Doug, a client of mine, once hurt his lower back while brushing his teeth. Doug’s story is not uncommon. In fact, over the past 24 years, I’ve heard many stories from back-pain clients who have tweaked their backs doing simple, everyday actions, like turning in the shower to reach for the soap. Granted, the root cause of back pain varies from person to person; however, there is one thing about these everyday back-pain events that seems to be consistent: lower-back neutrality is compromised, meaning the back is in a flexed, extended or rotated when the pain occurs. I’ve found the same to be true when doing massage. If I can keep my back as neutral as possible during a massage, I can avoid lower-back pain. The key to maintaining lower-back neutrality is to use the massage table as a support.
Reset Your Back to Neutral
Our work is below us. We need to bend. A tendency is to bend from the lower back which puts the lower back in flexion. Though the flexion may only be slight, over long periods of time, it’s taxing to the back joints and muscles, and may cause or exacerbate a back condition. In order to take my lower-back out of flexion during the course of a massage I breathe in while lifting my ribcage up. Next I slightly suck in my stomach until I feel there is no rounding in my lower back, and then I relax my stomach.
Lean into the Vanity (Massage Table)
This neutral back reset is a great reminder to “stand up straight”, but it has its limitations. Even if I were able to stay in the same place with a neutral back for the entire massage, I’d feel discomfort in my back because my back muscles still have to work hard to keep me upright. To maintain lower-back neutrality and give my back muscles a break at the same time, I need to transfer the workload of staying upright to somewhere else.
Picture my client Doug brushing his teeth right when he injured his back. His legs are straight and his lower back is rounded as he bends over at the sink. (The flexed lower-back position that I want to avoid when I’m doing a massage.) Now imagine Doug brushing his teeth with his legs apart, knees bent, the front of his thighs leaning into the vanity, and his back neutral, not flexed. In this scenario, Doug is using the vanity as a support to help him stay upright, which gives his back muscles a break and allows him to maintain a neutral back.
The same is true when I’m at my massage table: the more I can use the massage table to support my weight by leaning a thigh or both thighs into it, the less stress on my back, and the easier it will be for me to maintain a neutral back.
Wider Stance for Light/Medium Pressure
My stance is wider when I’m delivering light to medium pressure than it is when I’m delivering deep pressure. Why? Because in a wide stance my upper body is closer to the table and I lose leaning leverage. The only way I would be able to apply more pressure would be to press with my shoulders and arms—which I’m not going to do. That said, in the wide stance I can lean into the table with a lot of my weight (and give my back a break) without having to worry about putting too much pressure on my client because of the reduced leaning leverage.
Narrower Stance for Deep Pressure
Conversely, for deeper pressure my feet are closer together so that I have more leaning leverage. I’m also a little farther away from the table. Since I’m delivering deep pressure I can lean into the table with most or all of my weight and have the table (and/or client’s body) support my weight. Like with light to medium pressure, because I’m able to lean with most or all my weight, my back is less taxed and I’m in a position to maintain back neutrality.
Use Your Legs to Regulate Your Pressure
In addition to saving my back, leaning into the table allows me to regulate my pressure in two ways. One way is through how I direct my body weight when I lean. To work with deeper pressure I direct more of my body weight onto the client’s body, and to use less pressure I direct more of my body weight onto the table. I control how I direct the pressure with my legs, not upper body.
The second way to regulate pressure is with my feet. Let’s say that I’m doing deep pressure with my knuckles. My stance is more upright than wide with one thigh against the table and almost all of my weight is directed onto the client. If I want to ratchet up the pressure another notch, I don’t press using my shoulders and arms. Instead, keeping my arms straight, I push from my back foot so that I’m on the ball of my foot. If I want to lighten the pressure, I shift my weight to my heels so that less of my weight is on the client/table.
Easier Than You Think
Here’s my quick start to using the table to save your back: 1. Set the table height for the lean you’ll need. 2. Lean into the table (and client). 3. Push up to the balls of your feet for more pressure; shift your weight to your heels for less. 4. Periodically, do the lower-back reset. Work with using your table as a support for 10 massages and you’ll never want to go back to hunching again. I would love to know how it goes! Please leave a comment here or on our Facebook page: https://www.facebook.com/themassageinstitute.net/ .