Contraindications

Comment

Comment by Noel Norwick on July 31, 2009 at 10:09am

In the USA, the most current edition of Ruth Werner's book, A Massage Therapist's Guide to Pathology published by Lippincott, Williams & Wilkins provide the closest thing to a legal "safe harbor" (protection against being successfully sued for alleged malpractice).

One might also check with their trade association/insurance provider regarding what type of claims have been made against members during the most recent several years.

If you're willing to decide for yourself what is safe/unsafe and accept somewhat more legal/personal risk, I suggest you track:
1. http://www.ijtmb.org/index.php/ijtmb/login?source=/index.php/ijtmb/user
2. http://mtabc.wordpress.com/
3. Journal of Bodywork and Movement Therapies available online at www.sciencedirect.com

Comment by Denarah McHold, LMT on July 28, 2009 at 2:11pm

I think I was just surprised he was calling it an injury and saying it was probably inflammed with out palpating it.

Ofcourse inflammation from infection (heat, redness, swelling) is a contraindication, but I wasn't sick, and didn't pull or injure a muscle, just used it so much it got really tight which lessened blood flow and cramped up/ went into spasm when I lifted the suitcase.

thanks for commenting. Welcome new members!! Please feel free to bring up your contraindication experiences both as a therapist and a client!

Comment by Susan G. Salvo on July 28, 2009 at 10:30am

Inflammation may occur during infection, but it also is part of the body’s response to tissue damage after injury.

The purpose of inflammation is to stabilize the injured area, contain infection, and initiate the healing process.

My understanding is that massage is contraindicated while inflammation is present – give the body a chance to initiate, establish, and resolve inflammatory processes.

If you agree, treat localized inflammation as a local contraindication and widespread inflammation as an absolute contraindication.

If you need a review of inflammation’s cardinal signs, let me know.

Comment by Denarah McHold, LMT on July 27, 2009 at 5:02pm

I must have overworked my shoulder in a workout on Friday, and my upper traps were in spasm after leaning over and lifting a suitcase towards my chest Sunday morning. I increased ROM by deeply holding points in the belly of the muscles, and stretching pec major. Today I went to get a massage to break up the hypertonic tissue, and the therapist said it is not reccommended because the muscle may be inflammed. Has anyone heard that as a contraindication? I thought it was just sore from being so tight from working out, but he refused to do deep tissue work on it. Anyone have thoughts about that?

If I were a client of mine, I would have done myofascial work, and then slowly slowly worked with the client taking deep breaths as I went deeper, then letting the tissue release with a few breaths, and then moved to the next spot and continued.
(He did do a good job though, but this group is about contraindications, and I just was interested in hearing people's thoughts.)

Comment by Susan G. Salvo on July 22, 2009 at 4:58pm

I used to feel that way too about the first trimester. But research shows that's it's okay.

Yes, these are important discussions. I will help when I can.

I did a youtube video on how to position and drape pregnant clients. Check it out when you have a moment.

Comment by Denarah McHold, LMT on July 22, 2009 at 4:37pm

:) Thanks. I was just using those as examples.
Interesting though! I had been taught that unless you are trained in pregnancy massage, and even if, you don't massage for the first 13 weeks.

Thanks for joining and commenting! Let us know next time you come across other contraindications!

:D

Comment by Susan G. Salvo on July 22, 2009 at 9:39am

For psoriasis, massage is indicated. Be sure and use a highly emollient cream such as one containing Shea or cocoa butter to help counteract skin dryness; some clients do best with a hypoallergenic product.

Some scales may dislodge during treatment.

Inquire about pressure sensitivity over affected areas and any inflamed areas. Pressure should be adjusted in areas that are sensitive.

Hypersensitive areas or areas of inflammation or broken skin should be avoided.

Comment by Susan G. Salvo on July 22, 2009 at 9:37am

Great question!!!

The most recent information I have is that massage is safe in the first trimester unless the pregnant client is experiencing vaginal bleeding or abdominal cramping (these are essentially signs and symptoms of miscarriage).

The only other consideration is if her pregnancy is high risk. It’s the trump card and now medical clearance is a good idea.

Comment by Denarah McHold, LMT on July 22, 2009 at 8:39am

Hello, and welcome. I just started this group because as a newly practising therapist I am interested in hearing practical applications of what I learned in school, and how to deal with them in the field. For example, the difference in not working on a woman who is 8 weeks pregnant, but working on someone with psoriasis, and avoiding certain affected areas. Any thoughts or experiences you want to share? Please feel free!

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