Massage Therapy Contraindications

Ranpreet Kaur, LMBT NC License #17796 © 2019

While we all should know that massage should be avoided during an acute injury stage of 48-72 hours, there are many reasons that you may want to seek an alternative type of therapy or see a specialist for other conditions following that time period. Contraindication, as defined by the Merriam-Webster Dictionary, is something (such as a symptom or condition) that makes a particular treatment or procedure inadvisable, such as massage therapy in this case. Contraindications for massage could be categorized into General, Local, or Medical types. 

​Acute injury is a sudden, sharp, traumatic injury that causes pain, such as a fall, strain, sprain or collision. When the body experiences an acute injury, there is an acute period of healing, generally lasting 24-72 hours, which typically involves pain and inflammation.

---

Understanding Acute Injury

The four cardinal signs of inflammation are known as Redness, Pain, Increased Heat, and Swelling. During this time, massage would be contraindicated as an effective technique while the body's own immune response is stimulated and begins its job of healing.
​
R.I.C.E. is a well known methodology to treating the injury for the first 48 hours, consisting of Rest, Ice, Compression, and Elevation. If the pain or swelling has not decreased after two full days, a visit to a physician would be the next step. H.A.R.M. is another acronym known for Heat, Alcohol consumption, Running, and Massage that should be avoided as not to exacerbate the symptoms or make the injury worse. Once this time period has passed, some therapies would be acceptable depending on the individual nature of the injury and the patient being treated.

General Massage Contraindications

• acute injury or recent surgery
• fever
• contagious or infectious diseases, including cold and flu
• acute neuropathy, disease or dysfunction of one or more peripheral nerves, typically causing numbness or weakness
• bleeding disorders or blood clots
• fractures
• open or healing wounds
• severe, unstable hypertension

Local Massage Contraindications

• varicose veins
• deep vein thrombosis
• aneurysm
• acute flare-up of inflammatory conditions such as rheumatoid arthritis
• bruising, cuts, or abrasions
• local contagious or irritated skin conditions
• athlete's foot, warts, or impetigo (a contagious bacterial skin infection forming pustules and yellow, crusty sores)
• sunburn
• frostbite
• undiagnosed lumps, bumps, cysts, or moles
• malignancy
• trigeminal neuralgia, involving one or more of the branches of the trigeminal nerves, often causing severe pain
• edema, swelling caused by excess fluid trapped in your body's tissues, most commonly occurring in your hands, arms, feet, ankles and legs
• venomous bites or stings

Medical Massage Contraindications

• cardiovascular conditions (thrombosis, phlebitis, hypertension, heart conditions)
• any condition already being treated by a medical doctor, unless specifically authorized by your doctor as a complemental therapy
• radiation therapy, such as during active cancer treatment
• meningitis
• hemorrhage 
• severe atherosclerosis, a progressive thickening and hardening of the walls of medium-sized and large arteries as a result of fat deposits on their inner lining
• acute pneumonia
• severe hemophilia
• advanced kidney failure
• liver failure
• appendicitis
• metastatic cancers such as lymphoma or malignant melanoma
• diabetes mellitus 1 or 2 with advanced heart or kidney disease
• chronic active hepatitis, progressive inflammation of the liver
• endocarditis, inflammation of the heart's inner lining or pericarditis, inflammation of the pericardium (fibrous sac surrounding the heart)
• lung abscess or lung tumor
• sepsis, a potentially life-threatening complication of an infection

“When Not to Get a Massage: 26 Reasons You Cannot Get A Massage.” 
​Massage Therapy Reference, https://www.massagetherapyreference.com/when-not-to-get-a-massage/.