Pathology: Indications and Contraindications

Massage is a safe, relaxing and rejuvenating way of treating a client. It is important to learn to trust your own judgement and develop confidence in choosing the correct strokes to use in a treatment. However, it is wise to follow specific guidelines to ensure that at all times you are supporting the person you are massaging and helping them to remain present with you in a relaxed manner.

If you are in any doubt that you should treat a client having taken a thorough case history, if there is any condition presenting or information you have been given that requires further investigation before proceeding with massage treatment refer the client to their doctor, consultant, other healthcare practitioner or other therapist to get clearance for massage or better still work with other healthcare practitioners in supportive working groups and as part of a healthcare team.

Have notes and texts on hand at your place of practice to inform yourself of conditions that present. The more informed you are on a client’s condition the better you are able to design the most appropriate treatment and to aid the client. Use the following table to create a quick reference guide. Know what is appropriate treatment in the acute (24-72 hours), subacute (3 to 21 days) and the chronic (longer than 3 weeks) stages of any condition or injury that you encounter. Continue to build your own guide as you encounter new conditions. Use the following texts to aid you in this task:

1) Werner Ruth (2009) A Massage Therapists Guide to Pathology. Lippincott, Williams & Wilkins. ISBN: 9780781769198

2) Turchaninov Ross, Connie A Cox: edited by Gernstine B & T Sutton (2006) Medical Massage. Phoenix, AZ: Aesculapius Books. ISBN 9780967586809

3) Braun, M.B., Simonson.S.J (2008) Introduction to massage therapy. Lippincott, Williams & Wilkins. ISBN:9780781773744

Condition Acute
(24 – 72 hrs) Subacute
(3 to 21 days) Chronic
longer than 3 weeks
Sprain Contraindicated Massage
Hyperonic muscle Indicated good for pain, spasm, ischemia