I have been in this profession for 32 years now.
Began to get trouble with my MCP joints and thumbs after 10 years or so.
Changed my technique... and quite radically .....
When I "massage" I steer with my legmuscles and use weightshifting AND most importantly I use very soft techniques, skin deep.
You should all try it.... its amazing what you can do with the skin.......
think dermatomes and not only muscles/joints and you will see that you need not "overburden" you patient or your joints....
good luck.....
Esther