Contraindications and Cautions Flashcards
Any condition presenting with a FEVER
AVOID massage:
a fever indicates the body is fighting infection. Massage should be avoided due to possible person to person infection and to allow the body to fight the infection. Client should contact GP.
INFECTIOUS DISEASES - particularly those affecting the skin such as measles, shingles, influenza or skin diseases such as ringworm, scabies, warts or impetigo
Contraindications depend on the condition, it’s severity and the location:
- Whole body conditions (e.g. scabies or impetigo) - massage should be AVOIDED
- Local infections (e.g. warts or fungus) - avoid infected area in massage
VENOUS INSUFFICIENCY - e.g. known or suspected DVT, varicose veins, varicose ulcers etc
Varicose Veins - avoid actual path of vein as increases risk of DVT. Tissues adjacent can be treated as will improve circulation away from VVs and relieve some pressure.
Thrombophlebitis (inflammation in veins due to clots) - AVOID massage: any bodywork may disrupt clots which could lead to pulmonary embolism
Aneurysm (bulge in vein, artery or heart) - AVOID massage and be cautious if client fits profile.
Atherosclerosis (inelastic, brittle arteries) - AVOID rigorous circulatory massage with advanced atherosclerosis. Other modalities may offer benefits at min risk.
PHYSICAL TRAUMA - e.g. extensive bruising, recent fracture, acute joint sprains, recent surgical wound, whiplash injury etc.
AVOID LOCALLY and take care with large areas of bruising as could disturb blood clots.
ACUTE INFLAMMATION
Only use a COMPRESS:
working on an area inflamed from infection will disrupt the fascial walls which have thickened to isolate the infection.
Non infectious inflammation should also be avoided during the acute phase as massage is likely to encourage more fluid to the area, potentially increasing the pain
BROKEN SKIN e.g. sores, wounds, ulcers, bites, stings, abscesses, recent scar tissue, sunburn etc
AVOID LOCALLY
Scar tissue - massage is extremely beneficial for scar tissue as it will significantly reduce keloid formation (permanently raised mass of tissue due to excessive collagen activity at site of wound) by improving the skins condition.
Avoid massaging area until client receives medical clearance from specialist, avoid massaging scar tissue with 2 inch diameter for 6-8wks.
Anyone under influence of DRUGS OR ALCOHOL
AVOID massage - physical risk of overtaxing the liver and also possible behaviour risks associated with someone under influence
OEDEMA (undiagnosed, esp if widespread)
AVOID massage - circulation may not be able to cope with internal changes brought about by massage.
It pitting is present ref to GP
Lymphoedema (fluid build up caused by lymph gland removal) - due to complex nature, good idea to refer clients to specialist in manual lymphatic drainage (tech different, lighter)
CANCER
GENTLE MASSAGE - can be extremely beneficial but due to the complexity of the disease it is strongly advised the therapists works as part of a well-informed health care team. Gentle massage to appropriate areas (avoid any areas of radiotherapy) is highly recommended.
CERTAIN ENDOCRINE CONDITIONS e.g. Diabetes Mellitus, Hyper & Hypothyroidism
GENTLE MASSAGE - is fine as these conditions are often associated with vascular and connective tissue changes. Bear in mind this tissue fragility.
Hypothyroidism - associated with connective tissue changes
Hyperthyroidism - may be associated with osteoporosis
OEDEMA
GENTLE MASSAGE - if not widespread and has been diagnosed, gentle massage can help lymphatic drainage by moving excess fluid into lymphatic vessels to promote lymph circulation. Client should be supported and elevated to assist drainage.
Proximal areas should be worked first to clear the path for lymph from distal areas
PREGNANCY
GENTLE MASSAGE 12WKS +
Indicated after first trimester due to many hormonal and physiological changes taking place in body.
AVOID abdomen area pre 12wks but hand, foot, face etc can be very beneficial.
CAUTION with history of miscarriages or current IVF treatments.
CERTAIN DRUGS - especially:
- Anticoagulants (e.g. warfarin and Heparin)
- Cytotoxic drugs
- Steroids (long term)
GENTLE MASSAGE
1. Anticoagulants (e.g. warfarin and Heparin) - can cause bruising or bleeding
- Cytotoxic drugs (chemotherapy) - can lead to bone marrow problems with associated bleeding
- Steroids (long term) - may lead to osteoporosis and capillary damage
ASTHMA OR ANGINA
NB: If severe, make sure the client has medication to hand
ELDERLY
GENTLE AND SHORTER MASSAGE
due to the fragility of skin and that elderly people tire more easily. Generally be aware of pressure, treatment time and comfort of client.
Extra time to sit up - many elderly people experience sudden drop in BP when move to upright position. If feel dizzy, drop their head between legs (if possible) or assist them to supine position on couch and elevate their legs.
