What are Contraindications?

What is a Contraindication? A massage contraindication is a pre-existing condition that may respond negatively to therapeutic massage techniques. People with contraindications to massage therapy Should avoid massage or bodywork until the condition has resolved. In some cases, massage may still be provided IF the treatment is modified to compensate for the condition, or if treatment is avoided at the affected area of the body.

You should not get massage if you….

• Are intoxicated at the time of your massage
• Are showing signs of a fever, cold, or flu (contagious disease or virus)
• Have open wounds/acute (recent) injuries
• Have any contagious skin conditions
• Had surgery within the last 4-6 weeks, without a doctor’s note
• Are pregnant in first trimester– if so, you must have a doctor’s note citing approval prior to a session
• Have uncontrolled Diabetes or high blood pressure (Although if you are currently taking medication for these, you can still receive massage)
• Concussions
• Deep vein thrombosis
• Bleeding disorders such as hemophilia

CONTRAINDICATIONS FOR ADD-ONS

CUPPING

Cupping therapy has several contraindications, meaning situations in which it shouldn’t be used or should be used with caution. Here are the main contraindications:

Absolute Contraindications

1.  Bleeding disorders (e.g., hemophilia) or those on anticoagulant therapy (e.g., warfarin), due to increased bleeding risk.
2.  Skin conditions like eczema, psoriasis, open wounds, or sunburn in the treatment area, as cupping could further irritate the skin.
3.  Malignancies in the area to be cupped, due to the risk of stimulating cancer cells.
4.  Fractures or recent bone injuries in the area, as cupping can worsen these injuries.
5.  Deep vein thrombosis (DVT) or recent blood clots, as cupping may dislodge a clot.
6.  Organ failure (e.g., renal, hepatic, or heart failure), since cupping may stress the body.
7.  Severe anemia or other blood disorders where red blood cells are affected, as cupping may aggravate symptoms.
8.  Pregnancy—avoid cupping on the abdomen and lower back, especially in the later stages.

Relative Contraindications (Use with Caution)

1.  Elderly clients or those with fragile skin, as they may bruise more easily.
2.  Children under 4 years, or in children generally, as their skin and circulation are delicate.
3.  Patients with thin skin due to medications like corticosteroids, as their skin is prone to bruising and damage.
4.  Those with sensory deficits (e.g., diabetic neuropathy) should be monitored closely, as they may not feel discomfort or pain.

General Advice

Always check for client-specific contraindications, especially in clients with complex medical histories. If in doubt, consult with a healthcare professional before performing cupping therapy.

GUA SHA

Gua Sha is a traditional East Asian technique that involves scraping the skin with a smooth-edged tool to improve circulation and relieve muscle tension. However, it has several contraindications to consider for client safety.

Absolute Contraindications

1.  Blood clotting disorders or use of anticoagulants—individuals with clotting issues or those on blood thinners (e.g., warfarin) are at higher risk of excessive bruising or bleeding.
2.  Recent surgery or injury in the area—gua sha can disrupt healing and increase inflammation or pain.
3.  Active infections or inflammation (e.g., cellulitis, skin infections) in the treatment area—gua sha may worsen these conditions.
4.  Open wounds, burns, rashes, or other skin conditions—gua sha can aggravate or damage compromised skin.
5.  Fractures or broken bones—gua sha in these areas can increase pain and delay healing.
6.  Cancer in the treatment area—gua sha may increase circulation to the area, potentially spreading malignant cells.
7.  Deep vein thrombosis (DVT) or recent blood clots—gua sha may risk dislodging a clot.
8.  Varicose veins—gua sha over varicose veins can cause vein damage or worsen symptoms.

Relative Contraindications (Use with Caution)

1.  Pregnancy—avoid gua sha on the abdomen, lower back, and certain acupressure points that might stimulate uterine contractions.
2.  Diabetes with neuropathy—clients with reduced sensation may not feel excessive pressure, risking skin damage or bruising.
3.  Elderly clients or those with fragile skin—use gentle pressure as their skin may bruise or tear more easily.
4.  Clients new to gua sha—start with lighter pressure to gauge their tolerance, as gua sha can cause temporary redness and bruising.
5.  High blood pressure—gua sha may briefly raise blood pressure, so avoid vigorous scraping in clients with uncontrolled hypertension.

General Advice

Before performing gua sha, assess each client’s medical history, skin condition, and pain tolerance. Explain the potential for temporary bruising and petechiae (small red or purple spots) so clients know what to expect. Always monitor for adverse reactions and adjust pressure as needed for client comfort and safety.

HOT & SALT STONES

Hot and salt stone massage can be very relaxing but has some contraindications that therapists should keep in mind. Here are the primary contraindications:

Absolute Contraindications

1.  Cardiovascular disorders like uncontrolled hypertension, heart disease, or recent heart attack, as heat may put additional strain on the heart.
2.  Diabetes with neuropathy, as clients may have reduced sensation and may not feel if the stones are too hot, leading to burns.
3.  Skin conditions such as open wounds, sunburn, rashes, or inflammation in the area, as heat and salt could further irritate or damage the skin.
4.  Varicose veins in the area being massaged, as heat may worsen circulation issues.
5.  Cancer, especially if active, as massage may stimulate cell growth or spread.
6.  Infections (e.g., fever, flu, or localized skin infections), as heat can exacerbate infection and may risk transmission.
7.  Severe osteoporosis or fragile bones, as the pressure of the stones may cause fractures.
8.  Pregnancy—avoid hot stones on the abdomen and lower back, particularly in the first and third trimesters.
9.  Blood clotting disorders or those on blood thinners, as there’s a higher risk of bruising and bleeding.

Relative Contraindications (Use with Caution)

1.  Peripheral neuropathy or reduced sensation, where clients may not feel excessive heat or pressure.
2.  Elderly clients who may have thinner or more fragile skin, making them prone to burns or bruising.
3.  Respiratory conditions like asthma, as heat in the room may aggravate symptoms.
4.  Recent surgery or injury in the area, as stones may disrupt healing.
5.  Allergies or sensitivities to salt or oils used with stones, as these can cause skin reactions.

General Advice

Always assess each client individually, checking for specific conditions or sensitivities before using hot or salt stones. Adjust the temperature and duration as needed and confirm client comfort throughout the session to avoid burns or irritation.

CBD MASSAGE OIL

CBD massage, which uses cannabidiol-infused oils or creams, may offer benefits such as pain relief and relaxation, but there are some contraindications to consider.

Absolute Contraindications

1.  Allergies to CBD or hemp products—clients with a known allergy or sensitivity to CBD, hemp, or cannabis products should avoid CBD massage.
2.  Pregnancy and breastfeeding—CBD’s effects on pregnant or breastfeeding women are not well-studied, so it’s often recommended to avoid CBD massage in these cases.
3.  Severe liver or kidney disease—CBD is metabolized in the liver, and clients with impaired liver or kidney function might have difficulty processing it.
4.  History of drug or alcohol addiction—some individuals in recovery may wish to avoid any cannabis-related products, even if non-psychoactive.
5.  Open wounds, rashes, or infections—CBD oils can irritate open or infected areas of skin.
6.  Certain medications—CBD can interact with some medications, particularly those metabolized by the liver. Clients should consult their healthcare provider if taking medications like blood thinners, anti-seizure drugs, or antidepressants.

Relative Contraindications (Use with Caution)

1.  Low blood pressure—CBD may cause slight drops in blood pressure, so use caution in clients with hypotension or those on blood pressure medications.
2.  Skin sensitivity or dermatitis—clients with very sensitive skin may react to CBD oils or creams, especially if they contain additional ingredients.
3.  Autoimmune disorders—some individuals with autoimmune diseases may react differently to CBD, so it’s best to consult a physician if they are interested in trying a CBD massage.
4.  Clients new to CBD—individuals who have not used CBD before may want to start with a small amount to assess tolerance.

General Advice

Always discuss with clients any known allergies, medications, or conditions they may have. Starting with a patch test can help assess skin sensitivity to CBD. Since CBD can interact with certain medications, it’s recommended that clients consult with a healthcare provider if they are on regular medication before trying a CBD massage.

TRIGGER POINT TOOLS

Trigger point therapy tools, such as massage guns, rollers, or hand-held pressure devices, can be effective for muscle tension and pain relief, but they should be used cautiously. Here are the primary contraindications for using trigger point tools:

Absolute Contraindications

1.  Blood clotting disorders or use of blood thinners—applying pressure may increase the risk of bruising or bleeding.
2.  Recent injuries such as fractures, sprains, or muscle tears in the area—using tools could worsen the injury.
3.  Severe osteoporosis or brittle bones—applying deep pressure may increase the risk of fractures.
4.  Infections or inflammation in the area—trigger point tools can aggravate infections or inflamed tissues.
5.  Cancerous tumors in the treatment area—deep pressure could potentially increase cancer spread.
6.  Varicose veins or vascular conditions—deep pressure may worsen circulation issues or cause damage.
7.  Open wounds, rashes, or skin infections—using tools on compromised skin can lead to irritation or further infection.

Relative Contraindications (Use with Caution)

1.  Diabetes with neuropathy—reduced sensation can prevent clients from accurately gauging pain or pressure, increasing the risk of injury.
2.  Pregnancy—avoid using tools on the abdomen, lower back, and legs to prevent excessive pressure.
3.  Hypertension—intense massage or deep pressure on trigger points can elevate blood pressure temporarily.
4.  Fibromyalgia or chronic pain syndromes—some clients may be sensitive to pressure, so start gently to avoid triggering pain.
5.  Clients new to trigger point therapy—introduce the tools gradually to gauge their tolerance and avoid overstimulation.
6.  Children or elderly clients—their bodies are often more fragile, and excessive pressure can cause discomfort or injury.

General Advice

Before using trigger point tools, assess each client’s health history and sensitivity to pressure. Always start with gentle pressure, especially for new clients, and encourage them to provide feedback to avoid discomfort or injury.

AROMATHERAPY

Aromatherapy massage, which involves using essential oils for enhanced relaxation and therapeutic effects, has certain contraindications to be aware of. Here are the primary contraindications:

Absolute Contraindications

1.  Allergies to essential oils—clients with known allergies to specific essential oils or plants should avoid these in the massage.
2.  Pregnancy—some essential oils (e.g., rosemary, clary sage, and jasmine) may stimulate uterine contractions and should be avoided, especially in the first trimester.
3.  Epilepsy or seizure disorders—some oils, such as rosemary and fennel, may trigger seizures in sensitive individuals.
4.  Asthma or respiratory issues—strong scents may aggravate asthma or other respiratory conditions.
5.  Skin conditions like eczema, psoriasis, or open wounds—some essential oils can irritate the skin, worsening these conditions.
6.  Kidney or liver disease—these organs help process substances absorbed through the skin, and essential oils can place additional strain on them.
7.  Hormone-sensitive conditions (e.g., breast cancer, uterine cancer)—oils like lavender and tea tree may have mild estrogen-like effects, so avoid them in these cases.
8.  Infants and young children—many essential oils are too strong for young skin and should be avoided or used only in very low dilutions.

Relative Contraindications (Use with Caution)

1.  Low blood pressure—some essential oils, like lavender, can lower blood pressure, so use caution with hypotensive clients.
2.  Elderly clients—skin sensitivity may increase with age, so it’s best to use oils in lower concentrations.
3.  Photosensitivity—citrus oils (e.g., lemon, orange) can make skin more sensitive to sunlight, so avoid applying them to skin that will be exposed to sunlight shortly after.
4.  Allergy-prone clients—if clients have general allergies, patch test new oils to ensure there’s no reaction.
5.  Migraines or frequent headaches—strong scents may trigger headaches in sensitive individuals.

General Advice

Always perform a patch test with any new essential oil blend and adjust concentrations for clients with sensitive skin or medical conditions. Clients with complex health conditions should consult with their healthcare provider before using aromatherapy massage to ensure it’s safe for them.

If you are unsure, please bring a doctor’s note citing approval.