Precautions for Massage/Bodywork Therapy for Massage Therapy

The following precautions should be observed by Massage/Bodywork therapists when conducting their practice.

Massage/Bodywork therapists should not treat a patient or client:

• When the therapist or patient/client is in an altered state of cognitive awareness from the use of prescription, and/or over-the-counter medications, alcohol, or other substances, and the patient/client cannot give informed consent and/or the therapist cannot provide appropriate treatment. Consent for the patient/client may be given by guardians and other caregivers when authorized to do so.
• If a patient/client refuses to give the therapist consent to confer with his or her health care practitioner regarding massage/bodywork therapy when such consultation is essential to the patient's/client's health and safety, the therapist should not treat the patient.

Massage/Bodywork therapists should use caution in treating a patient or client:

• When the therapist or patient/client has a fever or contagious disease
• If the patient/client is on any medication that would be expected to weaken bone structure and/or connective tissue or lead to enhanced bleeding
• When the patient/client has edema due to chronic heart failure or kidney failure
• When the patient/client has decreased sensation, as for example, with diabetes
• If the patient/client has an inflammatory condition in the acute stage
• When the patient/client has acute phlebitis and/or deep venous thrombosis
• When the patient/client has had an acute trauma or recent surgery

Practitioners should observe these guidelines:

1. While massage of splint muscles around a swollen joint is appropriate, direct pressure to the joint itself should be avoided.
2. Avoid the local site of unstable fractures, open wounds, hematomas, varicosities, recently healed scars, burns, and foreign bodies or implanted hardware.
3. In the first trimester of pregnancy, no deep sacral work or abdominal massage should be done.
4. If the patient/client has cancer or other tumors or has acute or chronic infection in the skin or deeper tissues, seek the recommendation of the patient/client's physician or nurse practitioner after obtaining the consent of the patient/client.
5. If the patient/client is overheated due to hot tub, sauna, or exercise, apply appropriate techniques.