Indications and Contraindications for Massage: What You Need to Know

indications for massage - what you need to knowIf you’re about to embark on a massage therapy career, it’s likely that you will be often hearing the terms “indications” and “contraindications”. Understanding the correct terminology is imperative when communicating effectively with other health practitioners. A thorough understanding of what these terms actually mean is also necessary when communicating with your future clients.

Indications for massage
The definition of an indication for massage is literally, a reason to provide someone with a massage, or as a condition that massage may be able to influence positively. For example, a reason to recommend massage would be if they had pain or tension in a part of their body.

The list of indications for massage is extensive, as you would imagine, but here are some common ones to help you to understand the principle: back pain, neck or shoulder pain, muscle spasm, muscle weakness, whiplash, nerve injuries, carpal tunnel syndrome, sciatica, poor circulation, tendinitis, arthritis, fibromyalgia, constipation, headaches and migraines, sinus disorders and skin problems.

Contraindications for massage
The definition of a contraindication for massage is a reason not to provide someone with a massage. A contraindication is something that massage may interact with negatively, for example a fever or severe pain.

There is a long list of contraindications for massage. Put simply, if a patient presents with an absolute contraindication, under no circumstances should a massage be performed. For example, contagious diseases, vomiting, diarrhoea, fever, severe pain, kidney disease, or a history of thrombosis are all considered absolute contraindications for massage.

It’s not all black and white though. There are varying degrees of indications and contraindications. Contraindications may be further defined as relative or absolute, general or regional. What’s more, they can be a combination of these. Let’s look at the main categories:

Absolute contraindications
When something is considered an absolute contraindication, it means that the client should not be given a massage in that particular area no matter what the circumstances. For example, if someone had DVT (deep vein thrombosis) under no circumstances should the lower calf muscles be massaged.

Relative contraindication
When there is a level of caution or danger associated with a massage treatment, it is called a relative contraindication. With a relative contraindication, the massage may be performed, but simply modified to ensure the safety of the indicated area. This is typical where there has been a recent injury, or where there has been surgery. In these cases, a particular massage therapy treatment may be beneficial so long as it is performed by a knowledgeable and experienced massage therapist who knows how to avoid damaging the delicate tissues.

General contraindications
When a contraindication affects the entire body, it is known as a general contraindication.

Local contraindication
If the contraindication affects only a localised area of the body is known as a local contraindication.

Combined contraindications
indications and contraindications for massage - what you need to knowThis term sounds a little trickier than it is, but put simply, a condition may be any combination of local or general, and relative or absolute. For example, DVT is both local and absolute and an acute injury to the biceps insertion would be both relative and local.

If a patient wants to have a massage and has informed you that they have some type of contraindication, it’s a good idea for them to obtain medical approval from their doctor or physiotherapist before booking a massage therapy session. Depending on the condition, many massage therapy centres will insist on medical approval before commencement of the treatment. This is a sensible rule that covers both the practitioner and the patient. No matter what the condition is however, it is essential that the patient always informs the massage therapist before treatment commences.

Sage Institute of Massage – it’s more than a job, it’s a rewarding career.

Vicki Tuchtan

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