Contraindications & Areas of Caution for Massage Therapy

Instructor: Cara Sherman

I have a master's degree in Science. I have taught Anatomy & Physiology, Kinesiology, Medical Ethics, Resume writing, Cultural Diversity, and Medical Terminology.

In this lesson you will learn about contraindications that warrant a massage not being done, or not being done to a specific area. You will also learn about endangerment sites, and why they should be avoided in a massage routine.


Can a massage be bad for you? Have you ever thought, is there I time I shouldn't get a massage?

VE Note: potential image --

While massage has many benefits, there are general cautions that should be taken with certain medical issues and having a massage performed:

One, vigorous massage strokes should be avoided by people with a bleeding disorder or those who may be taking a blood thinner.

Two, massage should not be done in any area of the body where there may be blood clots, fractures, open or healing wounds, skin infections, and healing from a recent surgery.

Three, although massage therapy is generally safe for cancer patients, it is best to have the patient consult with their oncologist prior to receiving a massage.

Four, pregnant women should also consult their healthcare provider prior to using massage therapy, and then should seek a therapist who is specially trained in massage therapy during pregnancy.

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A contraindication in massage is a reason why a massage therapist or practitioner would not give a massage to a client because it may cause harm in some way. Contraindication in massage can be broken down into two categories. A local contraindication in massage is when massage cannot be performed over a certain area. Often times massage can be done to the rest of the body, but not to the area that is contraindicated.

A total contraindication in massage is when massage should not be performed under any circumstance.

Let's go over some examples of each type of category.


Contraindications for a massage can be discovered when the massage therapist is doing his/her assessment and intake. Some examples for areas of local contraindications include varicose veins, lumps or bumps that are undiagnosed, or haven't been cleared by a medical profession, severe bruising, deep or open cuts, frostbite, sunburn, and areas of recent local surgery.

VE Note: You might also show animation of the above examples to avoid having to show actual pictures; for instance, showing a cartoon female character with red shoulders to indicate a sunburn or a male character with gauze around his arm to indicate recent surgery.

Let's look at a practical scenario. Tim comes into the clinic to get a massage from Lisa. Tim tells Lisa he is sore because he played his first round of golf this weekend. Tim warns Lisa that he received sunburn on both lowers arms from being outdoors. He tells her he is sure the lotion will help.

VE Note: Here you might create a 'Tim' character showing off sunburn on his lower arms to a massage therapy character.

Lisa educates Tim on local contraindications for massage, and advises Tim that at this point, it is best for her to avoid massaging over the sunburn area so as to not irritate the skin any further.


For those with certain medical conditions, massage should be entirely avoided. Some examples of total contraindications include having significant fever, contagious diseases such as the cold or flu, recent operations or acute injuries, severe, unstable hypertension and local contagious or irritable skin conditions.

Let's say another client, Jennifer, calls Lisa the massage therapist to make an appointment for today. Jennifer tells Lisa that she hasn't been sleeping well because she has been sick from the flu, and she hopes to receive a massage to relax her enough to allow her to get caught up on some sleep.

Lisa informs Jennifer that the flu is contagious, and not only does Lisa not want to get it, but she doesn't want to make it worse for Jennifer. Lisa advises Jennifer to not receive a massage until she is healthy again.

VE Note: Here you might show both the Lisa and Jennifer characters, each on opposite ends of a phone. Lisa could be wearing a massage therapy uniform, while Jennifer has a red, stuffy nose and a box of tissues to indicate she's sick.


In addition to local and total contraindications, massage therapists should also be aware of endangerment sites. These are areas on the body where deep, sustained pressure should not be done because nerves and/or blood vessels travel in that area.

One area of endangerment is the anterior triangle of the neck, also known as the front part of the neck. This area contains both the thyroid and parathyroid glands.

Another area of endangerment is the posterior triangle of the neck, also known as the back of the neck or the nape of the neck. This area is where the cervical vertebrae are.

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