Repetitive motions with wrists and fingers and cumulative trauma results in many massage therapists choosing to leave their careers as therapists. Motion comes naturally to our bodies, however, problems will arise when the same joints are repeatedly used over and over again. Disproportionate use of the same joints cause body tissues to respond negatively; this is called repetitive motion injuries, or repetitive strain injuries (or RSIs). RSIs are produced by excessively using inefficient biomechanics, such as general posture, sporting motions, and work behaviors. Injuries to body tissues are a result of continual or repetitive motion together with compressive forces or joint hyperextension. This type of self-abuse over a prolonged amount of time is cumulative and is made up of many diverse injuries.

Repetitive motion injuries generally include carpal tunnel syndrome, thoracic outlet syndrome, tennis elbow, and rotator cuff problems. RSI symptoms will be redness, heat, pain, swelling, and limited range of motion (which is commonly called ROM). The soft tissues are not originally injured, instead, the soreness in muscles will generally progress to increased tonus, to the forming of multiple trigger points, and then occasionally to even to nerve entrapment. Neuropathy, subluxation, deterioration or trauma to the joints (like bursitis, arthritis, and involved bones stress fractures) all originate from chronic RSIs.

Muscles in the anterior forearm of the therapist will many times be too big and tense as a result of persistent flexing of the fingers. If this occurs for a long enough, the flexor retinaculum will eventually compress the tendons and nerves together.