Red Flags for Massage Therapy

Acute flare-up of inflammatory arthritides (ex. RA, systemic lupus, spondylitis, evythmatosus, ankylosing)

Absolute local contraindication (no treatment to affected area)

Acute neuritis,

Absolute local contraindication (no treatment to affected area)

Aneurisms deemed life threatening

Absolute local contraindication (no treatment to affected area)

Deep vein thrombosis, thrombophlebitis, arteritis

Absolute local contraindication (no treatment to affected area)

Ectopic pregnancy

Absolute local contraindication (no treatment to affected area)

Esophageal varicosities, varicosities in general

Absolute local contraindication (no treatment to affected area)

Local contagious conditions, local irritable skin conditions

Absolute local contraindication (no treatment to affected area)

Open wounds, sore, decubitus ulcer

Absolute local contraindication (no treatment to affected area)

Malignancy, especially if unstable

Absolute local contraindication (no treatment to affected area)

Pain syndromes such as reflex sympathetic dystrophy

Absolute local contraindication (no treatment to affected area)

Radiation therapy site both during and up to several weeks post radiation therapy

Absolute local contraindication (no treatment to affected area)

Recent burns, sepsis, undiagnosed lump, frostbite

Absolute local contraindication (no treatment to affected area)

Any condition of spasticity or rigidity (ex. Cerebral Palsy, hemiplegia, MS, spinal cord injury, Parkinson’s, Asthma, Cancer)

GENERAL modifications

Congestive heart failure

GENERAL modifications

Chronic Kidney Disease

GENERAL modifications

Patient who is immunocompromised

GENERAL modifications

Coma, Debilitation

GENERAL modifications

Diagnosed atherosclerosis

GENERAL modifications

Hypertension & Hypotension

GENERAL modifications

Drug withdrawal

GENERAL modifications

Emphysema

GENERAL modifications

Fibromyalgia

GENERAL modifications

Inflammatory Arthritides

GENERAL modifications

Major surgery or abdominal surgery

GENERAL modifications

Medications used by patients

GENERAL modifications

Moderate diabetes (check tissue health)

GENERAL modifications

Osteoporosis or Osteomalacia

GENERAL modifications

Pregnancy and labour

GENERAL modifications

Post cerebrovascular accident or myocardial infarction

GENERAL modifications

Recent head injury

GENERAL modifications

Seizure Disorders

GENERAL modifications

Acute disc herniation

LOCAL modifications

Aneurysm

LOCAL modifications

Acute inflammatory conditions and injuries

LOCAL modifications

Any anti-inflammatory injection sites (21 days past injection)

LOCAL modifications

Chronic or long-standing thrombosis

LOCAL modifications

Bell’s Palsy (possibility of eye infection)

LOCAL modifications

Buerger’s disease

LOCAL modifications. May be GENERAL contraindication if unstable, recurring progressive.

Bursitis

LOCAL modifications

Chronic arthritic conditions

LOCAL modifications

Chronic abdominal or digestive disease

LOCAL modifications

Contusion

LOCAL modifications

Diarrhea

LOCAL modifications

Endometriosis

LOCAL modifications

Flaccid paralysis or paresis

LOCAL modifications

Flare up of IBS/IBD

LOCAL modifications

Fracture while casted & post cast removal until muscle tone returns/tissue fragility increases

LOCAL modifications

Frozen Shoulder

LOCAL modifications

Hematoma

LOCAL modifications

Hernia

LOCAL modifications

Infections including parasites

LOCAL modifications (proximal drainage and circulation techniques are avoided)

Joint hypo mobility due to pins, screws, wires, plates, and surgical shortenings of ligaments

LOCAL modifications

Joint instability/hypermobility

LOCAL modifications

Lymphedema

LOCAL modifications

Kidney infection or kidney stones

LOCAL modifications

Mastitis

LOCAL modifications

Minor surgery

LOCAL modifications

Migraine

LOCAL modifications

Ostomy Site

LOCAL modifications

Pelvic inflammatory disease

LOCAL modifications

Raynaud’s disease and phenomenon

LOCAL modifications

Recent abortion, Recent vaginal birth

LOCAL modifications

Spasmodic torticollis

LOCAL modifications

Stress fracture site

LOCAL modifications

Temperomandibular joint (TMJ) dysfunction

LOCAL modifications

Tracheotomy Site

LOCAL modifications

Trigeminal Neuralgia between attacks

LOCAL modifications

Varicosities

LOCAL modifications