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Contraindications -- Stroke
Although I've been a therapist for quite a few years, I've never choosen to have it be my main source of income and was able to be very selective in regards to my clients. Now that I have made the choice to put more focus on my massage as a business, I find that I'll be dealing with a wider range of clients than I have in the past.
I was recently asked to give a massage session to a 59 year old who had just experienced a minor stroke (about a week ago). My first question to the client was, had they checked with their doctor. They said yes and that the doctor had said it would be ok (which surprised me). My thought was that it was too soon, but since I've no experience in dealing with this type of medical issue, I thought I'd put it out there and ask this group for their suggestions, experiences, advice, etc. Thanks
I was recently asked to give a massage session to a 59 year old who had just experienced a minor stroke (about a week ago). My first question to the client was, had they checked with their doctor. They said yes and that the doctor had said it would be ok (which surprised me). My thought was that it was too soon, but since I've no experience in dealing with this type of medical issue, I thought I'd put it out there and ask this group for their suggestions, experiences, advice, etc. Thanks
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Replies to This Discussion
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Permalink Reply by Mara Canlas on
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A light Swedish massage should be appropriate to provide a sense of relaxation and comfort to your patient. Be aware of several issues:
-Are they on anti-coagulants to combat further clots? Using pressure that's too deep can cause bruising.
-Have they been on prolonged bedrest? Deep pressure can loosen clots in the legs that can then become stuck in the lungs and/or brain.
-Have they experienced any loss/change in sensation to any part of the body as a result of the stroke? Be aware that the feedback they may give you regarding your pressure may not be reliable if their sensation has changed.
-Be prepared to adjust your positioning and be careful when moving your client.
Good luck, and congratulations on expanding your practice!
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Permalink Reply by Elena Barrioz on
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Mara, thank you for the questions you stated, I will most certainly ask them. In regards to liability, I normally have them fill out an intake form that has a blurb on medical conditions, would you recommend anything separate that would pertain only to this one condition?
Mara Canlas said:A light Swedish massage should be appropriate to provide a sense of relaxation and comfort to your patient. Be aware of several issues:
-Are they on anti-coagulants to combat further clots? Using pressure that's too deep can cause bruising.
-Have they been on prolonged bedrest? Deep pressure can loosen clots in the legs that can then become stuck in the lungs and/or brain.
-Have they experienced any loss/change in sensation to any part of the body as a result of the stroke? Be aware that the feedback they may give you regarding your pressure may not be reliable if their sensation has changed.
-Be prepared to adjust your positioning and be careful when moving your client.
Good luck, and congratulations on expanding your practice!
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Permalink Reply by Jennifer N. Bierma CMT on
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I work with several clients who have had strokes in the past. As Mara said, it is VERY important to be aware of feedback about the pressure you are giving....but added to that, you need to be careful with heat packs, cold packs or heating blankets on the table. Many times they have lost hot/cold sensory nerves and cannot tell if they are being burned.
Light tapotement (I often do finger tapotement/tapping) on areas where they have tingling or numbness can help stimulate the areas and bring back SOME of the sensation in those areas.
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Permalink Reply by Cathy Sue Segroves on
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Hello Elena,
I contract with a Chiropractor. If I have a patient that has had a stroke or history of blood clots, the Doctor advises me to only work on the upper part of the body. Nothing below the waist. Sometimes he has me to call and check with the patient's regular doctor for an okay.
I hope this helps.
Cathy Sue
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Permalink Reply by Susan G. Salvo on
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I suggest adapt the massage to any complications. Much of this depends on where in the brain the stroke was experienced (motor center, language center) and the type of stroke (ischemic [most common – 80%] or hemorrhagic [most serious]). Medical clearance is really not critical. Just ascertain from your client what has changed since the stroke and go from there. Good luck!
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Permalink Reply by ASIS Massage Education on
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I think the gentle modality of craniosacral work with a biodynamic approach would be a safe way to invite a healing of the nervous system and connection of mind/body functioning in a case like this. A "CV4" technique would not be recommended to someone who has had a stroke, but any other c.s. contact would potentially be helpful.
Heidi Wilson
ASIS Massage Education
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