When Should You Avoid Massage Therapy?

Cardiovascular Conditions

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• Deep Vein Thrombosis (DVT)
  Massage should be avoided in cases of DVT due to the risk of dislodging a blood clot, which could lead to a life-threatening pulmonary embolism. Massage on the affected limb or surrounding areas is contraindicated.

• Uncontrolled Hypertension
  Massage can temporarily increase blood flow, which may elevate blood pressure. Massage should be postponed until the client’s blood pressure is controlled and stable.

• Recent Heart Attack or Stroke
  Massage can increase cardiovascular stress in individuals recovering from a heart attack or stroke. Always wait for medical clearance before administering massage therapy to these clients.

 

Skin Conditions

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• Open Wounds or Unhealed Sores
  Massage can introduce bacteria into open wounds, increasing the risk of infection. Avoid massage on and around the affected areas until they are fully healed.

• Severe Bruising or Hematomas
  Massage can aggravate bruising and cause further tissue damage. Wait until bruising has subsided significantly before resuming massage in the affected area.

• Active Skin Infections (e.g., Cellulitis, Shingles)
  Active skin infections may worsen with massage, spreading the infection or causing pain. Massage should be avoided until the infection has cleared and the skin has healed.

 

Bone and Joint Conditions

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• Severe Osteoporosis
  Clients with fragile bones are at risk of fractures, even with moderate pressure. Only use extremely gentle techniques and avoid direct pressure on bones that are affected by severe osteoporosis.

• Recent Fractures or Sprains
  Massage can interfere with the healing process of fractures or sprains. Ensure the injury has fully healed and obtain medical clearance before resuming massage therapy.

• Acute Rheumatoid Arthritis Flare-ups
  Massage during active flare-ups of rheumatoid arthritis can increase inflammation and pain. It’s best to wait until the acute phase has passed before massaging the affected joints.

 

Neurological Conditions

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• Acute Spinal Cord Injuries
  Massage can worsen spinal cord injuries or trigger autonomic dysreflexia, a dangerous increase in blood pressure. Avoid massage until the client has been cleared by a physician.

• Advanced Peripheral Neuropathy
  Clients with advanced neuropathy may not be able to provide accurate feedback on pressure, leading to potential injury. Use extreme caution and only apply very light pressure.

 

Systemic Conditions

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• Active Cancer
  There is a concern that massage could potentially spread cancer cells through the lymphatic system. Medical clearance is required, and areas with tumors or metastasis should be avoided.

• Uncontrolled Diabetes
  Massage can affect blood sugar levels. Ensure diabetes is well-managed and monitor the client for signs of hypoglycemia during the session. Massage should only be performed when blood sugar levels are stable.

• Fever or Acute Infections
  Massage can spread infection or increase body temperature. Wait until the fever has subsided and the infection has cleared before resuming massage.

 

Medications

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• Blood Thinners (e.g., Warfarin, Heparin)
  Clients taking blood thinners are at an increased risk of bruising and internal bleeding. Use very light pressure and avoid deep tissue techniques to prevent injury.

• Corticosteroids
  Long-term use of corticosteroids can thin the skin and make bruising easier. Gentle techniques should be used, and caution should be exercised when applying pressure.

• Chemotherapy Drugs
  Chemotherapy can cause increased sensitivity and a higher risk of bruising. Be mindful of these effects and adjust the pressure accordingly, using gentle techniques.

Other Considerations

• Recent Surgery
  Massage can disrupt the healing process following surgery. Generally, it is recommended to wait 6-8 weeks after surgery and obtain medical clearance before starting massage therapy.

• Severe Edema
  While gentle lymphatic drainage massage can sometimes help reduce swelling, deep massage may exacerbate the condition. Consult the client’s healthcare provider before performing any massage on areas with severe edema.

• Cognitive Impairments (e.g., Advanced Dementia)
  Clients with advanced cognitive impairments may struggle to give informed consent or provide accurate feedback during the massage. Ensure that proper consent is in place and use extra caution during the session to avoid injury.

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Why Contraindications Matter

Massage therapy is a valuable tool for improving health, but knowing when to avoid it is crucial. Each of these conditions requires special consideration, and in many cases, consultation with a healthcare professional before massage is essential. At Thrive, our therapists are trained to provide safe, effective care that adapts to the needs of every client.