Contraindications Explained: When Massage Is and Is Not Right for You

One of the most important things a qualified massage therapist does before every treatment is assess whether it is safe to proceed. This process is called a contraindication assessment, and it is the reason every client is asked to complete a detailed consultation form. This article explains what contraindications are, why they exist, and what they mean in practice for you as a client.

What Is a Contraindication?

A contraindication is a condition or circumstance that makes a particular treatment inadvisable or unsafe. In massage therapy, contraindications fall into two broad categories. Absolute contraindications are conditions where massage must not proceed under any circumstances, such as a fever, an active DVT or blood clot, open wounds, active skin infections, or severe uncontrolled medical conditions. Relative or local contraindications are conditions where massage can proceed, but only with modification. Examples include high blood pressure that is managed with medication (massage can proceed with care), an area of skin with eczema or psoriasis (the area is simply avoided), or varicose veins (no direct pressure is applied over them).

Why Does a Therapist Ask About Your Health History?

The consultation form is not bureaucracy. It is a professional and ethical requirement, and it exists entirely to protect you. Knowing that a client is on blood-thinning medication, for example, changes the pressure that can safely be applied. Knowing that someone has lymphoedema in one arm means that arm requires specialist handling. Knowing that a client has recently had surgery means clearance is required before any treatment.

A qualified therapist will not name specific contraindications back to a client during the consultation, as this can cause unnecessary anxiety. Instead, they will ask open questions and encourage clients with any health concerns to seek guidance from their GP first.

Common Conditions and What They Mean for Massage

• High blood pressure: If well-controlled with medication, massage is generally suitable with appropriate care. Uncontrolled hypertension requires GP clearance.
• Diabetes: Massage is generally suitable. The therapist needs to be aware of reduced sensation in the extremities and take care with pressure accordingly.
• Cancer: Current or recent cancer, or active chemotherapy or radiotherapy, requires specific guidance. In many cases, specialist oncology massage is beneficial, but it requires medical clearance and a modified approach.
• DVT or blood clots: An active DVT is an absolute contraindication. A previous DVT requires discussion and possible medical clearance.
• Osteoporosis: Deep pressure is avoided. Gentle effleurage and light petrissage can be highly beneficial.
• Pregnancy: A relative contraindication requiring specialist qualification. I am qualified to treat from 12 to 36 weeks.
• Recent surgery: Requires surgeon's or GP's clearance before treatment. I specialise in post-surgical lymphatic drainage.

What If I Am Unsure Whether Massage Is Right for Me?

Please do get in touch before booking. A brief conversation is usually all that is needed to establish whether treatment is appropriate and, if so, what approach would be most suitable. I will always err on the side of caution and, where there is any doubt, will ask you to consult your GP first. This is not an obstacle to receiving treatment. It is how a responsible and qualified practitioner works.

Having a health condition does not mean massage is out of reach. Many of my most loyal clients have complex health histories, and the ability to work safely and thoughtfully with those clients is something I take great pride in.