Contra-Indications to specific Strokes:

Nervous trembling and nervous exhaustion must be treated in a way that is very supportive and nourishing for the person. Effleurage is the main stroke to use and very light petrissage can be used also. Friction, vibrations and tapotement are contra-indicated. Effleurage may be the only stroke one can use when the need is for a gentle building process, not a breaking down and expanding process. The massage is being used to calm and focus, to support the person and help them to build up again.
Where a person is holding emotionally once again stimulating work is contra-indicated. Do not work deeply or stimulate to force a change in the persons state. Effleurage and light petrissage are the strokes to use to encourage the person to relax and tune into their experience. In these last three conditions recuperation is what is needed. Time and gentle work will help best in supporting the person in their process of recuperation.
During pregnancy all tapotement is contra-indicated. Effleurage is always helpful. Petrissage can be used with discretion except on the lower back or pelvic area. Avoid massaging women who have a risk or history of miscarriage when they are trying to conceive.
First Trimester: It is often recommended not to massage during the first three months of a pregnancy but it is often 2 months before people confirm they are pregnant and some people keep it secret even after that. Positioning of client is not crucial in this phase.
Rest of Pregnancy: Lie client on their side. Bolster as necessary. Relaxin is in the system at this stage so avoid full range of motion movements and over stretching of ligaments, especially in the pelvic area. Oedema may be a problem towards the end. Perform lymphatic drainage.
After birth massage can be very supportive – relaxing strokes.
If a person has osteoporosis avoid deep and heavy work. Enquire about the degree of osterporosis and use caution on the effected area. (delete this bit) tapotement and friction as bones can be crumbly
After a heart attack or stroke effleurage only in the first six to ten months following consultant or doctor's advice. Introduce petrissage with discretion after this time and pay close attention to the person’s breathing, colour, and reactions. Tapotement may be introduced after eighteen months but once again with caution. If the person has angina and they have been cleared for massage, only use light strokes and avoid tapotement and friction. Caution is needed when treating people with high or low blood pressure. Pay attention to the clients breathing, sweating, colour, and pain. People with low blood pressure need careful monitoring when recovering from the prone position – so always stay with them after massage and help them off plinth.
Normally work one joint above the area of a treated broken bone. After the cast is removed and physiotherapy is completed (or with the clearance of the physiotherapist) effleurage and moderate petrissage are very useful to rehabilitate the area.
If scar tissue is red or sore or swollen or hot and over 18 months old you still avoid the area. Otherwise massage in general and friction in particular can be useful to break down possible adhesions. Multi-directional friction
Effleurage and petrissage are very useful to help in venous return of an overweight or obese person. Avoid deep, extensive or very stimulating work so as not to over-tax the heart. Consideration should be given to the patient's body image.
Massage is beneficial to the majority of people but there are times when for one reason or another it is contra-indicated. It is important to trust one’s own judgment and to proceed to the best of ones knowledge and ability. But when in doubt it is vital to err on the side of caution as you do not want to add to anybody's discomfort. Refer them to a medical practitioner, modify techniques to avoid specific conditions or body areas, choose the strokes best suited to the person’s state at that time, whichever is most relevant on the occasion. The person one is working on is the most important component in any massage and their comfort is foremost in the whole process.