Hettler’s wellness model features six dimensions: physical wellness, occupational wellnessintellectual wellness, social wellness, emotional wellness, and spiritual wellness. This post will discuss physical wellness.

Physical wellness promotes proper care of the body for optimal health and functioning (University of CA, n.d.). Broadly speaking, physical wellness involves regular physical activity or exercise, balanced nutrition, good sleep habits, hygienic practices such as routine bathing, and regular medical and dental examinations—things that safeguard health and improve quality of life. Physical wellness prepares the body for tasks of daily living and emphasizes core strength, balance, and endurance so individuals can meet personal, familial, and professional goals. Participation in a wide range of exercises helps keep the body fit and able to meet the physical demands of the massage profession (Wiecke et al, 2018).

Physical activity is movement produced by skeletal muscles and requires energy expenditure (WHO, 2018). The American College of Sports Medicine (2011) divides physical activity into four types, which include cardiorespiratory exercise, resistance exercise, flexibility exercise, and neuromotor exercise. ACSM basic recommendations for adults are listed next within their appropriate categories. Additionally, it is no longer recommended to stretch before exercise (Harvard Medical School, n.d.). Newer recommendations suggest beginning exercise with warm-up activities such as easy walking or low-intensity sport-specific routines for 5-10 minutes. Consult a physician or other qualified health care provider before beginning any exercise program.

Cardiorespiratory exercises. These are activities involving prolonged body movements that increase heart and respiration rates to improve stamina, lose/maintain weight, and reduce the risk of cardiovascular disease. Activities can range from low, to moderate, to vigorous/high intensity. The current recommendation is 150 minutes of moderate-intensity exercise per week. Exercise recommendations can be met through 30 to 60 minutes of moderate-intensity exercise (5 days a week) or 20 to 60 minutes of vigorous-intensity exercise (3 days a week). Examples of moderate-intensity activities are walking briskly at least 4 miles per hour (mph), biking with a light effort or 10 to 12 mph, water aerobics, and playing tennis doubles. Examples of vigorous activities are jogging at least 6 mph, biking fast or between 14 and 16 mph, swimming laps, and playing tennis singles. One continuous exercise session and multiple shorter sessions (at least 10 minutes) are acceptable to accumulate the desired amount of daily exercise. Gradual progression of exercise time, frequency, and intensity is recommended for best exercise adherence and for least injury risk.

Resistance exercises. These activities involve resistance to contract skeletal muscles to improve strength and muscular endurance. Current recommendations are to perform resistance exercises two or three nonconsecutive days each week on all major muscle groups (ACSM, 2013). Major muscle groups include the biceps, triceps, shoulders (trapezius, deltoids), chest (pectorals), back (latissimus dorsi), abdomen/abs, quadriceps, and hamstrings. For each exercise, perform one set of 8 to 12 repetitions or reps. Very light or light intensity is best for older or frail adults and for previously sedentary adults starting exercise. Two to four sets of each exercise are recommended.

Flexibility exercises. Flexibility exercises lengthen and stretch muscles to improve range of motion and balance. Current recommendations are to perform flexibility exercises at least 2 or 3 days each week. Each stretch should be held for 10 to 30 seconds to the point of tightness or slight discomfort. Repeat each stretch two to four times, accumulating 60 seconds per stretch. Static, dynamic, ballistic, and proprioceptive neuromuscular facilitation (PNF) stretches are all effective flexibility exercises. Muscle groups most often tight are the hamstrings, hip flexors, calves, and chest muscles, and the ACSM recommends these muscles can be stretched using different positions. Increasing blood flow to muscles before stretching can be accomplished by warm-up activities such as easy walking for 5 to 10 minutes.

Neuromotor exercises. These activities involve balance, agility, coordination, and proprioception to improve physical function and prevent falls in older adults. Neuromotor exercises such as yoga, tai chi, or Pilates combine resistance and flexibility exercises. Definitive recommendations on the amount of neuromotor exercises are not yet available because of the variability in research studies, but these activities performed 2 to 3 days per week 30 to 60 minutes per day is appropriate.

Be sure to get enough sleep.

Sleep is a recurring state of relaxation characterized by an altered state of consciousness, inhibited sensory activity, muscular inhibition, and reduced interactions (NIH, 2017). Sleep allows the body to rest, recharge, and heal from the day’s wear and tear. The amount and quality of sleep you get daily affect many aspects of your life. Adequate sleep is important for learning and memory, weight control, mood, health, and safety (Harvard Medical School: Division of Sleep Medicine, n.d.). Sleep deprivation contributes to slips/falls and errors in judgments, including medical mistakes and road accidents. Sufficient sleep is a key to the body’s ability to recuperate from the mental, emotional, and physical work of massage.

Picture Credits:



American College of Sports Medicine. (2011). ACSM issues new recommendations on
quantity and quality of exercise. Retrieved from http://www.acsm.org/about-acsm/

American College of Sports Medicine. (2013). Resistance training for health and fitness.
Retrieved from https://www.acsm.org/docs/brochures/resistance-training.pdf.

Harvard Medical School: Division of Sleep Medicine. (n.d.). Benefits of sleep. Retrieved from http://healthysleep.med.harvard.edu/healthy/matters/benefits-of-sleep.

Harvard Medical School. (n.d.). Benefits of flexibility exercises. Retrieved from https://

National Institutes of Health. (2017). Brain basis—understanding sleep. Retrieved from https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Understanding-Sleep.

National Wellness Institute. (n.d.). The six dimensions of wellness. Retrieved from

University of California. (n.d.). Physical wellness. Retrieved from https://shcs.ucdavis.edu/wellness/physical.

Więcek, M., Szymura, J., Maciejczyk, M., Szyguła, Z., Cempla, J., Borkowski, M. (2018). Energy expenditure for massage therapists during performing selected classical massage techniques. Int J Occup Med Environ Health, 31(5), 677-684.

World Health Organization (WHO). (2018). Physical activity. Retrieved from http://www.who.int/topics/physical_activity/en/.


Massage Therapy: Principles and Practice 6 Edition (Amazon)

cropped-susansalvo41.jpg  Dr. Susan Salvo is a massage therapist, author, educator, researcher, explorer, and perpetual student. To learn more, check out the “About Susan” tab. You can contact Susan at susansalvo@hotmail.com.

Renee-Michele-headshot 2019 Dr. Michele Renee began her career as a massage therapist in 1998. After several inspiring and successful years, she expanded her scope of practice, first with chiropractic and later with a master’s degree in acupuncture. Today she runs a multidisciplinary clinic in Minneapolis, MN and serves as the Director of Integrative Care at Northwestern Health Sciences University. Drawing from many years of teaching and administration in the health sciences, Michele shares her varied experiences in education, patient care, and many paradigms of healing with health care practitioners across the US. She lives in beautiful Minneapolis, MN with her foster son and four furry friends. You can contact Michele at dr.renee@stockheart.com.