Originally published in Massage Bodywork magazine, January/February 2011. Copyright 2011. Associated Bodywork and Massage Professionals. All rights reserved.
Barbara Lenihan consistently used her back and shoulders for a living and considered herself strong and fit. A longtime doctor of naprapathy and a sports massage therapist based in Chicago, Illinois, Lenihan says she was concerned when she noticed a persistent pain in the lumbar region of her back and the anterior region of her shoulders. After years of boasting about her near-perfect posture, she noticed she didn't stand as erect as she used to.
"It looked like I was shrinking when I took a good hard look at myself in the mirror," Lenihan says. "I figured out my shoulders were weak, leaning forward a bit, and rounding; my back was a little crooked; my posture was poor; and there was no natural curve to my spine."
Initially, Lenihan, who is also a competitive senior athlete, attributed her condition to many years of working as a bodywork professional, a naprapath, and the labor-intensive work she did as a sports massage therapist, not to mention her years of training on the triathlon circuit. Like many endurance athletes, she incorporated little to no resistance training in her own self-care routine. A friend suggested she try some exercises before her condition worsened.
Like many other bodyworkers, Lenihan chose a profession that keeps her on her feet for long stretches of time and puts lots of pressure on her upper extremities. That pressure can result in a myriad of injuries to the tendon, rotator cuff, and upper and lower back. The trouble in Lenihan's case was that she had never done any resistance or weight training. Her trips to the gym consisted of using the treadmill, swimming laps, or walking on the track. Her main method of exercise was traversing the many miles of trails in and around Chicago.
"I'd never held any kind of weight in my hand, and I didn't know where to start," she says. "I had no interest in lifting free weights anyway. But I didn't want the posture of a gorilla and the strength of a 9-year-old, so I had to do something."
Unfortunately, Lenihan's situation is common among bodywork professionals, who, in many cases, take care of others and leave themselves last, says Steven Devor, assistant professor of exercise science at Ohio State University and an expert on occupational fitness.
"Like many professional athletes who use their bodies for a living, bodywork professionals need to take care of their bodies like they take care of their clients' bodies," Devor says. "Repetitive motions put strain on the body, and if you don't build the muscles around the area having strain placed upon it, they will eventually break down."Shoulders Back
For a bodyworker, all parts of the shoulder experience an extreme amount of stress--from setting up tables and other equipment to the bodywork session itself.
"Every time you press, pull, and lift, you are engaging your shoulder and back muscles in some way," says William J. Kraemer, PhD, professor of kineseology at the University of Connecticut and former director of the Human Performance Lab at Ball State University in Indiana. "Back muscles are among the largest in the body and need to be conditioned to deal with the stress placed on them," Kraemer says. "The shoulder is comprised of some little fibers that tear and get worn down easily." Starting A Regimen
Doris Davidson wanted to build some strength in her back and shoulders without lifting weights. "I don't have the time or space in my apartment for a lot of exercise stuff anyway," she says. A suburban Chicago massage therapist, Davidson repeatedly strained the L4 and L5 region of her back and attributed it to her stature (6'3") and working for years with a table that wasn't tall enough. She was grocery shopping one day and reached for an item on a high shelf and it felt like it weighed a ton. She also felt an electric-like pain in her back.
"That was the wake-up call for me," Davidson says. "I haven't done any exercise since college. I need to be stronger for my height, age, and profession. It's funny, because I have pretty strong arms, but not my back and shoulders, where I need a certain amount of strength."
Davidson began doing modified push-ups on her knees several times a week. Then she bought a spring-loaded exercise bar that her friend recommended and placed it in a doorway and tried doing different types of pull-ups.
"I did some push-ups on my knees with my legs crossed and got up to doing 10 pretty fast," she says. "And I set the [spring-loaded] bar fairly low so that I didn't have a long distance to pull up my body. As it got easier, I moved the bar a little higher. I definitely felt the difference in my back, chest, and shoulders doing these simple exercises a couple of times a week."
Davidson is convinced her generation--the baby boomers--was misinformed about various ways to build strength: lifting weights is always the first thing that comes to mind. "It takes the help of someone who knows about that kind of stuff and a little creativity," she says.
Wayne L. Westcott, a consultant at the South Shore YMCA in Quincy, Massachusetts, and a leading authority on resistance training, says there is something about the term strength training
that scares people, even those in the bodywork professions.
"Weights scare people; gaining muscle scares people, and that's strange particularly for people who know how important having muscle is for you in everyday life," Westcott says. "I see many massage therapists, yoga instructors, and physical therapists with chronic pain and horrible posture as the result of overused and underdeveloped upper extremities. The fact that there are still so many misconceptions when it comes to resistance training and building muscle makes getting started without using weights even more important."
Westcott describes a simple back and shoulder routine that you can do at home without weights. He suggests that between clients, use an exercise band with low-to-medium resistance and do three sets of 10 repetitions of front, side, and lateral shoulder raises; also, attach the band with a wall hook to a closed door and do lat pulldowns and seated cable or band rows sitting on an exercise ball.
"You're combining the pulling motion of the back exercise with the lifting motion of the shoulder exercises," he says.
The bands cost $10-15 and come in various colors, depending on the tension or resistance. The wall hook allows for mimicking the motions of several back exercises and can provide similar results when compared with weights. Getting Motivated
Many bodyworkers seem motivated to gain strength, not only to better serve their clients, but for their long-term health. Osteoporosis is also a major concern. As a personal trainer who has worked in health clubs and private residences, the desire I found for a stronger upper body didn't equal the objection to dealing with crowded gyms, confusing equipment, and the embarrassment of using barbells and dumbbells in the free weight areas. Emphasizing the fact that shoulders and back muscles are complicated and that there are a myriad of things to train those muscles provides motivation.
"Both sets of muscles respond well to exercise and being stressed," says Vonda Wright, MD, an orthopedic surgeon with the University of Pittsburgh Medical Center. "When you think about the hours and hours that massage therapists and other bodyworkers have these particular sets of muscles engaged, you can understand how they are really at a great risk of injury without cushioning themselves to deal with the stress brought on by having less lean muscle and poor flexibility."
Wright says the top three non-weight shoulder and back pieces of equipment to own are the resistance (stability) ball, exercise bands, and kettlebells, which are weighted balls with handles that don't have the bulkiness of free weight dumbbells.
Wright also says if a resistance ball is too much to deal with, try a balance disc, which is more portable and a little less wobbly. It can, like the ball, help improve posture, balance, and core stability. Medicine balls can be used for shoulder and back work as well. They come in different sizes and weights and can be good for newbies.
Ralph Kruse, DC, with Chiropractic Care in Chicago, says he's seen several bodyworker's careers cut short because of pain as a result of an injury. "In the case of bodyworkers, the ability to accomplish a particular task is important to their livelihood and you don't want to do anything to take away from the available strength," he says. "It doesn't take much to make positive changes. Those with little strength or exercise experience can start by tying something weighted around a towel and do front, side, and rear deltoid raises, and push-ups of any kind work the shoulders and the back."
Kruse says that calisthenics are simple ways to build body strength without lifting weights. "Push-ups work your back, shoulders, and arms. Sit-ups help your core muscles, which help your back. A strong core should be the staple of any exercise routine. The main concept of pushing against your body weight and pressure has been around forever."
Kruse likes using blast straps, as they can be looped around any heavy stationary object indoors, or an outdoor jungle gym. (Blast straps are like bands except there are no handles, making controlling them more challenging.) "Rows, pull-ups, upright rows, and the four shoulder exercises [front, middle, and rear deltoid raises, along with shoulder presses] can be executed with the blast straps," Kruse says.
Heidi Bonn has been a competitive runner and massage therapist living in Madison, Wisconsin, for more than 20 years; she has been a yoga instructor for 10. She says she suffered from rheumatoid arthritis in her shoulders as a result of working on many University of Wisconsin athletes over the years. She says one of the trainers at the school provided her with an exercise routine that consisted of using bands and bottles of milk.
"The handles on the milk bottles made it easy to do shoulder exercises," she says. "And I used the bands to make my back stronger by doing a lot of repetitions. The arthritis is less painful than it was years ago and working on some of those 300-pound football players isn't as taxing on me. I'm considering going to the next level and trying free weights soon."Career Longevity
Lenihan says her change in exercise routines has made a difference. She can see definition in her shoulders now, her posture is better, and, more importantly, she has the strength and endurance to do her job more effectively. "I've included some arm exercises and have gotten pretty good doing push-ups," she says. "And it all came without lifting any weights."
Lenihan recommends hiring a trainer with a wide array of expertise outside of the gym. She, like other bodyworkers who travel or are on a tight schedule, doesn't have the time to ferret out a gym. She added that there are so many 5-pound things around the house that can be substituted for weights, and bars in closets make for great pull-up and chin-up bars.
"Nothing builds a stronger back than pull-ups and chin-ups," she says. "Just make sure the bar is heavy enough to hold your weight so that you don't fall."
Fitness and exercise specialists agree that bodyworkers should be aware of their posture at all times and wear supportive shoes and other back-stabilizing items if they are experiencing back pain. The rounding of the shoulders and poor alignment of the back have cut short the career of many of those making a career of helping others. Kevin Harmon has worked as a personal trainer, personal chef, and writer for several daily newspapers, including the
Indianapolis Star, Kansas City Star, and Chicago Tribune. Contact him at email@example.com.