Unlock better self-care practices by learning to rely less on your hands and more on your forearms.
By Buddy Hammonds, LMT, BCTMB, August 1, 2023
“When the only tool you have is a hammer, every problem starts to look like a nail,” is attributed to various luminaries and refers to a cognitive bias called “The Law of the Instrument,” an overreliance on a familiar tool. I’m gonna call it like it is. In massage, that tool is your hands.
You can’t deny that there’s a logic to it. In your day-to-day, your hands are the tools that help you interact with the world and connect and communicate with others. They’re highly sensitive to pressure, movement, temperature, and vibration. They’re deeply embedded in common English idiomatic phrases like “to lend a hand,” to know something “like the back of your hand,” that something is “in good hands,” and for a situation to “get out of hand,” to name a few. They’re incredibly valuable tools both physically and philosophically.
And though it may sound counterintuitive, I’m suggesting you depend on them less in your massage.
Overreliance on your hands may have long-term implications on the sustainability of your career, especially if you’re “hammering” away with them for your whole workweek. So when possible, having options beyond your hands can increase your career longevity. I suggest your forearms.
Working with your forearms might feel different when you first start, like learning a foreign language. You may feel that you’re less sensitive to your client’s body, and you may worry your client feels too much “elbow” or that your work feels less personal, less connected. You may worry that your client expects you to work with your hands.
Despite those concerns, learning to use your hands less can help keep you in the profession you love longer, and I know that from personal experience.
In early 2015, Google hired me as a massage therapist. The perks were just as good as I’d heard, but the work was harder than I’d anticipated. I gave 24 hours of massage per week for four and a half years. If I crunch the numbers conservatively, I estimate I gave over 5,000 hours of massage in that time.
Think about that: 5,000 hours of massage! Would I have been able to sustain that level of work if I’d relied only on my hands? If I’m honest with myself, I don’t think so.
As demanding as that time was, the opportunity provided me great space for personal growth, specifically around how to think more holistically about how massage therapists perform massage. I learned that whether I’m performing deep tissue massage, massage for relaxation, the meditative work of Esalen massage, pre-event sports massage, or working with a perinatal client, there’s always an opportunity or even therapeutic indication for me to use my forearms.
This knowledge has kept me practicing, and put me in a better position (pun intended) to help my clients while also taking care of myself.
There are countless reasons why using your forearms makes good sense, but here are are a few that are especially important:
You can make more contact with your forearms than with your hands. People are paying you to touch them after all, and you can touch them more with your forearms.
There’s less risk of injury to your hands and wrists. Between your two hands, there are 52 bones, 54 joints, 68 muscles, and over 200 tendons and ligaments (to say nothing of nervous and vascular tissue). You need to stabilize a lot of structures to work sustainably and efficiently when massaging with your hands.
Forearm techniques take those joints out of the equation entirely and minimize the likelihood of injury. If you’re working with just your hands, the table stakes are pretty high (another pun intended).
You can accomplish greater pressure with less effort. When attempting to create an experience of greater pressure, the more force you apply, the more you must stabilize your own body to effectively transfer that force into your client’s body. When giving massage with your forearms, you no longer need to actively stabilize hundreds of structures in the hands and wrists.
Overall, giving massage with your forearms allows you to make more contact, more efficiently, and you accomplish greater pressure and decrease your risk of injury. How can anyone say no to that?
As you begin to learn more about how you can take advantage of your forearms during a massage session, it’s important to remember that every body is different.
Throughout this article, I’ll make suggestions and you’ll make decisions. I’ll make suggestions about positioning and engagement based on body mechanics and the techniques I’ve studied, experienced and taught. You’ll make decisions about what feels good and sustainable in the context of your work, your body and your life.
While the forearm is the tool in forearm massage, the technique involves the whole body.
Work with your proximal forearm. Let’s talk physics for a moment. The further away from the fulcrum a load is applied, the more effort that’s required to lift that load using a lever. In terms of forearm massage, the further away from your elbow you work, the more effort that’s required to do that work. In other words: to actively resist elbow flexion you need to engage the elbow extensors.
“Work closer to your elbow” is something I say often as I teach, and a common reply I hear is, “But I’m worried that my client will feel my elbow.” Here’s the truth: just because your elbow is touching your client doesn’t mean that you’re working with your elbow or that your client feels “elbow.” But if you work in fear of your elbow, you’re going to work too close to your wrist and your work will be less efficient. If you’re not working with the proximal third of your forearm, you’re too close to your wrist.
Try it: Stand at the head of the table with your client lying prone and lean into your client’s shoulder and upper back while making contact with your distal forearm. Stay there for five slow, deep breaths. Notice what you’re feeling in your upper arm and shoulder. Then lean into your client’s body with the proximal forearm. Stay again for five slow, deep breaths. How do the two experiences differ?
If you’re concerned that your client will feel too much “elbow,” find a partner you trust for candid feedback. See how close you can work to your elbow, especially along the erector spinae, before your partner says, “I can feel your elbow.” You’ll be surprised by how close to your elbow you can work before it creates a notable sensation for your client, and the closer to your elbow you can work, the more efficient your work will be.
“Soften your fingers, soften your wrists.” Many of the therapists I work with have developed a habit of holding tension in their fingers and wrists (think Jim Carey’s “ the claw” in the movie “Liar Liar”). Working with the forearms offers a chance for the muscles and joints of the fingers and wrists to go lax, to soften, to do nothing. So take advantage of that and let your fingers go floppy.
Don’t let your stance happen by chance. Start with your stance. We massage therapists focus so much on our hands that we often forget about our feet. Sustainable, efficient forearm technique starts with your stance, so position your lower body purposefully.
If I’m using a stroke that moves my body forward and backward, I use a lunge stance. If a stroke is moving me from side to side, I use a wide parallel stance.
The next time you massage, notice how you’ve positioned your lower body without trying to change it. Then try positioning it purposefully.
Try it: Ask a partner to lie prone on your table. Position yourself at the head of the table in a lunge stance with your left leg in front with your toes pointing forward and right leg back and slightly externally rotated at the hip. Engage the tissues of their shoulder and upper back with your right proximal forearm.
Allow gravity to draw your body weight forward and down. There’s no rush. Sink into the tissue and wait. We’ll add movement to this a little later.
How does this feel for you? How does it feel for your partner?
Alignment. The key to aligning for sustainable forearm massage technique is to position your body behind the stroke so that your body mass, gravity, and the movement of your hips can shift you in the same direction.
As much as feels reasonable, point your hips, rib cage, shoulders, and chin all in the same direction. Because I’ve suggested a slight external rotation in the back leg in your lunge, your back hip probably won’t face fully forward, and that’s okay.
Mobility and stability. Stabilize with your upper body and mobilize with your lower body. Create movement with the larger muscle groups of the lower body (the quadriceps, the hamstrings and the musculature of the hips) and create stability with the musculature of the shoulder girdle.
When giving massage with the forearms, the forearm moves because the shoulder girdle moves–which in turn moves because the spine moves–which in turn moves because the hips move–which in turn moves because the knees bend.
The shoulder girdle primarily provides stability and resistance but, broadly, not the movement itself. Bending my knees shifts my hips, which moves my spine, which moves my shoulder girdle (which engages to stabilize the glenohumeral joint), and allows my forearms to transfer force into my client’s body, which they experience as pressure.
Remember: the forearm is just the tool. The technique lives in the whole body.
Try it: Ask a partner to sit in a chair and stand behind them. Place your proximal forearms on their shoulders at the same time. For a moment, allow your shoulders to passively retract. Hammock your chest down between your shoulders, really allowing it to sag. Stay for the space of five slow, deep breaths and check in with the sensations that your body offers you.
Then, try the opposite. Strongly and actively protract your shoulder blades–push yourself away from your client. Stay again for the space of five deep, slow breaths. What sensations is your body offering you?
Then, find some middle ground. Actively protract just enough that you aren’t sinking toward your client’s body but not so much that the movement feels forceful.
Try this same exercise with your shoulder blades. Let them passively slide up toward your ears and check in with your body. Then strongly depress them for a few moments and check in with your body. Find the sustainable middle ground where you can offer resistance to gravity without overworking.
Then try the stance exercise again. This time, start with your back knee bent and slowly shift your weight into your front knee as you glide along the erectors.
Working with your forearms is a technique, not a modality. I absolutely use my hands when I work. Some parts of the body require the sensitivity and precision that my hands and fingertips offer, like the neck and face. Sometimes, even the broader, more resilient tissues want more precision, as in muscle stripping or ischemic compression.
But my hands are always a choice. They’re never my default.
Every massage therapist should have forearm massage in their toolbox. Like any technique, there are times in massage sessions when your hands will be impactful and even ideal. But if the only tool you have is your hands, you’re going to use them for everything. Should you use your hands in massage? Absolutely. Should they be the only tool that you use? If you want a sustainable career, absolutely not.
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