Expert: Michael - 7/18/2004

Question
Hi Michael
I am currently studying neuromuscular therapies and have been asked to massage someone who has had a mitral valve replacement and is on warfren.  Is massage contraindicated?
Also if someone is a hemophiliac would massage be contraindicated?
I look forward to your reply.

Thanks Michelle

Answer
thanks for your questions Michelle.

Regarding the mitral valve replacement (heart murmur), normally when a client mentions he/she has a heart murmur (mitral valve prolapse) and it's a minor case, I will provide them with their usual massage. However, if as in this case, client has had the valve replaced, I see massage as contraindicated "as it may not be able to keep up with rigorous circulatory massage."  The Warfarin (Coumadin) is an anticoagulant (prevents blood clotting) drug.

Regarding the hemophiliac, "Severe cases of hemophilia contraindicate bodywork that can mechanically stretch, manipulate, or accidentally injure delicate tissue. Milder cases of hemophilia may be safer for circulatory massage."

For both of my above responses, I have referred to Ruth Werner's "A Massage Therapist's Guide to Pathology", an excellent resource that every massage therapist should have in their personal library.

Hope that helps,
Michael, LMT