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The client or the therapist? A perspective on therapist’s posture.

It is always at the heart of the spa therapist, to offer their clients a treatment that will relax, destress, ease pain, or even improve bodily function. As we know, this list is not exhaustive. 

At the heart of brand treatments, conscientious therapists will use their learned cutting-edge techniques, alongside their own knowledge and experience, to provide a positive treatment for their client regardless of the modality of the treatment being offered. 

A healthy and well-informed therapist should view their daily column of clients as a great day ahead, with the tools to plan the day’s treatments – as opposed to a working day that will leave them exhausted, or in pain. 

The question arises, who is the most important person in the room?

The client or the therapist?

If the therapist sacrifices their posture, damages their joints, or suffers from cumulative biomechanical and postural issues…the answer must be the therapist. 

Bizarrely, we as therapists are supposed to know how to avoid it – or at least treat it. 

Yet from my own recent experiences, of judging the National Massage Championship at London’s Olympia, alongside other judges, we observe that many therapists slip into poor habits, probably over time, and to the detriment of their own health. This of course along the way, will have a bearing on their ability to deliver quality and consistency, in terms of spa treatments. 

From an industry perspective as well – we want to retain staff and ensure that morale and commitment are present.  

It is perhaps worth considering, that therapists who have been qualified longer, may have forgotten, or lost sight, of the importance of posture and biomechanics – or may not have been afforded the advantages of recent developments and new ways of thinking, backed up by science.  

For example, we are now more acutely aware of the concept of muscle and its relationship with fascia, which plays a huge part in how we treat and how we deliver effectively for our clients. 

This of course means then that the therapist must make a conscious effort to safeguard themselves, for the longevity of their joints, their back, their neck – the list goes on. 

Amongst all this, spa management will want to ensure that staff are looking after themselves properly as well. 

With a clear understanding of the correct use of posture, body weight and the safe application of pressure through the joints, much of the overuse injuries and postural drifting can be avoided. This comes about from being taught the implications of long-term unstable or damaging movements. 

What can be done simply and immediately?

Three immediate steps that we suggest that therapists take are: 

1. Ensure that the couch is the correct height

 As obvious as this may sound, I never cease to be amazed, when observing or teaching therapists, that the couch height and position is unsuitable for the therapist’s height.  

To compensate for this, we see therapists deliver strokes and techniques, on the ball of their foot, (which is an unstable position in the first place!) whilst hunching their shoulders, which engages muscles such as the trapezius, in a contorted fashion.  

The significant damage of this poor posture is stiffness, with shoulder and neck pain. The longer this persists as a negative postural habit, the more risk of muscular pain and dysfunction becomes a real and long-term possibility. 

Many spas of course have the luxury of hydraulic couches, but is the therapist confident of exactly what height the couch should be considering the client size and treatment style required?   

As an example, for deep tissue massage, a couch may need to be slightly lower than it should be set for Swedish-style massage.  

For any treatment, such as pregnancy massage, which involves side-lying work, the couch will need to be higher than usual, to avoid excessive twisting movement of the lower back. 

But I suspect that the real reason is that therapists simply get accustomed to their working posture. Often, they are aware that things don’t feel quite as they should when delivering a stroke - but put simply, they dapt and simply ‘put up with the feeling’.  In other words, they are aware of it, but simply manage it as best they can, until the moment arises when something simply ‘gives’, be it the lower back, shoulders, or neck. 


2. Overuse of thumbs 

Many treatments use thumbs to deliver certain techniques, but how is the thumb being used?

Can the technique or stroke be delivered with reinforced fingers (one braced over another) rather than the thumb, is a consideration. 

Where thumbs are deemed as a necessity, they should be used in line with the forearm and shoulder, as opposed to the abducted thumb position, which puts unnecessary and damaging strain on the thumb itself, alongside the interosseous muscles and membranes of the forearm.  

This overuse can cause significant radial nerve pain and loss of simple functions, such as gripping a glass, loner-term and if left unchecked. 

So, we begin to see many aspects of bad posture and the aforementioned are only a small fraction of the longer-term possibilities. 

3. Stretching 

The importance can never be underestimated, both before and after treatments. It is recommended that any form of stretching or movement of the joints, to pump synovial fluid into the therapists’ joints, is a huge advantage to self-care.  

Therapists should focus on stretching the muscle groups that they have or intend to use for the treatment – largely this would be shoulders, arms and hands, but this list is not exhaustive.

If these points are something that you recognise as an issue for you, or indeed your team, please do get in touch if you wish to address these issues. 



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Wednesday, 28 February 2024

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