Massage Injury Prevention: How to Save Thumbs + Index Fingers

At first, this is not going to sound like a massage injury prevention guide for your thumb and index fingers, but it really is.


Your client, Taro, is waiting on the table. When he was changing you had grabbed a quick snack, but then remembered that you nails were like daggers.

You frantically fumble for your nail clippers but know if you don’t get in that room like now, Taro is going to be major grumpy. You decide that you only have time to cut 3 nails per hand. Which 2 nails on each hand are you going to leave uncut?

Let me see if I can guess…


…could it be these two?!

Let’s take this a step further. Here are two hands. The fingers are numbered 1 – 5, starting with the thumbs.

If you taped your 4th and 5th fingers to your palm, could you do a massage?

Yeah, no problem, right?

Now imagine that 1, 2 and 3 are taped down to your palm. That massage ain’t happening, is it?

For me, fingers 1 and 2 do the most massage work. Finger number 3, the middle finger, comes in third. Finger 4 gets used some. And finger 5 is basically along for the ride unless I’m squeezing which I rarely do (Trap Release Without Squeezing).

Years of Overuse Can Cause A Massage Injury

Now imagine what happens after 20 or so years of primarily using fingers 1 and 2. It’s a massage injury waiting to happen, right?

Here’s a common sense but under-utilized strategy that will set you on a course to saving your thumb and index finger.

The strategy is: Take the workload off the overworked parts. Also known as use overworked parts less.

Prevent thumb and index finger injuries by using the other fingers more. Click To Tweet

How to Prevent a Finger Massage Injury

Experimenting with Fingers 4 and 5

For the longest time, when it came to massage, fingers 4 and 5 were decorations on my hand.

But when fingers 1 and 2 started to feel persistently tight, I started experimenting with offloading some of the work to fingers 4 and 5.

At first, it was like trying to eat with my non-dominant hand. But after a few months, fingers 4 and 5 started to adapt, and fingers 1 and 2 got happy again.

Substituting fingers 4 and 5 for fingers 1 and 2 has its limitations, but the substitutions work particularly well in these situations:

Three Ways to Use Fingers 4 and 5

Supine Occiput Work

This is the best starting point for engaging fingers 4 and 5 more and using fingers 1 and 2 less.


Because you don’t have to press hard with fingers 4 and 5 to do this technique. The weight of the client’s head resting on your fingers creates the pressure. And slightly pressing up with fingers 4 and 5 is a great way to start to strengthen them.

Temporalis, Masseter, and Pterygoids Work

From a requiring strength standpoint, working jaw muscles is a more advanced move than the supine occiput work. I would start by getting some reps in with fingers 4 and 5 on the body of the temporalis.

Then I’d work in the masseter and pterygoids.

Sinus Work

When you’re ready to fine tune your pressure with your 4th fingers, try them out on sinus cavities. It’s definitely challenging at first, but like anything else, it gets easier after a few attempts.

Cervical Work (Light to Medium Pressure)

When you resign yourself to learning how to spread the workload out to prevent a massage injury, it’s only natural to experiment. I find that it’s during heavy massage weeks, when body parts get tired, that I experiment the most. This move came about when I had a lot of necks to do in one week.

I’m combining finger 4 and my thumb on the opposite hand. This combination is good for light to medium pressure.

Going to the Next Level

If you want to take spreading the workload out to the next level, try substituting fingers 4 and 5 for other tasks that finger 1 and 2 do.

For instance, when I’m doing a massage, this is how I usually get cream from a massage cup.

Finger #2 working hard.

Here’s what I try to do now.

This is a minuscule task in the grand scheme of overuse. But in this case, it’s not about changing an action to prevent a massage injury. Instead it’s about making you feel more adept using finger 4. When I do things like this, I want to use fingers 4 and 5 more often in daily life. Here’s what I mean.

Spilling Over Into Life

The other day my wife was watching me type, or as she put it “pound the keyboard”.


But she also made another interesting observation. She pointed out that I was only really using 3 fingers on each hand to type.

Guess which ones?

Yep, fingers 1, 2  and 3.

Well, of course, I can’t let this go. So, I’m fixing this by forcing myself to use fingers 4 and 5 about 15%ish of the time when  I type. I hate it because it really makes me slow down. But I know I’ll like the end result.

At this point, I need to talk about obnoxious thumb pain. If you’re in a state where your thumbs are aching all the time, you’re going to want to seriously consider these suggestions.

Other Ways to Save Your Thumbs and Index Fingers

This is my favorite:

  1. Use a T-bar or an L-bar.

The T-bar…

…and L-bar

…are my top choices for massage tools. For one, they have a simple design which means you can hold them in a variety of ways. Over-designed tools lock you into one or two holds.

T-bars and L-bars are the ultimate thumb savers because they literally substitute for thumbs. And they don’t stress thumbs because you can hold them in many different ways.

Here’s a quick T-bar and L-bar intro: Save Your Hands: Use a T-bar and L-bar.

  1. Use knuckles and fingers in combinations.

Combining body parts is foundational to saving your thumbs. When you combine body parts, you brace and stabilize joints and spread out the workload.

If you want to get started combining body parts, begin here: How to Do Very Precise Pressure

The last thing you need to know is that you have to experiment.

Embrace the Experiment to Prevent a Massage Injury

Experimenting live (on a client) is a little scary because we’re not sure how it feels to the client.

You can lessen the chances of the client saying “Ouch! What the hell are you doing?!” by first working on people who can give you immediate feedback, like friends.

I never use this approach for this reason: I’m a wimp. If something hurts during a massage, I want it to stop hurting. So, automatically, I start experimenting with different techniques until the pain goes away.

Introducing a New Technique

So, when I introduce a new technique, I look for warning signs with the client, like a leg twitch, as an indicator to determine if what I’m doing is okay.

And I don’t spend a lot of time using that new technique at first. Rather I introduce it briefly, look for client reactions, and then reintroduce it in small doses. It slowly becomes a tool in my toolkit when I know clients like the technique and I’m comfortable with it.

Joyriding with Fingers 4 and 5

Ready to take fingers 4 and 5 for a spin?

I’d start with supine occipital work. Then I’d try out jaw work, and when I felt comfortable with that I’d fine-tune my finger 4 touch with sinus work.

If you’re thumbs and index fingers need a serious break, try using a T-bar, L-bar or body part combinations.

Now you have the information that will help you prevent a massage injury to your thumb or index finger. And if you’re currently in pain, experiment. You just need to find the way out.

P.S. If you’re struggling with something, jump on my email list. Once I know what you need help with, I can send the right videos, tutorials and articles. The email group is free and you can unsubscribe anytime.

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