Expert: Christopher Hall - 9/7/2003

Question
Could you please give me the reasons why massage/massage therapy is not appropriate for the following conditions?  

Cancer
Osteoporosis
High Fever
During Menstruation
Heart Problems
Rheumatism
Joint Dysfunction
Systemic infections
Skin Conditions
Sensory Impairment
Pacemakers
Gastro-intestinal complaints, gastritis, Hepatis, enteritis
Asthma
Diabetes
During Menstruation

Thank you for your help.
Luana Bricco

Answer
Greetings Luana. You ask a great question. I'll go by each disorder:

Cancer - There is a great deal of debate about if massage is appropriate for cancer. One side says that since massage increases circulation and lymphatic flow, there is a possibility that it can helps the cancer metastasize. Others say that it is no more stimulating that a brisk walk or a hot bath. I personally believe that, as long as it is not a lymphatic cancer (which can metastasize easily and quickly), and as long as their vitality is high, it is fine. I believe that anything that relieves stress, and makes a person happier will help them fight the disease. I do inform my clients about the debate, and if I ever feel any doubt, I insist on getting the doctor's permission. I once had a client call her doctor, since she had lymphomas in the neck and shoulder (some of which were removed two weeks before), and he said no to the massage for the moment. So I gave her 30 minutes of scalp massage, and foot and hand reflexology instead.

Osteoporosis - Massage is fine, as long it is not done deeply. With brittle bones, you could run the risk of accidentally breaking one.

High Fever - Definately contraindicated. Fever indicates infection, and massage can be taxing on a weakened body. It can also sperad the infection and make it feel worse. There is also the possibility that the therapist could get sick, if the fever is caused by something contagious, like a cold/flu.

During Menstruation - I have massaged women during their period with no problems. Many say that it helps with the cramping and pain in the low back, and eases the stress felt during such times.

Heart Problems - This depends on the problem. If it is something minor like a heart murmer, there is no contraindication. If they have a chronic problem like a weakened heart or blocked arteries, massage might not be good as it can add a bit of stress on the circulatory system (caused when lymph and blood are moved around).

Rheumatism - This depends on the person's vitality. If there is an accute flare up, the person would probably be in too much pain to be touched, and feel to lousy to go to an appointment. If it is not flaring up, massage can help relax the muscles that tighten up around the joint.

Joint Dysfunction - Same as above. Sometimes, like with bursitis, massage can often help increase the range of motion. Special consideration needs to be taken if the client dislocated a joint in the past (it can re-dislocate if pulled too hard) or if something prevents a joint from moving (like a spur of bone; that is not something that can be worked through.)

Systemic infections - Like above, it is contraindicated, due to the stress on the body and the risk of contagion. With something like a cold or flu, if you get massaged it will make the cold/flu worse, but shorter in duration.

Skin Conditions - With skin conditions, it would probably be too painful to massage the area. There is also the risk of passing it on to the therapist. For something small and local, like ringworm, you can still get massaged, as long as the infected area is avoided. But if it is not contagious and not painful, it can be massaged if the therapist is comfortable.

Sensory Impairment -  Except for neuropathy, people with sensory imparement are fine for massage, although a method of communication should be worked out before hand. I once had a client who would not respond to my question about the pressure. When I tapped her on the shoulder, she looked up from the face cradle, and said "Oh, I guess that I should have told you that I am deaf, and read lips." (It would have been very helpful if she had told me that during the intake interview.) So anytime I had to ask her a question, I had to tap her so that she could look at me. If a person has no feeling in a part of their body, they will be unable to tell you if the pressure is too deep, and the muscles can be damaged. Locations that are numb have to be avoided or worked very lightly.

Pacemakers - As long as care is taken around the site of the pacemaker, and the person's vitality is good, amssage is fine. I have massaged clients who have pacemakers.

Gastro-intestinal complaints, gastritis, Hepatis, enteritis - For the most part, the client will not want to be touched during an episode of things like gastritis and Crone's Disease. Massage is fine when there are no symptoms. With things like hepatitis, massage is contraindicated because it is so highly contagious. It would also weaken the person, and they probably would not even want one.

Asthma - Perfectly fine, unless there is an acute attack. I have asthma, and I actually found that massagine the breathing muscles, combined with breath training, I actually saw a decrease in my need for my inhalor.

Diabetes - Massage is fine for people with diabetes. There are two things to keep in mind: Blood sugars drop after a massage, so the client needs to be aware of this, and possibly have a snack ready. Also, the therapist needs to be aware of any peripheral neuropathy. If that is present, deep tissue work is contraindicated since the person cannot give accurate feedback about the pressure.

I hope this helps, Luana. If you have any questions regarding specific conditions or need more information, please let me know.

Sincerely,
Christopher Hall