Massage therapist self-care: Wrist pain

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Are you a massage therapist with wrist pain? It's not uncommon, but it doesn't need to be that way. In this video, I talk about ways of changing your routine to allow your wrists to recover from massage-related aches and pains, ways to promote speedy healing, and how to prevent injuries in the future. By listening to your pain, and through stretching, strengthening, and self-massage, we'll get you back on the road to happy wrists.

Disclaimer: If this pain is new or unusual, if it persists, or if it worsens, please do consult a doctor for evaluation.

Phase I: The Wrist Vacation (1:20) Yes, this is as scary as it sounds. While we can't completely remove your palmar hands/wrists from the picture, we can emphasize other moves that don't cause wrist discomfort. We can also change the angle of pressure, using 90 degree carpal pressure less often. Finally, double up and support your hands during each massage stroke. Think of this as a time to be creative and explore all the tools at your disposal. This time of minimal palm use should last at least two weeks.

Phase II: Icing and Wrapping (4:50) While your wrists are inflamed or just tweaked, I recommend ice twice a day for the first 1-3 weeks. Think no more than 10-15 minutes. During that time, if your wrist gets numb, remove the ice and do some gentle movement until sensation comes back, then repeat until the time is up. If you're doing ice immersion, keep it under 10 minutes. Keep your wrist wrapped for at least 4 hours out of your day, using either a brace or an ace bandage. Don't sleep with compression applied unless your doctor gives you the okay.

Compressive ice wrap: http://amzn.to/2blzFuP

Phase III: Gentle Self-massage (7:13) Use easy warm-ups and pin-and-stretch techniques on your forearms throughout your day, starting after the worst of the pain has subsided. Continue these... well, indefinitely! They're great for keeping these tissues from becoming more and more tonic over time, and can keep your wrists and forearms in good shape. Once your wrist has moved out of the acute pain stage, you can start implementing the gentle myofascial release for the forearms shown in the video. Think slow as molasses, taking up to 5 minutes per arm. Add in active engagement as your pain reduces further. Do one repetition per day in order to see how your body responds, and increase to two if you find that helpful. Continue until about week 4 (or forever, if you want).

Phase IV: Stretching and Strengthening (12:19): Stretch your wrist flexors and extensors gently and frequently, starting after the acute phase of pain is over. I recommend about 2-3 sessions per day, with 3-5 gentle repetitions of each stretch. Each session should take you about 2 minutes.

Strengthening doodads:
Wrist curl thingy: http://amzn.to/2bS8jZU
Flexbar (wringing exercises): http://amzn.to/2bS8MeK

Freeweight exercises:
Flexion: http://www.exrx.net/WeightExercises/W...
Extension: http://www.exrx.net/WeightExercises/W...

Do weight training exercises at your own risk. Go slowly, use less weight than you think you need to (especially at first), and consider consulting a professional if anything hurts or just feels too awkward.

Phase V: Reintroduction of Palmar Pressure (15:50) After you've done at least a month of resting, self-massage, stretching, and strengthening, you might want to try using those old palmar massage techniques again. Your forearms will be happier and stronger, you'll have more alternative techniques at your disposal, and you'll be less likely to do things that caused your pain in the first place.

That said, don't be afraid of your wrists! They're capable of a lot, now more than ever. Just keep your eye on the fatigue you feel during your massages, and switch techniques/strategies before discomfort sets in. Keep your routine varied, and try to err on the side of using less extreme angles when applying palmar pressure.

That's it! Let me know what you think, and whether you have any wrist tips of your own. If your pain doesn't resolve, or if it gets worse, please do see a medical doctor for evaluation and treatment.

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