Health Intake
Ask about relevant health history, current symptoms, recent illness or injury, surgeries and procedures, pregnancy, medications, skin concerns, allergies, pain, and meaningful changes since the previous visit.
Massage & Body Care
Massage Safety & Contraindications
A practical framework for recognizing when massage may proceed normally, needs modification, should be postponed, or is not the appropriate next step.
Before the Session
Good safety decisions begin before hands-on work.
Clarify the Goal
Understand why the client is seeking massage and whether the requested work fits the therapist's training, professional scope, setting, and available time.
Observe Without Diagnosing
Notice visible swelling, skin changes, mobility difficulty, distress, unusual breathing, or other concerns while avoiding medical conclusions outside scope.
Consent Is Ongoing
Explain the session plan, positioning, draping, areas to be addressed, and meaningful changes. Clients may ask questions, request modifications, decline an area, or stop the session.
Reasons to Postpone or Refer
Some situations require a different next step.
Acute or Contagious Illness
Fever, significant systemic symptoms, active contagious illness, vomiting, severe diarrhea, or feeling acutely unwell can be reasons to postpone massage and seek appropriate healthcare guidance.
Sudden or Severe Symptoms
New severe pain, chest pain, major breathing difficulty, fainting, sudden weakness, new neurological symptoms, or other potentially urgent changes should not be managed as a routine massage complaint.
Possible Blood-Clot Concern
Unexplained one-sided swelling, warmth, redness, pain, or a known high-risk situation requires caution. Do not use massage to test or treat a suspected clot.
Major Recent Trauma
Significant falls, collisions, suspected fractures, serious sprains, head injury, or rapidly worsening symptoms may require medical assessment before massage.
Unexplained Significant Swelling
Swelling can have many causes. When it is new, substantial, rapidly changing, painful, or medically unexplained, avoid assuming massage is appropriate.
Medical Instability
When a client's condition appears unstable or the therapist lacks enough information to make a safe scope-of-practice decision, postpone and refer appropriately.
Local Contraindications & Modifications
The whole session may not need to stop when one area should be avoided.
Open Wounds & Skin Infection
Avoid direct contact with open wounds, active contagious skin conditions, draining lesions, or areas where massage could irritate tissue or spread contamination.
Acute Injury or Inflammation
Fresh injury, marked swelling, heat, severe tenderness, or suspected structural damage may require avoiding direct work and obtaining appropriate evaluation.
Recent Procedures & Incisions
Healing tissue, surgical sites, injections, cosmetic procedures, and post-procedure areas may have specific restrictions. Follow appropriate medical instructions and professional scope.
Bruising & Fragile Tissue
Modify or avoid pressure over significant bruising, fragile skin, areas affected by certain medications, or tissue that is unusually vulnerable to injury.
Altered Sensation
Numbness or reduced sensation can limit a client's ability to judge pressure or heat. Use conservative techniques or avoid the area when safe feedback cannot be obtained.
Medical Devices
Avoid inappropriate pressure over ports, lines, implanted devices, healing access sites, or other medical equipment. Work only within training and applicable guidance.
Medical Complexity
Individualize instead of relying on one-size-fits-all rules.
Pregnancy
Use appropriate positioning, draping, pressure, screening, and pregnancy-specific training. New bleeding, severe headache, significant swelling, severe abdominal pain, or other concerning symptoms require appropriate healthcare attention.
Cancer & Cancer Treatment
Massage may be appropriate for some people receiving or recovering from cancer treatment, but pressure, positioning, infection risk, blood counts, surgery, radiation areas, lymphedema risk, devices, and treatment effects can require specialized modification.
Cardiovascular Conditions
Serious or unstable cardiovascular conditions, significant edema, recent events or procedures, and complex medication use may require individualized guidance and conservative decision-making.
Bone Fragility
Osteoporosis, metastatic bone disease, prolonged steroid exposure, advanced age, or other factors can increase fracture risk. Pressure and positioning may need substantial modification.
Neurological Conditions
Changes in sensation, motor control, balance, autonomic function, or communication may affect positioning, pressure, transfers, feedback, and overall safety.
Medication Considerations
Medications can affect bruising, bleeding, blood pressure, alertness, sensation, skin integrity, or other factors. Therapists should recognize relevant precautions without changing or advising on prescribed medication.
During & After the Session
Keep assessing; the intake form is not the end of screening.
Monitor Client Response
Check comfort, pressure, temperature, positioning, breathing, and any new symptoms. A client's condition can change during a session.
Stop for Concerning Symptoms
Unusual pain, dizziness, faintness, breathing difficulty, sudden weakness, new numbness, confusion, or other concerning symptoms require stopping or modifying the session and responding appropriately.
Document Meaningful Changes
Record relevant findings reported by the client, areas avoided, modifications, consent, response, recommendations within scope, and referrals according to applicable requirements.
Know Emergency Procedures
Professional settings should have a clear plan for medical emergencies, including how to access emergency services and maintain client safety until help arrives.
Professional Boundary
Safety screening is not medical diagnosis.
Contraindications depend on the individual, symptoms, setting, training, local professional rules, and available medical guidance. When information is incomplete or the situation exceeds massage scope, choose the safer option.