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:
- While massage of splint muscles around a swollen joint is appropriate, direct pressure to the joint itself should be avoided.
- Avoid the local site of unstable fractures, open wounds, hematomas, varicosities, recently healed scars, burns, and foreign bodies or implanted hardware.
- In the first trimester of pregnancy, no deep sacral work or abdominal massage should be done.
- 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.
- If the patient/client is overheated due to hot tub, sauna, or exercise, apply appropriate techniques.