Turned Away From Massage: Contraindications and Precaution.
I recently had a handful of people call and tell me the same thing.
“I was turned away when I called to set up an appointment.”
It wasn’t because they had been to the location and misbehaving but because they had some specific condition such as cancer, pregnancy, or obesity that the facility didn’t want to work on. If it was lack of training or liability I can’t say but it made me sad to know there were people out there being turned away when they needed help the most. I was shocked when I heard this the first time, but since then in the year and a half I’ve been in Indiana, I have had a few of these calls. I wanted to write on the topic of massage contraindications to let those who have been denied know that they may just need to find a specialist like myself instead of going to a chain.
When it comes to those with health conditions you will want to seek out a trained medical massage therapist. There are some who specialize in certain conditions like oncology, post operative lymphatics, hospice, or pediatrics. It’s great if you can find a specialist who works with your specific case type but if not, a medical massage therapist has broad knowledge on conditions, pathology, medications, and contraindications. Those who specialize in medical massage can work with clients who have complex health histories. This is what I love doing. When someone comes in with pain I can work with their conditions knowledgeably to give them the best results. Chain spas often wont work with these clients due to liability and limited therapist skills, however many independent therapists will and know how.
So what is a contraindication?
A contraindication is something, such as a symptom or condition, that makes a particular treatment or procedure inadvisable. This means that the condition could worsen or have poor side effects if a treatment was done. A great example of this is the flu. If you have the flu and try to get a massage you will be turned away. Not only because therapists don’t want to get sick but because it can compound your symptoms. Massage moves lymph fluid and causes stress on the body and it can intensify symptoms of a flu making fevers spike, congestion worsen, increase nausea, and increase fatigue. This is a reasonable time to turn a client away for massage and there are many conditions that warrant the same caution. However some conditions just warrant extra training and a different caution during the session.
A handful of contraindications are
Injuries such as fractures, sprains, or strains in the acute phase
Flu, Covid, Colds, or other communicable diseases
Rashed, fungal infections, hives, or other skin irritation
What conditions are a precaution instead of a contraindication?
Prenatal or Pregnancy massage is a good example of precaution not a contraindication. With prenatal many clients require different bolstering such as side-lying or semi-prone (half seated) positioning. There are areas like the inner thigh that need to be avoided or gently touched as blood clotting is common. Unless a pregnancy is high risk then massage is not contraindicated, but a client should find someone who is trained in prenatal specific massage. Many people have the misguided idea that massage can cause a miscarriage or spontaneous labor however this is not a proven risk. Massage is proven to be very beneficial to the mother especially with those experiencing pain, stress, fatigue, or anxiety.
Cancer can be tricky depending on the treatments the individual is experiencing. There are some chemotherapies that are so aggressive the patient has to quarantine their bodily fluids and dishes from other household members and at that stage a client shouldn’t get a massage. They may also have skin frailty or damage from radiation that should be avoided in that stage. They may have ports that need to be carefully worked around and kept clean. However there are also less aggressive treatments that don’t contraindicate massage at all. Some therapy is gentle enough that if a client is cleared for other treatments or life activities they are safe to come in for a session. A therapist trained in oncology or medical massage will know how to assess the risk of a patient and adjust to fit their needs at each stage. Therapists will often wear gloves as an added protection for the clients immune system. We wash our hands thoroughly but gloves make sure any residual germs stay with us. As for those who are big and tall this condition can be just as easily turned away when it doesn’t need to be. However this isn’t a health issue as much as it is a safety one. Most people over 250 lbs will be turned away from clinics because it has to do with our equipment. Majority of massage tables including electric and hydraulic are designed for 300 lb weight capacity. This capacity limit included both the client weight (static) and the pressure we are creating as therapists (active). The concern is especially present with older tables. As they are often made of wood with adjustable legs, the weight capacity reduces with the age of the table. Often tables will be used for upwards of 10 years! The more strain a table endures the shorter its lifespan and the lower its capacity over time. There are tables designed for higher weight limits but most spas won’t pay for the difference when they are purchasing multiple for a location. They will always keep significantly under the limit as well to extend the table life and avoid table collapses for liability reasons. While all this is reasonable from a business perspective it’s still unfortunate for those who can’t help their size. In my practice I am willing to take larger clients as long as they understand that their feet may hang off the end, it’s a little narrow so some may prefer their arms to hang off the sides, and there is a small risk that the table may break. I do everything to mitigate the risk and use a table with a higher capacity and have a second on standby.
Other cases that require precaution are
Those on heart or blood pressure medications
Bruises, varicose veins, spider veins
Recently recovered injuries
Arthritis, osteopathy, brittle bone
Numbness, or lack of sensory input
I may be biased as a therapist but I think many individuals with medical conditions can benefit from massage. Often those undergoing critical health treatments get handled in a medical setting as a patient and may gets poked, prodded, and handled in an uncomfortable way to achieve effective treatment. However, positive touch is just as important for a patient's outlook. Positive touch like massage can help their nervous system calm down and relax, reducing not only physical pain but anxiety and depression. As social creatures humans need touch and massage can help with that for many who may not be getting enough. Having something wonderful to look forward to each week can also help those struggling to push forward through unpleasant moments.
If you are uncertain about if you should get a massage, contact a medical massage professional who works with your condition and have a conversation. We are always happy to answer questions and share knowledge. Doctors notes are not necessary to receive massage and not all doctors understand that we may be specially trained to work with medical conditions. However, if you have a care team, express your interest in massage and share your preferred therapists contact information with them. Oftentimes medical professionals can collaborate on your health and wellness for the best results.
Have a question? Contact us at EmmaLaniMT@gmail.com