Pathology, Contraindications & Special Populations
This chapter addresses conditions that affect whether, where, and how massage can be safely performed. Recognizing contraindications protects clients from harm and guides appropriate referral.
Absolute vs. Local Contraindications
An absolute (general) contraindication means the whole session should be postponed, such as an acute deep vein thrombosis, fever, or contagious illness. A local contraindication means the therapist avoids a specific area, such as an open wound, bruise, or localized rash, while the rest of the body may be treated safely.
Acute Injury and Inflammation
During the acute inflammatory phase of an injury, typically the first day or two, tissue is swollen, painful, and vulnerable. Direct deep work over the injured site is avoided to prevent further damage. As healing progresses, more targeted work may become appropriate, ideally with medical guidance for significant injuries.
Special Populations and Referral
Pregnant clients, older adults, and people with conditions such as diabetes, cancer, or cardiovascular disease may require modified pressure, positioning, or medical clearance. When findings fall outside a therapist's scope, the safe course is to refer the client to a qualified healthcare provider rather than attempt to diagnose or treat the condition.