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The type of repetitive motions that massage therapists engage in often leads to chronic pain, which can surface in just about any area of the body, from the feet and ankles to the upper back and neck.  

The great irony of being a massage therapist is that the very physical work you do every day can sometimes lead to the same type of chronic pain you are helping your clients overcome. You’re on your feet all day, performing forward-reaching movements in the sagittal plane—think of moving forward and backward through a doorway without touching the frame—and using your body weight to produce considerable force.

Whether you’re currently experiencing chronic pain or are trying to ward off future complications, the strategies and exercises presented here will be a great addition to your routine.  

Preventive Strategies 

Pain prevention is always a better option that pain management. So, let’s start with some preventive strategies that you can use to reduce the likelihood of developing or exacerbating chronic pain as a massage therapist.

The first involves analyzing the ergonomics of your massage table and making sure it is at the right height to allow you to bend from the hips rather than with your back. Bending from the hips will allow you to activate the glutes and hamstrings while sparing the smaller postural muscles in your back keeping the spine in a relatively neutral position.

If your table is too low, you might find yourself reaching with your arms and rounding your shoulders and upper back, which over time can potentially lead to pain in the back, shoulders, neck and head. 

Few things are as debilitating to a massage therapist as chronic hand pain, so it’s important to learn a variety of techniques so that you are not solely relying on your fingers and hands to do all of the work. Another way to prevent overworking your hands is to get training on the use of tools like thumbsavers, rollers, hot stones and cryotherapy.  

Proper footwear is also vital, so be sure to do your research. Common options include a variety of slip-on shoes designed for standing work, as well as running and walking shoes. It may take some trial and error, but finding comfortable, supportive footwear may save you a lot of trouble down the road. 

Another key element of preventing foot pain is working in a proper stance. A split stance, where the feet are hip-width apart and one foot is in front of the other, provides the most stable base for a massage therapist. It may seem like a minor issue but beginning your work from a stable base is essential for proper technique and pain prevention. 

Of course, the best way to overcome an injury is to never experience it in the first place, so identifying the potential causes of pain before the pain actually surfaces is vital. So, evaluate your setup, technique and stance, perhaps with the help of a colleague, and address any concerns that you think may have the potential to cause future pain. 

Choosing the Right Exercise

Before we get to a list of exercises that all massage therapists should consider incorporating into their exercise programs, it’s important to note that these should be part of a well-balanced program that includes at least 150 minutes of moderate-intensity cardiorespiratory training and two resistance-training sessions each week. By combining cardiorespiratory, resistance and flexibility training, you will reap the countless health, fitness and wellness benefits of a balanced exercise program.  

The suggestions below are not meant to represent a full-body, comprehensive training program. Instead, they are suggestions for the types of exercises that massage therapists should consider adding to their workout regimen in an effort to prevent, reduce or manage pain.  

The focus of an exercise program for massage therapists should be on developing a strong posterior chain (i.e., the muscles on the back of the body), which includes the hamstrings, glutes and back muscles. A strong, balanced core is also essential, as stability and strength through the core will help protect the lumbar spine and prevent low-back pain.  

Stretching in an Exercise Program

In addition to strengthening the posterior chain and core muscles, the exercise program should include stretches for those muscles on the front of the body (i.e., the anterior chain). For example, strengthening the upper back (on the posterior), in combination with lengthening the muscles of the chest (on the anterior), will help alleviate any discomfort you may experience in your upper body. 

One final tip associated with flexibility: It’s a great idea to incorporate some basic stretches into your daily routine, including one- or two-minute breaks between clients and a 10- or 15-minute stretching routine at the end of the day. This will go a long way toward alleviating the tightness many massage therapists feel throughout their workday. 

Rotational Exercises in an Exercise Program

Your exercise program should also include rotational exercises to counter the fact that massage therapists work almost exclusively in the sagittal plane. Rotational movements will help build strength in the abdominal obliques and allow freer movement through the spine. 

In addition to muscular strength, there is a muscular endurance factor related to standing over a client for long periods of time and holding that position. Therefore, muscular endurance must be developed to prevent fatigue. Muscular endurance can be achieved by performing sets with a high number of repetitions, as opposed to shorter sets with heavier weights, which target muscular strength. 

15 Exercises to Prevent Pain

The exercises listed below are great choices if you are trying to prevent future pain or manage occasional discomfort as the result of your work. If you are experiencing acute or chronic pain that is inhibiting your ability to work or is heavily localized, seek out the expertise of a  physical therapist or personal trainer who can collaborate with you to create a personalized exercise program.

Be sure to carefully read through the exercise descriptions and modifications so that you—or your personal trainer—can develop a workout regimen that meets your needs and aligns with your goals.  

Also, note that these exercises use a variety of equipment and may need to be modified based on the types of equipment you have available. Visit the American Council on Exercise (ACE) Exercise Database and Library to see additional exercises and build a workout that meets your needs. 

Strengthening the posterior chain: 

Core exercises: 

Stretching the anterior chain: 

Ankle and foot flexibility: 

Rotational exercises: 

Take Care of You, Too

All pain cannot be avoided. After all, massage therapy is a physically demanding job that requires you to be on your feet all day. That said, the creation of an ergonomically sound workspace, along with proper technique and a targeted exercise routine, may help you keep future pain at bay or reduce any discomfort you are currently experiencing. 

Many clients view a massage therapy session as a form of self-care, so don’t overlook the fact that you need to take care of yourself as well, not only to better serve your clients but also to stay as healthy and pain-free as possible so that you can have an active and healthy lifestyle, now and into the future. 

Cedric X. Bryant

About the Author

Cedric X. Bryant, PhD, FACSM, is president and chief science officer at the American Council on Exercise. He stewards ACE’s development of strategies to deliver exercise-science and behavior-change education in ways that are engaging and compelling, recruiting more people to become exercise professionals and health coaches and equipping them for growth in their respective fields. 


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Exercises, SelfCare


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