Ergonomics For The Therapist

My column on ergonomics for clients prompted much discussion in my workshops here and in Europe. Likewise many asked, "Great for clients. But what about ergonomics for us, the therapists?"

Having been trained in the Dojo tradition, where every movement, exercise and intention is prepped by <Qi/Ki focus, a sense of space, expansion, and honoring the Qi/Ki circle around oneself and others, I can watch colleagues and know instantly if they received a similar training or not. Qi/Ki training is the essence of Dojo training, whether in the martial arts or healing arts. It becomes such an instinctive part of the way we move and work, it's really hard for those of trained in this way to encounter a teacher or therapist from a different type of training who does ABT or needles like a robot.

As Qi/Ki training is such an integral part of Dojo training, it seems bizarre for us when we experience a disconnect between, say a therapist who practices Tai Chi or Qi gong, but does not integrate those movements and philosophy in the way they work or approach an acu-point.

Sense Of Qi Space And Flow

Space is key. As therapists we conserve our own qi if we pause before treating a client, to honor the qi space or qi "house" surrounding the client. Pure ergonomics. The client feels the difference between this conscious, measured, almost slow motion approach, and a therapist who "dives in." Therapists squander their own qi if they work in a cramped environment, or on a table that is too high or too low. To see if a table is the correct height, it's good to extend your arm and place your hand flat on the table, without dropping or raising your shoulder. Pure ergonomics.

Similarly there is a huge difference between a Bodywork Therapist with qi or Dojo training, and a Bodywork Therapist who approaches a work table as though prepared for combat. Tuina can be painfully invasive if done without subtle qi, and will soon exhaust the therapist's hands and joints. Shiatsu Therapists or Acupressurists who jab an acu-point without qi will soon sprain or strain their thumbs. Visualizing the qi moving through and not from the thumb, in a Tai Chi like movement, makes all the difference to both therapist and client.

Variety Is The Key

I'm often asked by bodywork therapists for advice on avoiding RSI, to avoid or prevent sprained thumbs, tight shoulders, or strained backs. Stop being repetitive I tell them. It's helpful to ask a colleague to video you at work, and, like an athlete, to examine the way you work for clues on how to avoid common aches and pains caused by repeating the same movement or technique over and over. In Shiatsu we learn the art of varying the way we use our hands, thumbs, fingertips, heals or sides of our hands, forearms, soft elbows, laced or cupped fingers, and knuckles. In this way our hands not only become supple and flexible, but we acquire subtle differences in touch and texture whether on a meridian or acu-point. It's a win-win. Our clients appreciate the subtleties. We avoid RSI.

Take Care As You Mature In Years

One of the downsides of a traditional Dojo training in Shiatsu, is, of course, the years we spend working on our knees on a futon on the floor. Those of us who trained two or three decades ago found it all very Zen and graceful as we worked around a client on the floor or sat hours in seiza position in a Zendo.

Until, 20 years on, we developed severe knee problems – or - those telltale plum-like varicose veins behind our knees, especially post menopause. When I came out with my problem and the required laser surgery to correct it, many of my colleagues expressed relief that the topic was taboo no longer. Many of us swapped our futons for tables and developed equally graceful ways of working in different positions. I use mainly tables in my classes. When a futon is necessary, I use a variety of standing positions or minimize time on my knees in between lunge positions. I encourage all my students to develop flexing and stretching positions to maintain healthy circulation in their legs, and to integrate more table work as they mature in years. I assure them there is no loss of tradition or form, no disgrace, as they move away from the obsession with futons and form. "In the years ahead, you will thank me for this advice!" I tell them. "I wish our teachers had given us similar advice a few decades ago!"