Not a Good Day For a Massage

I’ve been a Licensed Massage Therapist for over 20 years and every now and then I have to turn a client away because they have a condition where a massage is not advisable. For one reason or another, people (usually very innocently) don’t realize they should have rescheduled or checked with their doctor first before the massage. Some health conditions might be glaringly obvious to some but not to others. As we approach the cold and flu season, rescheduling becomes more common.   It’s been a while since I wrote a blog, so I figured why not touch on this subject?

If you don’t know the term already, “contraindication” is defined by Merriam Webster dictionary as “a symptom or condition that makes a particular treatment or procedure inadvisable”.  To me, there are two levels of contraindications for massage, I’ll refer to them here as “red light” meaning “stop, do not pass go” and yellow light “make sure you check with your doctor first”.  There are also local contraindications like “hey I broke my toe can you avoid that” and general contraindications like a fever. 

Please note, there are literally hundreds of conditions where massage may or may not be advised, this blog post is not an extensive list of massage contraindications.  However, these are the most common situations that I see in my practice.  Remember, it is always a good idea to disclose any new health issues, medications or diagnoses during the intake portion of your massage, even if you don’t think it would be important for me to know!  Massage Therapists are required by law to uphold HIPPA.  Your secrets are safe with me!

Red Light Contraindications - Conditions When Massage is Never Advisable:

Fever - This means your body is actively fighting an infection and you are likely contagious. Please stay home and rest.

Cold/Flu-like Illnesses - even if you don’t have a fever, even if you’re telling your co-workers that “it's just allergies” please don’t come in for a massage!  First of all, you WILL feel worse and you will also likely make me sick too.  Because massage is such close contact, I prefer to err on the side of caution and reschedule clients when I am sick, even if it's just a mild cold.  Please do the same for me!

Story time - years ago when I was a young LMT employed at a spa I had a client come in (lets call her Rachel) who admitted she was sick in bed and achy for the past few days. She did not have a fever, so I went ahead with the massage against my better judgement.  Sure enough 2 or 3 days later I was sick and achy in bed.  Don’t be like Rachel!

Pro tip: If you are sick and achy, a hot epsom soak bath is a great way to seek relief.  Make the bath as hot as you can stand it, the heat will essentially cause an artificial fever to help kill off the bug.  The combination of hot water with the magnesium-rich epsom salts will also do wonders for your achy muscles.  Essential oils like lavender, eucalyptus, peppermint, rosemary, tea tree, Thieves blend or any citrus are my go-to’s for cold season and make a nice addition to a hot bath.

Yellow Light Contraindications - When You Need to Ask Your Doctor First

After Surgery - This one might seem obvious but typically you need to wait 6-8 weeks post OP for massage.

Recent Injury - Most people aren’t seeking massage immediately after breaking their ankle but injuries like whiplash might have you seeking relief before your body is ready. Typically in the case of whiplash, you need to wait at least 48 hours depending on the severity.

Cancer - if you are undergoing treatments like radiation or chemotherapy I will need clearance from your doctor.  Massage increases circulation and there is a risk that it could spread the cancer.  Sometimes hand and feet work is ok - but Reflexology is contraindicated since it can impact specific organs and areas of the body.  There are massage therapists who have taken further training for oncology massage, you may want to seek their services if it's available.

Injections for Pain Management - whether it's a cortisone shot for back pain or botox injections for migraines, your doctor will often advise you to avoid massage for a period of time following the injection because massage can actually move the medicine or spread it to other areas.

Story time - I once had a client who got multiple injections IN HER SPINE the day before her massage and she didn’t even think to ask her doctor if massage was ok. She felt embarrassed about this “duh” moment, no judgement!  But this is why I’m writing this! 

Botox and Fillers - Please check with the Esthetician or professional who provided the service because massage can move or spread these injectables to an undesirable location.  Depending on where the injection was placed you may also want to avoid using the face cradle for a couple weeks too.  

Localized Infection - An infected tooth or active ear infection are particularly inadvisable for massage because they are so close to the heart and brain. Because massage increases circulation, an infection anywhere on the body has the potential of spreading.

Story time: A good friend of mine had a super tight and painful neck so she went to a massage therapist for deep work. She felt even worse after the massage.  Turns out her pain was actually coming from an infected tooth and the massage almost spread the infection to her heart!  You can never be too careful, this is why I ask a lot of clarifying questions during intake.

If you need to reschedule due to illness I am always grateful that you did!  I do have a rescheduling fee but I can’t remember the last time I used it. I’m fortunate to have amazing clients who don’t make a habit of frequent last minute cancellations or being a “no show”.  Life happens!  As we approach the winter weather months I am also very lenient with cancellations due to weather - I tend to err on the side of caution here too.  I don’t think a massage is worth risking anyone’s life or safety!  

Sometimes it’s tough to make the decision about whether to reschedule or not, if you are ever unsure please reach out to me and ask via email, text or phone. Some people are worried I’ll be upset or that it will mess up my day.  Illness, weather, family emergencies - things like this happen!  I won’t be upset.

I hope this was helpful and a reminder of some things to consider before your massage.  I think because a massage usually makes you feel so amazing afterwards, people forget that there can actually be some serious consequences in certain cases!  Also, just to reiterate, this is not a full list of massage contraindications.  When in doubt, ask your doctor and discuss it with me during intake.  Thanks for reading!