Most massage traditions don’t just use their hands for massage. The forearm is used in Hawaiian massage and many parts of Eastern Europe. The knees and feet are used in many Asian floor massages.

However Swedish massage and its derivatives have relied solely on the hands, with the potential for overuse and strain. Practitioners with long, slender and/or hyper-mobile digits (especially thumbs), those with slender/flexible wrists, and those whose clientele require a firm massage need to be particularly watchful about this.

Using the forearm and elbow 

‘Hands Free’ Massage has developed recently in western massage - using the forearm and elbow to deliver Swedish massage-style strokes, deep tissue techniques and mobilising stretches in massage sessions. There are two immediate benefits for massage practitioners - reducing strain on your hands while increasing your effectiveness in applying pressure (where appropriate). In the long-term, this can help practitioners to sustain their careers. 

Three main areas are commonly used:

The soft forearm (the bellies of the flexor muscles on the inner forearm) for broad sweeping strokes;

The hard forearm (the ulna) for firmer sweeping and pressure strokes;

And the elbow for very specific pressure.

The forearm can also be used as a substitute for the hands in many stretches and mobilising techniques.

Using your body

It’s also important to learn to use your body appropriately to support these tools - in the same way that you need to use your body to deliver power, fluidity and evenness to the work of your hands in ‘ordinary’ massage. However, there are two extra elements when doing ‘Hands Free’ massage on an ordinary height massage table:

Widening your stance and bending your knees more because you are need to get lower to the table than when using your hands;

And moving more in order to follow the client’s body contours with your forearm by ‘tilting’ it.

Working with sensitivity 

Using these tools in a massage session needs to be preceded by lighter strokes to prepare the tissues. Because of the power that can be delivered through these massage ‘tools’ with significantly less effort than using your hands, it’s easy at first to overdo the pressure (often without realising because of the ease of delivery). 

So it’s important to learn to use them skillfully and with sensitively - the deeper the massage the more carefully one needs to work to avoid brutalising clients. The elbow, in particular, has unfortunately developed a poor reputation among massage clients because of its use in a ‘gung-ho’ way - instead of in a controlled way, monitoring and adapting to the client’s responses.