Isolated Musculo-skeletal injury:
Injuries to the muscle and bone systems are best evaluated by a trained physician prior to massage. Acute or recent injury should not be massaged within 48 to 72 hours post injury. The best therapy for first 24 to 48 hours of a musculo-skeletal injury are have the injury evaluated by a physician and treat with R.I.C.E, see below for details of acronym:

Rest the injured area and the surrounding joints.

Ice the affected area to reduce swelling, pain and inflammation. Ice is most effective if applied within the first 24 to 72 hours after the injury. To avoid frostbite and tissue damage, Do not apply ice directly to the skin.                                
Follow manufacturer instructions for commercial ice packs as they often contain chemicals that can burn the skin if the ice pack leaks.    

Compression of the affected area with an elastic bandage with light to moderate pressure will help to reduce swelling. Do not apply the bandage so tight that it increases pain or reduces circulation and pulses located at away from the injury, toward the end of a limb. Do not apply compression bandages to the chest or neck area without medical attention.

Elevation of the affected arm, hand, wrist, ankle, leg, knee, elbow about 6 to 8 inches above the level of the heart will also help to reduce swelling.

In isolated injuries, Relaxation and other therapeutic massage can be done while avoiding the injured area. Once the injured area has begun to heal, within 5 to 7 days light massage, and friction can help to decrease adhesions and remove toxic debris from the injury and healing process.  After your doctor clears you for massage therapy, massage to healing injuries can assist in the healing process and reduce the amount of scar tissue adhesions that form.

Massage can be beneficial to the body in supporting the healing process and relaxing the mind and body. Inflammation is reduced and toxins produced as part of the healing process, can be lessened with the increase in circulation that is provided by massage therapy. In cases of minor isolated injury to the musculoskelatal system that is already in the healing process the use of thermal therapy such as ice and heat can be incorporated in the massage therapy. Ice reduces inflammation, pain and swelling. Heat increases circulation, relaxes muscles and can also reduce pain after the initial injury has begun to heal and swelling is not a factor.

Major Trauma, multiple injuries and emergency injuries: Massage is not recommended and is most likely contraindicated in these cases emergency care and physican evaluation is necessary. Call 911.

ILLNESSES:
Anyone who has an illness should be evaluated by a physician and cleared for massage. If you have an acute emergent illness call 911 and follow up with your doctor.

If you are feeling ill or have come down with a virus, the flu, respiratory infection or other infection it is rEQuired that you call to reschedule your massage until you feel better. This is to protect the therapist, the client, and other clients, Family members and the public at large and to avoid the spread of invasive germs. Massage is not advised when you are ill as it can put added strain on an immune system that is already taxed.

Massage can be beneficial to the body in supporting the healing process but is not a replacement for professional healing on the advice  of a physician. Massage is beneficial in relaxing the mind and body. Inflammation is reduced and toxins produced as part of the healing process can be lessened by the increase in circulation that is provided by massage therapy.

Contraindications to massage therapy:
There are times when massage therapy is not indicated or has to be modified to suit the specific situation of the client.

See chart below:

General Contraindications

For certain medical conditions massage therapy is generally contraindicated
(that is, massage should be avoided at this time).
These include:

   - systemic contagious or infectious diseases (including the common cold)
   - acute conditions requiring first aid or medical attention
   - severe unstable hypertension
   - significant fever

Local Contraindications

For the following conditions massage therapy is locally contraindicated (affected areas are to be avoided):

   - Acute flare-up of inflammatory conditions such as rheumatoid arthritis 
   - Deep vein thrombosis
   - aneurism
   - frostbite
   - local contagious or irritable skin conditions
   - open sores or wounds
   - recent surgery
   - recent burn
   - varicosities
   - malignancy

(in some of these cases contraindications may be general, depending on location and severity)

Massage therapy does not constitute medical treatment and is not a substitute for a medical examination or diagnosis. If you are dealing with a serious health condition check with your health care provider before seeking massage therapy. You must make sure you inform your massage practitioner of any health conditions that may affect the work.

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