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Contraindications in Massage

A contraindication is a pre-existing medical condition that could make it inadvisable for a massage treatment to be carried out. This could either be due to conditions that could put your client at ri...

Contraindications in Massage

A contraindication is a pre-existing medical condition that could make it inadvisable for a massage treatment to be carried out. This could either be due to conditions that could put your client at risk as well as illnesses that could be contagious and potentially affect you and your place of work.

Contraindications that prevent or restrict massage therapy

There are three kinds of common contraindications that would prevent or restrict your clients from receiving treatment: total, local or medical. You should assess each client individually to identify and address any contraindications in accordance with their severity. Remember that any total contraindications mean that massage therapy is totally inadvisable.

Total contraindications refer to conditions that prevent your clients from receiving massage therapy due to their illness posing too much of a risk to either yourself or the client.

Local or medical contraindications restrict massage treatments by avoiding the area affected by a medical condition or require a doctor’s confirmation that the treatment can indeed be carried out.

We’ve compiled a list of the most common contraindications for massage, including deep tissue massage contraindications below.  

In order to ensure that you’re doing everything that you can to identify any contraindications in your clients, and comply with common insurance policy conditions, you should use a client questionnaire for your customers to complete before you carry out any treatments. It should be comprehensive, covering some of the most widespread illnesses and disorders and asking about any known conditions that might not be listed on the form.

Virus / Bacterial / Fungal Infections. Any kind of infection in your client poses a risk to you as the massage therapy provider because of the nature of the treatment. Massages are very hands-on, meaning you will come into very close contact with any person that steps through the door of your treatment room. 

Many viruses and bacteria can be transferred via air, which could result in you contracting the infection by simply being in close proximity to the infected person, but particularly through touch. It could also be passed onto other clients who you might end up seeing in the same room or by coming into contact with you after you’ve contracted the infection. 

Fungi particles can easily attach themselves to your hands while you’re carrying out treatment and from there, onto other surfaces and equipment within the room. You could also end up transferring some harmful cells onto your face, if you touch your mouth, eyes or nose before thoroughly washing your hands, resulting in further spread of the infection. As a massage therapist, you should always make sure that your working space and equipment are sterile at all times. This also means that you should pay attention to your personal hygiene and wear gloves and masks where necessary. 

As an extra precaution and to minimise the risk of any kind of infection spreading, you should refuse to carry out massage treatments, including facial and deep tissue massages, to clients suffering from any form of infection.

High Fever. Clients with a significant fever (38 degrees Celsius or above) should be refused treatment, as this could be an indication that they are fighting off an infection. Performing a massage on a client with a high temperature could result in their natural defences being disrupted, which could lead to the illness sticking around for longer and requiring more aggressive treatment. It is better to wait for whatever might be causing the fever to clear before offering massage therapy to the customer. This will also protect you from potentially catching an infection that you might then spread to others. 

Stroke / Heart Attack. If your client has just had a stroke or a heart attack, you should refuse any massage treatment until it is known that they are past the acute phase of the condition. This should be confirmed by their practitioner on a signed note and, just to be safe, a disclaimer should be signed by the client declaring that they are aware of any risks. These precautions must be taken due to the high risk of a second episode occurring within the first months of a stroke or a heart attack.

Skin Conditions. Some skin conditions such as severe acne, eczema, psoriasis, cold sores and open sores should prevent or restrict massage treatment to minimise the risk of more severe conditions developing. Avoiding massage treatment in patients or affected areas will also minimise the risk of transmission, as some conditions could be infections due to being caused by bacteria, fungus and viruses. If your client suffers from any conditions of the skin, make sure to research what treatments, if any, can be carried out and ask them to provide a medical note confirming that it is safe for them to receive massage therapy.

Pregnancy. There are a number of massage contraindications relating to pregnancy, which could prevent or restrict treatment provided to your clients. It is important to identify whether your pregnant customers suffer from any of the following:

  • Eclampsia
  • Pre-eclampsia
  • Varicosities due to organs pressing on the veins and arteries 
  • Hyperkyphosis or hyperlordosis due to poor posture 
  • Compression Syndromes
  • Edema
  • Gestational Diabetes

Cancer. Cancer sufferers are likely to be undergoing treatment which includes chemotherapy and radiotherapy, having a severe impact on a person's body, including their immune system. Cancer patients could be at risk of contracting infection that they might not have the strength to fight off. It is important for them to avoid public spaces such as massage parlors and spas and to ensure that their body is not put under unnecessary stress that a massage would create.

Recent scarring. Fresh scarring (less than 6 months old) should not be put under any undue stress that could result from a massage. It needs to be given enough time to heal, as disturbing the affected area could worsen the condition or reignite the root cause of the scarring. If you notice any old scars, make sure to perform a quick inspection to ensure they will not cause any issues during or after the massage.  If the scarring affects large areas of the body, the client should be advised to wait until the wounds are completely healed.

Recently consumed drugs/alcohol - including some prescription drugs. Clients who are intoxicated with drugs and alcohol should be refused treatment until the substances wear off. Drugs and alcohol impact blood pressure and heart rate significantly, increasing the risk of complications from a massage, especially deep tissue massage as this stimulates the blood flow and could potentially raise a person’s blood pressure even further. 

A person under the influence of any substances might also not be behaving like their usual self, potentially posing danger to themselves and those around them. 

If you’re dealing with an intoxicated client, calmly explain why treating them would be too dangerous and politely ask them to return at a later date.

Contraindications in Massage and Insurance

All of your clients, regardless of their conditions, should be assessed on a case by case basis, and any illnesses that they might be suffering from, considered under the full list of contraindications for massage therapy. Those suffering from lesser conditions that only restrict treatment should be made aware of the risks that come with receiving a massage in relation to their specific condition. Where applicable, be sure to obtain a medical note from their GP or consultant.

However, not everyone is willing to share their medical history and therefore might not disclose relevant information to you. Some clients might simply not be aware of their condition(s) could have an effect on their massage treatment and may not see it as information worth sharing. On the other hand, clients might have conditions that they have not yet been diagnosed with, making it even more difficult for you to follow the right procedures.

To make sure that you are prepared for every scenario, you should always invest in an insurance plan that will protect you should a compensation claim is brought against you. A good insurance plan will cover any legal costs that you might incur as a result of a claim for injury or damage to third party property. 

At Professional Beauty Direct, we offer comprehensive salon insurance, hairdressing insurance cover, and beauty therapy cover to keep you and your business safe. To make sure that you remain operational at all times, get in touch today to speak to one of our advisors on 0345 605 8670 or use our comprehensive quote and buy online system at www.professionalbeautydirect.co.uk .

3rd March 2020