Are You a Candidate for Massage?
When working with a massage professional, it is important that they understand when massage is and isn't beneficial or safe for the client. Although massage can be helpful for so many reasons, it is equally important to know when massage should be avoided or modified to prevent harm or cause pain or worsen an existing condition or malaise.
If massage assists or supports an individual or improves a condition we say that massage is indicated. If performing massage worsens or threatens an existing condition we say that massage is contraindicated for that person.
So, are you a candidate for massage?
90% of the population is. As massage professionals we are obligated to keep our clients safe. That means knowing when to refer a client to another specialist with the expertise to treat the client's conditions if they are beyond the scope of our expertise.
The true massage professional will also know when to turn away a client if they have a condition (temporary or permanent) that massage is not permitted or recommended for.
Please review the following list. It is not exhaustive, but it will help you make an informed decision. When in doubt, consult a doctor.
As massage professionals, we can not diagnose our clients or prescribe medication. Our focus is treating your muscles, alleviating pain and stress and using energy work to clear blockages that might be the source of your physical challenges.
Atherosclerosis - a build-up of plaque in artery walls. Care needs to be taken so that any thrombi are not dislodged.
Arteriosclerosis - hardening of the arteries. Care is needed because there is usually some atherosclerosis and high blood pressure associated with this. No bodywork in advanced stages. Get medical clearance for your work if the client takes medication for circulatory problems.
Any situation that might put the massage therapist of client in contact with bodily fluids (blood, semen, vaginal fluids, or mother's milk). We avoid all visible rashes, sores, lesions, or swelling. We also take precautions against contacting cuts or scrapes or scratches.
Autoimmune Diseases: The immune system produces antibodies against the body's own tissues. We don't work on acutely inflamed tissues.
A) Lupus - Contraindicated during acute flares.
B) Rheumatoid Arthritis - contraindicated during inflammatory stage.
C) Scleroderma ("Hardened Skin") - Contraindicated during inflammatory phase.
D) Ankylosing spondylitis - inflammation of tissues around the spine causing the connective tissues of the sacrum and spine to solidify. We don't work on areas of pain and inflammation in acute episodes.
Bipolar Disorder (Manic - Depressive): during manic phase, deep bodywork could be contraindicated, since it could then increase the amplitude of the extreme mood-swings.
Broken Bones: Our therapists stay away from an area of mending bones. A little light massage to the surrounding areas, though, can improve circulation and be quite helpful.
Cerebral Palsy: Extreme caution to avoid worsening issues around shortened tissue and limited mobility. We recommend seeing a Physical Therapist for anything other than light, relaxation bodywork.
Cancer: Although massage can be highly supportive when done correctly (via light touch and relaxation massage), deep tissue work may cause the cancerous cells to metastasize (move through circulatory or lymphatic system to other places in the body). We need to be careful NOT to stimulate circulation. Also, we have to be sensitive to lumps in abdomen, or lymph nodes in groin or armpit. Also, be sensitive after mastectomy and a doctor should be consulted as to whether massage in the area (incl. the arm) is indicated.
Connective Tissue Disease: E.g. osteomyelitis, lupus, scleroderma: no deep work.
Diabetes: We avoid deep work on area of recent insulin injection which could accelerate Insulin uptake.
Embolism or Thrombus: a) Venous emboli - usually land in the lungs causing pulmonary embolism. b) Arterial emboli - can lodge themselves in the coronary arteries (heart attack); the brain (stroke), the kidneys, or the legs (phlebitis). Deep bodywork is contraindicated because of the risk of dislodging a thrombus. If the client takes blood thinners as a medical precaution against clotting, ask for a medical clearance for any kind of deep tissue work affecting the circulatory system.
Fever: Massage increases overall circulation and could work against your body's natural healing cycle.Once the fever is gone, come see us.
Headaches: Some types of headaches get worse with any kind of massage around the head/neck/shoulder area, especially if overstimulated or overworked. This is quite common for migraines in the acute stage. Tension headaches (which are usually more bilateral) tend to respond more positively.
Heart Conditions: OK. if not restricted from exercise.
High Blood Pressure: client with high blood pressure or a heart condition should receive light, sedating massages.
Hemangioma: These are congenital benign tumors, made up of newly formed blood vessels. Different types, usually on the skin, yet sometimes also in brain and viscera. Specially in cases of known visceral type (e.g. hepatic hemangioma) no deep work in this area because of the severe danger of internal bleeding.
Herpes (and other potentially infectious skin conditions, including warts).
High Blood Pressure (Extreme): Don't work in way that makes clients hold breath. Deep work on uncontrolled high blood pressure patients should be with medical supervision (deep bodywork often RAISES blood pressure).
Impaired Elimination Systems: Use caution with colostomies, Candida, kidney, and liver issues; careful.
Infectious Diseases: Massage is not a good idea for someone coming down with the flu or diphtheria. It also put the therapist at risk.
Inflammation: Massage can further irritate an area of inflammation. In the case of localized problems, you can still massage around them, however, avoiding the inflammation itself.
Intervertebral Disc Problems
I.U.D.: We have to be careful with any deep abdominal work in female clients which use an intra-uterine device for birth control. It is possible that an I.U.D may become displaced, possibly leading to complications.
Menstruation (If Strong): If the client tends to have very strong menstruation symptoms with high amount of blood loss, any kind of deep tissue work or even massage in the area of pelvis, abdomen and thighs - if done around the days of the client's period - can sometimes increase circulation and therefore the severity of the menstruation. We can give only a very gentle movement awareness session which does not tend to increase circulation in the pelvic region.
Osteoporosis: Elderly people with a severe stoop to the shoulders often have this condition, in which bones become porous, brittle, and fragile. Massage may be too intense for this condition.
Pain Medication: Use caution regarding reduced sensation and greater possibility of tissue or nerve damage. (Same with paresthesia)
Pregnancy: Rule of thumb: no deep work. Be aware: danger of triggering a miscarriage by strong myofascial work is greatest during first 3 months (specially through work around the pelvis, abdomen, adductors, medial legs, or feet). Later in pregnancy this gets less likely.
Psychosis: Full psychosis is in most cases a contraindication.
Skin Problems: Rashes, wounds, bruises, burns, boils, and blisters, for example. Usually these problems are local, so you can still massage in other areas.
Varicose Veins: Don't work varicose veins. However, a very light massage next to the problem, in a direction toward the heart, it can be very beneficial.
Whiplash: If inflamed, it might get worse.
Although relaxation work may be performed with caution with a doctor's approval, no deep massage or bodywork on:
- Abscess teeth (no intraoral work)
- Bone fractures or acute soft tissue injuries: wait for full healing (6 weeks - 3 months)
- Clients on Cortisone: (wait 2-3 months)
- Hodgkin's disease (cancer of lymph system)
- Phlebitis: same risk as for 'embolism or thrombus'
- Recent scar tissue (including regular or plastic surgeries): no work on this area until scarring process is complete (usually at least 6 weeks)