hard on the wrists - i want to talk about my wrists...

[Punk Princess]

i know i can (and will) talk to my instructor about this. and i know that my problem is a combination of (1) applying pressure with the palms of my hands while wrists are extended and (2) giving too many massages in too short of a time. since my clients are mostly friends and family - it's pretty easy to put them off for a week or two, which is what i'm doing. but i'm still massaging in class - about 5 per week.

i don't know. it seems like such a simple (and valued) warm up. why can't i do it "right"? is there a trick to providing a good amount of pressure while using the soft comfortable palm and not stressing the wrist???

my wrists hurt. when i start working on someone's back, i love to make a bunch of passes - starting from the top of the traps down to the sacrum, one palm on each side of the spine. direct, flat even pressure against the traps. i'll take a step back and lean forward so my shoulders are level with theirs, arms outstretched and push straight into them. i let the traps sink a little. as i straighten up and step into the table i slowly glide down and get a feel for the tension held in various places along the spine. each pass is just a bit deeper than the one before. i also like to stand on one side of the client and work across them, pushing from the spine out - from sacrum to t1. i feel like it offers a decent warm up and allows me to evaluate... but my wrists are almost ALWAYS extended while i do this. i've been trying to focus on taking a step back to get them in a more neutral position. but that doesn't offer the pressure i (or my clients) prefer. i use my forearms almost exclusively once i'm past the warm up seforum.xxxe, but i'm still killing my wrists.

again i ask - is there a trick? or a better way to warm up the back? or is icing and wrapping going to become an inevitable bedtime ritual?

thanks in advance for your help. you guys always give such good advice and i ALWAYS appreciate it!

 

[Unpalalgarp]

hard on the wrists - i want to talk about my wrists...

Some of the problem may be just overworking yourself. Generally when you're first starting out you will have soreness but your strength will build up over time. I never apply pressure with the palm - but rather with the heel or outer side of the hands. You may want to try that subtle shift & see if that doesn't work better for you.

That said, you should consider doing more work with your forearms, when possible, to take the pressure off your wrists and of course practice good body mechanics so you don't strain yourself. Have your instructors watch how you're standing & also check on the table height you're using to be sure that those issues are covered & corrected if need be.

There are also some books out on protecting the wrists & hands that you may want to look for:

Save Your Hands! The Complete Guide to Injury Prevention and Ergonomics for Manual Therapists, 2nd Edition by Greene & Goggins 352 pages, 83 photos & illustrations, Softcover edition ISBN: 978-0-9679549-1-2 - (However a few of our mods & readers don't feel the basic info in this book to be of much use)

Hand Maintenance Guide for Massage Therapists by Shogo Mochizuki ISBN: 1-57615-075-5 (I like this one myself!)

The Carpal Tunnel Helpbook/ Self-Healing Alternatives for Carpal Tunnel and other Repetitive Strain Injuries by Dr. Scott M. Fried ISBN: 0-7382-0455-2

Dynamic Bodyuse for Effective, Strain-Free Massage by Darien Pritchard (Highly recommended by Jason in one of his posts)

Also if you can look back for links on MassagePlanetL there are several posts regarding hand, arm & wrist problems. When I have more time I'll see if I can put them together for you.

 

[divineintervener]

hard on the wrists - i want to talk about my wrists...

Just a little add to what riversinger said, I was taught that the first time you do something that doesn't feel right or you get some other negative response from your body, change tools. Your body is telling you it doesn't like what you're doing, so if you keep repeating it with any frequency, you're going to get hurt. Yes, part of it is that you need to build up strength and endurance, but you also need to do it at the pace your body is comfortable with.

Things to keep in mind - if you're using so much pressure that your hands/wrists hurt, then maybe you need to use other techniques to warm the area first so that you don't need as much pressure to go deep in that area? This goes for sustained compressions with fingers as well - like with trigger point work. If you're smashing into a point with thumbs or stacked fingers, then maybe the area needs more warming or the body needs more time to accept the work, so you don't have to exert yourself so much? Last of all, again - if something doesn't feel right, STOP and change what you're doing.

BTW - forearms and elbows are AWESOME tools to practice with. Keep using them and you'll get just as much sensitivity with them as your fingers.

 

[Scgf Cnhds]

hard on the wrists - i want to talk about my wrists...

You may also need to do some icing everyday & consider using any one of these products - that can be taken orally or applied topically depending on your needs
(in your case you may want to consider doing both at once):

Arnica - This herb is found in various forms - from a homeopathic remedy or in tincture form - in tablets as well as in creams & oils too.

Boswellia is also good: This extract is best known among herbalists as a treatment for arthritis. One of its primary active ingredients, boswellic acid, is an anti-inflammatory that can be used in ointments to ease joint pain. It can also be found as an ingredient in many formulas for pain relief.

One of my favorites:
Traumeel : Available in both tablets, and creams - There's even an injectable form for use in those needing joint relief for which many people use steroid injections (which over time will actually destroy the joints).
These homeopathic products are anti-inflammatory and analgesic and have been used successfully for over 30 years. They are even included in the Physicians Desk Reference (PDR.) They are useful for the temporary relief of symptoms associated with inflammatory, exudative, and degenerative processes due to acute trauma, repetitive or overuse injuries or arthritic conditions. These can include sprains, bursitis, dislocations, fractures, bruises, post-operative or post-injury swelling, etc., as well as various arthritic conditions.

One Supplement I use is New Chapter's Zyflamend - which contains a number of anti-inflammatory herbs - including both Turmeric & Ginger. Adding those 2 ingredients may also help in your diet - so by all means look for ways to incorporate them in meals.


List of related posts for you: - As you will see strengthening is key - along with watching your body mechanics!

Excellent Site with products for hand & wrist exercises to build up your strength - (from one of Jason's posts)
http://www.fitter1.com/Catalog/Category/35/HandWrist.aspx

Post: Carpal Tunnel ~ ugh
Link to it here: http://www.massageplanet.com/forum/viewtopic.php?f=24&t=11813&p=100315#p100315

http://www.massageplanet.com/forum/viewtopic.php?f=23&t=21236&p=152841&hilit=+wrist+#p152841 - This group of posts provides another book reference & some words of wisdom from another one of our moderators - Jason - whose advice is always excellent!

http://www.massageplanet.com/forum/viewtopic.php?f=24&t=19810&p=148920&hilit=+wrist+#p148920

http://www.massageplanet.com/forum/viewtopic.php?f=24&t=15510&start=0&hilit=wrist

These are all from the same thread: Hello and A Strengthening Question: (with enough back & forth info that you can see how crucial strengthening can be to your career!)

Poster: Smeyers - http://www.massageplanet.com/forum/viewtopic.php?f=23&t=2604&p=130984&hilit=+wrist+#p130984

A good site to go to for products concerning hand strength information is: http://www.ironmind.com

This is more along the lines for the strongman, Olympic and Powerlifter types, but they do have offer quite a bit of devices along with books on how to build the different types of hand strength,......pinching, crushing, open hand, etc,....most of the griping tools aren't overly expensive, and they're small,.....thus being able to be used in the car. They also offer different levels of bands to work your extensors,........in order to prevent a muscular imbalance, again small cheap and convienant.

You can also do some old school work by using different movements with a large bucket full of sand, or whatever substance that'll give you friction, get creative with different depths,....offereing different levels of resistance, and different movements,........radial and ulnar deviation, circumduction, flexion, extension, Ab and Adduction of the fingers, thumb opposition,etc.

As far as movements in the gym, there are movements that will directly work the grip and forearms, wrist curls, hammer curls, etc. .....however in my experience, indirect work,(which is what most pple will refer to it as), works best,.........for building strength that is,........not so much endurance. For example, deadlifts power cleans, exercises with kettlebells or clubbells, (or a baseball bat weighted at the end if you prefer),.....motions where the body is either more integrated, and/or your moving more weight, and always visualize crushing through the bar with your hands, in every lift that you do when going for general wrist and forearm strength,.............a nice bonus to this is that most people will find that their poundage on lifts will go up ostlightly b/c of this.

Again, as mentined before stretching and joint mobility drills need to go hand and hand with the strengthening drills,.........relaxation as well, .........recieving work on them, soaking in them in different baths, etc..........rest and recovery are integral parts in making muscle and neural physiological gains.

From the same post - Jason's reply:

Excellent post! I have used many of the methods noted above, and am very happy with the results. My favorite methods are stretching and joint mobility drills, yoga, and clubbells. All three will support the development and maintenance of multiplanar strength and endurance for the hands, forearms, shoulders, and the rest of your body. For info on the specific methods I use, visit my site http://www.CSTMinnesota.com

I've read Save Your Hands and I was not impressed. Very basic material, and the author's background doesn't inspire much confidence.

A much better book on body mechanics and self-care for manual therapists is Dynamic Bodyuse for Effective, Strain-Free Massage by Darien Pritchard. Pritchard has excellent credentials and I was VERY impressed by this book when I skimmed through it. A copy is on its way to my home right now

Post by Seforum.xxxgnant: (but if you're going to do this - experiment with the amount of weight you use - (start with less & build up)10lb weights may be to heavy for you since you're already experiencing problems)

Here's a great way to work out your forearms...Grab a 10-lb weight, the circular kind that go on bar/dumbells. Next get a dowell or a dumbell, and about 4 feet of rope. Drill a hole in the dowell/dumbell, and put the rope through it, tying a knot in the end to make it stay. Tie the other end of the rope to the 10-lb weight.Stand with your arms out in front of you holding the weight device by the dowell. Make a twisting motion, making the rope wrap around the dowell as the weight is lifted upward toward the dowell. Continue rotating the dowell until the weight is about 6 inches away from the dowell. Now hold it there for about 10 seconds, and slowly rotate the dowell the other direction, making the weight go back down toward the ground. If you can, do this about 3 times, resting about 5 minutes in between. Do NOT do this before a massage, it's pretty intense.

Post by Merlescuz:

Cool idea! I've done wrist curls with dumbbells; sounds like it works similar muscles (flexors/ extensors). In seated position, rest your elbows on your knees, forearms supinated, holding light weights one in each hand. Allow hands to drop slowly, uncurling fingers so that the weights are hanging at 2nd interphalangeal jts. Then curl fingers into palms, and flex hands. Repeat 10 - 15 times.To work extensors, flip hands over and essentially do the same maneuver, but without extending the fingers.

From the post: Staying Fit - http://www.massageplanet.com/forum/viewtopic.php?f=43&t=16988&p=142816&hilit=wrist+pain#p142816
check out this thread & the link Jason posted there: https://rmaxinternational.3dcartstores.com/The-Intu-Flow-Complete-package_p_14-129.html

If you've gotten this far you probably have enough good info to keep you busy for awhile & also discovered that building up your strength & living a healthy lifestyle (nutrition wise, plus doing exercise from yoga to kettle bells, etc.) is what's going to help you maintain a long career. Taking care of yourself is what will keep you in practice for as long as you choose to do it. Best of luck to you!

 

[leeroy c]

hard on the wrists - i want to talk about my wrists...

thank you!! i am taking your advice - a little bit at a time. i already have "save your hands" but ordered "dynamic bodyuse..." the other night. it may come in the mail today we have some exercise equipment for forearm, wrist and hand strength and i'm easing into a daily routine. i also ordered arnica a couple of weeks ago - still not in. i ordered the oil and was planning on adding it to my massage oil as needed. as time and money permits i will continue to explore the advice given. thank you all again! your help is invaluable :grin:

 

[A. E. Moreira]

hard on the wrists - i want to talk about my wrists...

I would like to second the suggestion of arnica. I have had great results from using it. I like both Badger Balm and Weleeda.
Some additional suggestions to the fabulous ones above:
Try using a soft fist instead of palms, or try using the sides of your hand, with your thumbs up like you are holding a cup.
For strengthening you could try wrist curls (similar to bicep curls only curling at the wrist instead of the elbow) and putty for general hand strength.

And definitely talk with your instructor or other MTs who can give you some hands on help.

 

[Dominic]

hard on the wrists - i want to talk about my wrists...

a little update -

i brought this issue up in class and my instructor took time to talk to all of us about self care. (not for the first time, but i think it had more of an impact than it did at the beginning of class, since we are now experiencing soreness from massaging). and during hands on, she spent time with me observing and correcting my body mechanics - which she says is mostly pretty good. i just have some bad habits in my life that are hard to break, i.e. holding my shoulders up. i have learned in class (but not really applied this knowledge to myself) that hand, wrist and arm pain can be caused by proximal muscle tension. it's funny to me how obvious that is but still something i over looked. i learn more about massage every day. and every day i am reminded of how inexperienced i am and how much more i have to learn and practice.

anyway, the conclusion - while i did over work my hands/wrists a couple of weeks ago, my main problem is in my shoulders, neck and chest. we have a student in our class who moved to indiana from california. he has practiced in cali for 16 years but in order to get his license in indiana, he has to take a class - indiana's requirements are higher than california's. so we have this rare and awesome opportunity to have a classmate with a huge amount of knowledge and experience to share! he paired up with me for hands on and worked on my trouble spots, giving me tips the whole time. when he was finished i felt brand new! it was amazing. i am so grateful to him, both for making me feel better and for teaching me...

 

[Eliza The Animal Lover!!]

hard on the wrists - i want to talk about my wrists...

I'm glad you are getting the knowledge you need. I didn't get a chance to read the responses, beside your beginning and end, so this may be a repeat.

Just a thought... when I was in chiro college I kept a gripper in my vehicle which I would use at the stop lights on the way to school. I was also taught to work my forarm flexors and extensors with certain exercises and had an entire work out regimen to boot (including push-ups). At that time I was 30 lbs lighter than I am today, but I will tell you that that made a difference. Luckily I was already physically fit going into bodywork, but all the same, a good regimen can help.

I would ask your instructor how he/she feels about something of the same. You may really get good benefit from a few simple things like this.