![]() Alcohol and recreational drugs impair a client’s ability to feel when a massage is too intense or too deep, increasing the possibility of being injured during a massage ( 12, 13). While massage is not completely contraindicated for people with this condition, it is imperative that no deep tissue work or trigger point therapy, for instance, be used as this could cause bruising or even extensive leakage of blood, known as hematomas ( 5). Thrombocytopenia “is a condition in which your blood has a lower than normal number of blood cell fragments called platelets” (11). For this reason, clients with severe or even moderate osteoporosis may be experience broken bones as a result of massage, especially deep work ( 5, 7). Osteoporosis generally affects older people, especially women, and is characterized by a loss of bone density and mass, making bones very porous and fragile. Clients who are taking blood thinners like Warfarin may also be more prone to internal bleeding, as well as bruising ( 10). “Internal bleeding (in joints and muscles) can be caused by even a minor trauma to muscles and joints in people with severe and moderate hemophilia” ( 9). Hemophilia, a hereditary blood defect, “is marked by delayed clotting of the blood with prolonged or excessive internal or external bleeding after injury or surgery” ( 8). Hemophilia or if blood-thinning medication is being taken.For diabetic clients not experiencing numbness due to nerve damage who are receiving a massage, any area where insulin has recently been injected should be avoided because “massage may accelerate insulin uptake” ( 5). Hot stone massage is also contraindicated because the client wouldn’t be able to sense if the stones were burning him or her ( 7). If diabetic neuropathy (i.e., loss of sensation) is present, massage is contraindicated because the client is unable to tell if the pressure is too deep. ![]() Brian Becker offers the reminder, though, that “strokes on extremities (arms and legs) should always be toward the heart to assist venous return” ( 6). However, a past history of blot clots does not preclude massage ( 6). ![]() Because massage increases the risk of a blood clot being released ( 5), deep tissue massage should not be done. (“Ascites” is the accumulation of fluid in the peritoneal cavity, causing abdominal swelling.) In addition, there is potential for bruising in those with impaired livers because the liver combines many clotting factors. Massage is contraindicated for those in liver failure because “it increases the fluid returned to the blood from edema and/or ascites, which would further tax an already debilitated liver” ( 4). In fact, clients experiencing cold and flu symptoms should be rescheduled because of the risk they pose of infecting others, rather than any risk to themselves-although any congestion they were experiencing would certainly be made worse from lying face down in the face cradle. While some massage therapists believe that, for clients in the early and acute stages of such illnesses, “massage can accelerate the onset of the infection and intensify its severity” ( 2), this isn’t the case, according to Tiffany Field of the Touch Research Institute who says that “massage boosts natural killer cells and natural killer cells kill cancer, viral and bacterial cells so there is no way that massage would exacerbate cold symptoms” ( 3). may help a client with a fever sleep better” ( 1). For a client with a fever of 100.4✯ or higher, any massage that might challenge his or her internal environment “is strictly contraindicated because the body is going through an acute healing process” ( 1). ![]() 13 Conditions in Which Massage Should Not Be Given In some instances, however, massage should be avoided altogether because of the risks posed to those populations. In some cases, massage is contraindicated only for an affected area-for instance, an open sore of any kind, bruises, and burns-but may be done for the rest of the body. There are also, though, instances where massage isn’t appropriate because of the risks involved. Massage therapists tend to focus on-and promote-the benefits of massage therapy, which are many, ranging from stress and pain relief to an array of positive effects on specific medical conditions.
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