can happen to those who work a lot on computers too. It is extremely painful and because nerve tissue doesn’t heal quickly, you could find yourself out of work for an extended period, if not for good. Once this condition has set in, you will need to find as many ways as you can to reduce the pressure on the nerve, to prevent it from getting progressively worse.

How to avoid it

Because you are using your palms to create pressure, this can also be problematic, so it would be sensible to find other methods of creating this pressure too. You can try supinating the forearm or the ulnar side of your hand, to give the center of the wrist/palm a break now and then. Forearms and elbows certainly offer equally good opportunities to create pressure if a strong massage is required. Conditioning the arms and wrists through stretching activities is a must, as well as massaging yourself between treatments.


Pain or injury to the hands and arms seems to be up there at the top of the list with back problems. Tenosynovitis causes pain at the base of the thumb and is caused by adhesions between tendons and the synovial sheaths around them. It occurs as a result of repetitive use of your thumb tendons, but the movements that cause it are very difficult to avoid as a massage therapist, given that they are part of the most basic techniques. This debilitating condition can get progressively worse if you don’t take time out, so it’s definitely best avoided in the first place if you can.

How to avoid it

Awareness is key. Pay attention to those small twinges and aches that might seem intermittent. You never know when they are going to start showing up more regularly. To prevent this from taking hold, it is important to condition your hands by stretching out the tendons before and after every massage you do. You can actually massage your own hands, with special focus on the affected tendons; this should reduce any adhesions occurring in the area before they become a problem.

Last but not least, we should be paying attention to other details of our lives, like our nutrition, relaxation and mental wellbeing. Stress is a known contributor to many conditions, and without the correct nutrition our entire body can become unbalanced, paving the way for injuries to take hold and fatigue to prevail. If we are not spending enough time resting and recuperating after the strenuous activity that is our average working day, we are allowing all of the little things to combine and create a potentially big thing – poor health or permanent injury. 






Lisa Rose
Lisa Rose


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Massage Table Size Guide

Massage tables comes in many different shapes and size. It can be confusing for you, the customer, to choose the right one but we are here to help!

A lot of customers call us up after they have bought the wrong size massage table elsewhere and we would like to help you avoid this mistake. It normally goes something like this; they like the look of a picture of a massage table on a website, they like the low price and then they check the carrying weight is ok. If the carrying weight fits their needs they click add to cart and the new massage table turns up at their doorstep in a few days. They unfortunately assume all massage tables are pretty much the same width and size.

The standard size of a massage table is 28 inches wide (71cms) and 73 inches (185cms) long. One of the reasons many "lightweight" budget massage tables are so cheap is because

  1.  They are smaller in size (normally around 61cms wide) and as such have less materials
  2. They are sold by specialist retailers who also sell anything else they can import and turn a profit on. As such they just buy the cheapest massage tables they can find in China. They go for smaller sizes as they are cheaper.

Make sure the massage table is the right size for you and your clients as the narrow massage tables at 61cms can be very uncomfortable for anyone who isn't petite and many clients cannot relax with their shoulders and arms unsupported.


The Width of the Massage Table:

Almost all therapists choose the standard 28 inch wide massage table. All our massage tables are the same length so it is only the width and shape our customers need to decide on.

Your massage table should be wide enough to cater for the wide variety of shapes and sizes of your clients. It needs to be wide enough to comfortably accommodate your treatment style, while being narrow enough to ensure you don’t have to strain your own back during treatments.

Each therapist's postural training and ability is different, so only you will know what massage table width you can handle. We have spoken to therapists who are five feet tall and get the wider 30 inch massage tables, and we speak to six foot therapists who have back problems and go for a 25 inch wide massage table. Everyone is different.

Generally speaking, if you are of smaller stature, you may do better with one of the narrower 25-inch massage tables. If you're quite tall, or are particularly keen to offer your clients a very spacious experience, a 30-inch massage table might be more suitable.

If you are in doubt, see if you can go into your local training college and see whether the massage tables there suit you. However, there is another way to get a feel for what will work of you don’t have access to a couch when you are deciding:

Cut out a piece of cardboard to the dimensions of both sizes you are deciding between. Put it on top of the kitchen table and lean over it. Visualise a client lying there, and see which width will suit you and your client best.

measuring the width of a massage table

Make sure you can get close enough to the table that you can pivot at the waist and have your shoulders squared to the clients hips, with your hands parallel to the clients' spine. Working in this position will ensure an injury-free career, so it's an important factor in your decision.

The most popular massage table widths are 28 and 30 inches. We sell 25-inch massage tables but you should really only choose this width if you are shorter in height and having a wider massage table might put your own back at risk over the course of your career.

You can also choose the 25-inch if you want to have the lightest massage table possible. By reducing the width of the massage table, the weight is also reduced. Now, this can mean a trade-off of some client comfort, but this trade is often worthwhile if you are a fully mobile therapist and use public transport frequently, where saving a kilogram or two will make a difference to you over time.


The Height Of the Massage Table

Nowadays, almost all portable massage tables come with height adjustable legs. Whichever massage table you choose should come with a large height range to accommodate you, and to cater for a broad range of therapies.

A common height range of massage tables is between 60 to 80cm, and this height range should cater for everyone. To check which height you need your massage table to be at follow this rule of thumb:

1. Stand up straight with your hands by your sides. Clench your fists.
2. Measure the distance between the floor and your knuckles
3. This distance should equal the height of your massage table.
4. Add a few inches in height to allow for the body of the patient on the massage table.

The height of a massage table is usually only adjusted when different therapists are using the same massage table, or if you have a client that is outside the average size you normally treat. So for example, if someone with a lot of body depth comes for a treatment after an average size person, you may need to adjust the height a notch or two.

You should be able to adjust the height of a massage table in just 2-3 minutes. Even though you mightn't adjust the height very often, the faster the better when you do have to!

There are 2 types of height adjustment mechanisms found on modern massage tables.

1) Twisting knobs (found only on wooden massage tables):

If you are working with a wooden massage table, it is better to have two knobs on each of the four legs for greater strength and reliability. When buying online, make sure to check how many knobs are on the legs. Cheap massage tables often only have one knob, and when you raise the legs to the highest heights they are less stable and have been known to snap.

2) Telescopic push-buttons (found only on aluminium massage tables):

The mechanism to adjust the height of an aluminium massage table is much the same as the push-button method on aluminium crutches. It only takes a few seconds to adjust each leg, and the mechanism is very reliable. Check out the video to see how it’s done.


Massage Table Shape:

The following are the different shapes of massage tables on the market.

1. Rectangle shaped with square corners 

This is the traditional shape of a massage table and the one you are probably familiar with seeing. Our Combi-lite 3 in 1 and Affinity Portaflex are shaped like this.

2. Rectangle shaped with rounded corners

Same as no 1 above in every way except the corners are rounded. Does not affect function in any way, just a different design/look.


3. Hour glass shaped with gradual gradient 

A fabulous massage table innovation in recent years, which solves a lot of the problems around choosing the correct width is the hourglass shaped massage table.

This style of massage table is wider at the ends, and tapers somewhat at the middle. This provide a spacious and comfortable experience for your client (as the shoulder and feet area are 30 inches wide) without compromising your own posture and health, as the middle of the couch where you lean over is a much narrower 26 inches wide.Having recently upgraded to one of these hourglass massage tables myself, I can vouch that my working days are much more comfortable, and many of my clients have commented on the extra comfort from the wider shoulder area.


4. Hour glass shaped with sharp gradient
Same as point above but instead of the it gradually going from wide to narrow, the massage table changes quickly from normal width to narrow width so people of very short stature can get in close.
5. Oval Shaped

 The name says it all! There are no corners on the massage table. Therapists normally choose this for one of two reasons. They simply like the look of this massage table and it is aesthetically more pleasing in their treatment room and/or they find it easier to move around the massage table during the treatment without having to side step the corners. This is particularly handy when space is limited in your treatment room.

oval massage table


Have any questions or comments about anything above? Please let us know in the comments below!