Sometimes it’s just as important to know when not to get a massage as it is to know when one is indicated. There tend to be three levels of contraindication, or situations when you shouldn’t have massage – modified local, absolute local, and complete.

Local contraindications are areas that shouldn’t be worked on, but other parts of the body can be. Sometimes these are considered absolute local contraindications like a deep vein thrombosis where I won’t work the entire leg that contains a blood clot. Other times they are modified contraindications, such as unregulated high blood pressure where I would change the direction of the flow of massage and keep an eye on the colour of the back of your neck/ears. Some are obvious, like open wounds. You don’t want massage oil getting into an open wound any more than I want to touch it, so I will move around the spot but not go directly over it. Other local contraindications would be recent surgery scars before they’ve fully healed, injection sites (insulin, cortisone, etc), an active cancer site, severe varicose veins (the bulgy ones that are thick and blue), or broken bones.

The modifications for massage might be a change in pressure, extra pillows, slower speed, or shortened duration of treatment. Pregnancy is another good example of modified contraindication. Massage can still be given at all stages of pregnancy, but certain changes are made depending on the size of the belly and the health of the mother. Adjustments are made to pressure over the low back and pillowing to alter the body’s position as the pregnancy progresses.

Complete contraindications are ones where I will send you home without treating you. Most of these are obvious like right after major surgery, a stroke, or heart attack, or while in organ failure. If you’ve had a stroke or heart attack, it is preferable to have the okay from your doctor if it has been between one and six months since the event. Unexplained, severe internal pain should be cleared by a doctor before coming in for massage.

If you are currently sick and have a fever, you will be sent home. Similarly, if anyone in your family has a stomach bug and there has been severe diarrhea or vomiting in the house in the last 24 hours, I’d really appreciate you not bringing it to my house. Massage is a unique situation where we are pretty close for a solid 30 minutes to an hour. I remember one night a patient came in sick and by the end of her hour I was feeling lousy. It’s rare to have it hit that quickly, but there’s only so much I can prevent with washing my hands every time I turn around. Every therapist has a cancellation policy and I can’t speak for them, but in my practice, if you are legitimately sick, please call to let me know you won’t be able to make it and there will not be a penalty. Keep in mind though, telling me you’re sick when you just forgot an appointment or something better came up will not be tolerated. Santa Claus isn’t the only one who keeps naughty lists.