What are the Contraindications to Massage Treatment?

Massage treatment is non-invasive, relaxing and natural. It is therefore generally considered a safe treatment for most people.

However, there are three types of contraindication (conditions that make massage unadvisable):

  • TOTAL, when massage should not be performed at all
  • LOCAL, when massage can be performed but not over the contraindicated areas
  • MEDICAL, when massage can only be performed once medical permission has been granted

I have put the following restrictions in place to protect your health and well-being. Thank you for taking them as seriously as I do.

Total Contraindications

When you have any of these conditions, please do not book a massage:

  • Fever
  • Contagious diseases, including any cold or flu, no matter how mild it may seem
Easily contagious through airborne droplets and by hands touching contaminated surfaces and for that reason it is generally preferable to
delay any massage until the acute phase has passed (5-7 days).
Some research studies indicate that if a person receives a massage while the infection is being established then he or she may become more
ill then otherwise. Also, working with clients who have common cold or flu puts therapists at high risk for contracting this infection!
  • Under the influence of drugs or alcohol-including prescription pain medication

Disorders of the Nervous System

  • Stroke

There is a high risk of a second stroke occurring within six months.

  • Undiagnosed Severe Headaches that come on suddenly, with no previous history of similar headaches, and dizziness, numbness or sleepiness
  • Meningitis

Symptoms of acute meningitis include a very high fever, rash, photophobia, headache and stiff neck. Symptoms are not always consistent
and may appear in different combinations for different people. Meningitis is inflammatory, potentially communicable, and has the
possibility of creating a very severe damage. People who fully recovered can enjoy any form of massage

Infectious Respiratory Disorders

  • Tuberculosis (TB)

TB is contagious through indirect casual contact, for this reason active untreated disease contraindicates any massage, until the client has
been on medication for 1 month

Disorders of the Heart and Blood

  • Heart attack

Because there is a very high risk of a reoccurrence in the two to three months after the attack, massage is contra-indicated. After this time is
permitted with a doctor’s note

  • Haemophilia

Severe haemophilia is a total contraindication to massage. Any bodywork that can accidently stretch or injure delicate tissues (incl. blood
vessels) is very risky and can be dangerous. Mild forms - written consultant's consent will be required

  • Severe Anemia

Massage is fine for mild anemia, but contraindicated for severe anemia.

Disorders of the Abdominal Organs

  • Hepatitis is contra-indicated in acute stages.

Acute hepatitis carries a risk of several serious complications, including jaundice, cirrhosis and liver failure. Any massage that puts an extra
adaptive stress on the body may be overwhelming rather than supportive during this time. Further, some types of hepatitis are
communicable without direct contact with body fluids and this presents a high risk to therapist as well as client

  • Cirrhosis of the liver

Complications of cirrhosis can damage the skin, interfere with blood toxicity, and generally impair function of several systems

Disorders of the Urinary System

  • UTI's are uncomfortable and when acute, may involve fever and malaise
  • Acute or Chronic renal failure

Patients undergoing dialysis are at increased risk for infection, especially where the equipment enters the body. Those with kidney
transplant also take immune-suppressant drugs, so they are vulnerable to any pathogens carried by a massage therapist

  • Kidney Stone attack
  • Acute stages of gout

Conditions of the Reproductive System

  • Herpies
  • Genital Warts
  • Syphilis
All of the above can travel by skin-to-skin contact, and lesions may not be confined to genitalia

Infectious Skin Conditions
(viral, fungal, parasites and bacterial)

  • Scabies
  • Head Lice
  • Ringworm
  • Impetigo

Non-Infectious Skin Disorders

  • Areas of skin that are bleeding, broken or weeping fluid.
  • Open wounds

Disorders of the Immune System

  • Cancer – if undergoing treatment.

If the client is currently undergoing any form of treatment for cancer then a doctor’s note must be produced prior to treatment. If the
doctor is happy for the client to receive a treatment then his note should be attached to the therapist consultation form and then the
relevant treatment can be carried out.

If the client has cancer but is not currently undergoing any treatment for the disease then we would carry out the treatment, making any
relevant notes on the consultation form. If the client is having a massage then the following adjustments should be made by the therapist:
the massage should be very light and gentle, no aromatherapy oils should be used and the site of cancer if relevant should be avoided

Skeletal System Diseases

  • 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.

Disorders of the Nervous System

  • Stroke – after 6 months
  • Transient Ischaemic Attack

TIA- a mini-stroke from which the person recovers with little or no damage

  • Meningitis, Brain haemorrhage and Brain tumours
  • Epilepsy

Active epilepsy only (previous 18 months). Do not use essential oils

Disorders of the Motor Nerve System

  • Parkinson’s disease

Massage is indicated under medical supervision, to maintain flexibility and reduce anxiety

  • Multiple sclerosis (MS)

Massage is indicated in sub-acute stages, when the client is in remission

  • Neuralgia

Massage Light massage to relieve muscle tension can be beneficial. Deep massage on the site is contra-indicated

Disorders of the Endocrine System

  • Diabetes

Doctors note only needed if not under medical control (diet or insulin)

Inflammatory Respiratory Disorders

  • Emphysema

Disorders of the Heart and Blood

  • Unstable angina

Should only with permission from the person’s doctor

  • Heart failure

Get medical permission, and then give only gentle massage to avoid stressing a weak heart

  • High blood pressure

Deep abdominal massage is contra-indicated, high blood pressure that is not controlled by medication requires a doctor’s note. Low Blood
pressure is not contraindicated but extra care is needed

  • Thickening of the arteries - Seek medical permission, and then give gentle massage only.
  • Deep vein thrombosis (DVT)

Totally contra-indicated for 3–6 months after diagnosis, for client/therapist protection. After that period, seek medical permission, and give
gentle massage only

  • Leukaemia (‘cancer of the blood’)

Seek medical permission and then use gentle massage

Disorders of the Immune System

  • HIV/Acquired Immune Deficiency Syndrome

HIV isn’t contraindicated itself — it can’t be transmitted during massage if there’s no exchange of bodily fluids. However, some of the
infections that people suffering from the later stages of AIDS experience are contraindicated, and you should avoid those infections.

Other Conditions

  • Fever

Contraindicates massage and bodywork for the dual reason that the client is already challenged and the practitioner shouldn't run the risk of
exposure to a contagious condition

  • Inflammation

Those who have used anti-inflammatory drugs prior to their massage may be less sensitive to pressure and consequently vulnerable to

  • Any headache that is accompanied by fever, confusion or numbness is a contraindication for any massage

Local Contraindications

The therapist can massage but not over any areas affected by:

  • Undiagnosed lumps or bumps
  • Pregnancy
  • Bruising
  • Cuts
  • Sunburn

Skeletal System Injuries

  • Partial fractures
  • Simple fractures
  • Compound fractures
  • Sprains

Joint Problems
  • Osteoarthritis and Rheumatoid arthritis – in acute stages
  • Ankylosing spondylitis – in acute stages

Disorders that affect motor nerve supply

  • Shingles

Non-infectious Skin Conditions

  • Skin cancer
  • Blisters
  • Eczema – only when open and weeping
  • Psoriasis – only when skin is broken
  • Recent Surgery and open wounds

Infectious Skin Conditions (bacterial, fungal and viral)

  • Acne (vulgaris) – depending on severity and degree of inflammation
  • Boils and carbuncles
  • Warts and Verrucas
  • Herpes – coldsore
  • Athlete’s foot

The Cardiovascular System

  • Varicose veins - Massage is contra-indicated in the area directly over, or immediately below the veins
  • Phlebitis - Massage of the affected area is contra-indicated.

Disorders of the Abdominal Organs

  • Abdominal hernia

Abdominal Contraindications – massage needs to be adapted.

  • Endometriosis
  • IBS
  • Crohn's
  • Colitis
  • Cysts
  • Fibroids if localised pain

Urinary System Disorders

  • Joints/limbs affected with gout or on the abdomen in non-acute stages of urinary tract infection

Medical Contraindications

If you suffer from any of the following conditions, massage can only take place once it has been approved before your session in writing by your Medical Practitioner.

Skeletal System Diseases

  • Osteoporosis

The primary risk for a person with Osteoporosis who receives massage is the fracture may occur because of undue pressure or problematic
positioning on a massage couch. Massage can help with pain and limited movement.

Disorders of the Nervous System

  • Stroke

After 6 months only - a person who survives a stroke is at increased risk for a repeat episode and may have other cardiovascular conditions.

  • Transient Ischaemic Attack

TIA- a mini-stroke from which the person recovers with little or no damage.

  • Epilepsy

Active epilepsy only (previous 18 months). Do not use essential oils.

Disorders of the Motor Nerve System

  • Parkinson disease

Many Parkinson disease patients have difficulty getting on/off the table and will probably need more assistance throughout the session.

  • Multiple sclerosis (MS)

Massage that is too deep or too fast can sometimes stimulate uncontrolled muscle spasms, even for clients who are in remission. Massage
can help relax, manage stress and depression.

Disorders of the Endocrine System

  • Diabetes

The risk of massage for a person with advanced or poorly managed diabetes are complex.
Cardiovascular disease, kidney disease, skin ulcerations and neuropathy compromise only a short list of common complications that alter any
bodywork choices. Injection sites or insulin pump attachement sites are a local contraindication. In addition, timing any massage/bodywork
choices around insulin doses is preferable to avoid causing a hypoglycemic episode.
Written consultant's consent will be required.

Disorders of the Heart and Blood

  • Angina

Written consent from the consultant will be required

  • High Blood Pressure

High blood pressure that accompanies other cardiovascular disease suggests that the client may have trouble adapting to changing
environment, and those who take medication for hypertension may feel dizzy or lethargic so may need more time after a massage to make
the transition back to full speed. People with mild or borderline hypertension who are encouraged to exercise are good candidates for any

  • Deep vein thrombosis (DVT)

Totally contra-indicated for 3–6 months after diagnosis, for client/therapist protection. After that period GP/consultant's written permission
will be required.
A client with a diagnosed blood clot is not a candidate for any massage until that situation has completely stabilized. Clients who use
anticoagulants are at significantly increased risk for bleeding and bruising.