There’s no doubt that technology has been a huge boon for many people. But, there are downsides to technology as well, particularly for those who work with devices such as computers and tablets every day. Repetitive use injuries and other conditions that lead to chronic pain are increasingly common and cause a variety of symptoms that can take a toll.
Common Workplace Issues
Carpal tunnel syndrome and cubital tunnel syndrome are two issues that people in an office setting may face and, with these conditions, come a variety of symptoms that massage therapy can help relieve pain being but one. “Pain, fatigue, weakness, and stiffness in the affected areas are the most common symptoms of these injuries,” explains Deborah Kimmet, a massage therapist and educator from Missoula, Montana. “Numbness and tingling, as well as trigger point referrals, are also common.”
Along with overuse, Kimmet also sees poor posture being the cause of painful conditions affecting the neck, shoulders and back. “For example, a forward head posture can lead to neck pain as the person unconsciously reaches forward with the head to better see the screen,” she says. Additionally, improper posture can sometimes be the result of other conditions like carpal tunnel syndrome. “Sometimes, improper posture occurs because the body is trying to find a comfortable position,” Kimmet says.
How Massage Can Help
Massage therapy is proving beneficial in helping clients with chronic pain find relief—andsome of these conditions are no different. “Massage therapy can help reduce postural imbalances, nerve entrapment, inflammation in the tissues, and trigger points and their referrals,” Kimmet says. “In addition, massage therapy can address the symptoms caused by nerve compression if the nerve compression is due to improper posture.”
For example, Kimmet sees massage therapy being beneficial for clients who may have a hemipelvis imbalance that might cause back discomfort and pain, or those whose forward head posture is contributing to neck and upper back pain. “A shortening of the anterior musculature in the abdomen and chest that causes back pain can also benefit from massage,” she adds, “as can shortened pronators of the forearms that might be causing forearm, wrist and hand pain.”
Before beginning a massage therapy session, however, you need to be sure you understand the mechanics of your client’s pain. “Assess postural imbalances to guide your treatment,” explains Kimmet. “Then, treat the tissues determined by the postural assessment and those specific to the overuse syndrome diagnosed by the client’s physician, for example.” In order for massage therapy to be effective, you need to understand what muscles are involved in any condition, cautions Kimmet.
When treating the soft tissue, Kimmet suggests starting by warming up the tissue with five minutes of heat and then doing some myofascial work and stripping the area with four or five long strokes. “Then, go somewhere else,” she says. “For example, move to the other arm. This reduces the sensitivity of the area and allows you to work even deeper into the tissues. I never try to get all of the work done in one area at one time. Moving around is less painful and gentler for the client.” If the area is extremely tender, Kimmet encourages massage therapists to go back and repeat the longer strokes. “You can end by doing specific trigger point work and movement education to add more release to the tissues,” she adds.
Kimmet is quick to remind massage therapists, however, that knowing when not to work on an area is just as important as knowing when massage therapy might help. “If the client has cubital tunnel syndrome or is postoperative for the condition, stay away from the elbow because you run the risk of irritating the nerve even more,” she says. “Instead, work on the postural alignment of the rest of the body everywhere but the elbow until most of the acute symptoms have abated.”
Additionally, remember that massage therapy is not going to cure the problem, even as the work helps relieve symptoms. “The crux of the issue is overuse,” Kimmet explains. “No matter what the massage therapist recommends or does, unless the client can find a different way to do what they are doing, the problem will return. Discussion with a client to help them find a way to do certain tasks can be helpful. As part of the session, I will include movements that help release and retrain the affected musculature. And, I teach the movements to the client so they can do them on their own, as well as a simple method of finding a comfortable sitting posture.”
What About You?
Although the cause might be different, massage therapists are also at risk for some of these injuries. “The massage therapist makes a living by pushing and pulling the upper extremities,” Kimmet says. “So, we are susceptible to any overuse issues in the upper extremities, not to mention the back pain that can go along with them.”
Not unlike a client who needs to resolve the root of the issue by adjusting posture or making their work spaces more ergonomic, massage therapists need to be aware of how they are working. “Proper technique is key to avoiding injury,” Kimmet says. “I always recommend that massage therapists try to use their large muscles instead of their small muscles. Perform effleurage by shifting your body’s weight over your feet and rotating through the waist rather than simply pushing the arms from the shoulder or straightening the elbow.”
Additionally, pay attention to the alignment of your forearm, wrist, finger and hand. “We want them all to be in a straight line, so the structures are supporting each other,” Kimmet explains. “If not, the muscles will do that job and this will lead to muscular overuse.” Although Kimmet understands that using hand tools can take the stress and tension off the body, she advises caution. “You need to make sure that your body is in alignment when holding the tool,” she explains. “Tools that cause improper alignment or discomfort when being used are not helpful.”
Today’s world is fast-paced, and technology is an integral part of many people’s lives. For your clients who work with computers, smartphones and tablets on a daily basis, however, overuse injuries can arise, disrupting both their personal and professional lives—and causing a lot of pain. But massage therapy can help, and knowing how to work with these conditions can give you ways to both reach out to new potential clients as well as provide yet another tool to current clients looking for help with pain.
Tablets and Laptops: What's the Issue?
From smartphones to tablets to laptop computers, you can’t look anywhere today without seeing someone on one of these devices—sometimes more than one. Yet, as a massage therapist, you’ve probably also noticed some body mechanic and posture issues that, if not now, will eventually cause the user some pain.
“Narrow keyboards on laptops cause ulnar deviation and strain on the hands and wrists,” explains Deborah Kimmet, a massage therapist and educator in Missoula, Montana. “In addition, improperly carrying a laptop case can cause neck, shoulder and arm pain.”
How users are holding these devices can also cause problems, according to Kimmet, as to relieve strain in one area, you’re oftentimes adding stress to another. “To place the device’s screen at a good height to avoid neck strain can mean straining the arms as they elevate a tablet to eye level, for example, or reach to the keyboard,” she says. “However, lowering the device to protect the arms can compromise the neck through excessive neck flexion.”
Quick Tips for You and Your Clients
1. Go wireless and go big. Particularly if you use a laptop, investing in a wireless mouse and keyboard can really help create a more ergonomic work environment. To help with potential neck problems, you might also consider purchasing a separate monitor, suggests Kimmet. Additionally, think about setting the display to show items and copy at a size that allows you to view things without having to crane your neck to look at the screen.
2. Ergonomic keyboard: These can be great tools to help decrease the risk of strain on the hands and wrist for people who have to work on a computer daily, though proper set up and use is key to success. “You need to make sure you’re properly fitted for the keyboard,” explains Deborah Kimmet, a massage therapist and educator from Missoula, Montana. “Most off-the-shelf ergonomic keyboards are not designed for small people, for example, and may cause some people to hold the elbows away from the body, creating a whole set of problems for the shoulders and neck.”
3. Get moving. For those clients who spend their working days on computers, consider suggesting some stretches or movement exercise they might do to help relieve the strain and tension they may be putting on their bodies. “I suggest movement education specific to the issue they’re having,” Kimmet explains. “In general, I will suggest three movements at most, as any more than that and the compliance rate drops.”
Published March 2, 2015 AMTA