Contraindications

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When you go for a sports massage you may wonder why you spend 10 mins, 15 mins, or maybe longer talking about you and your health. There is a very good reason for this. The point is that the therapist needs to work out not only how best to treat you by questioning about your injury or reason for coming, but also to find out whether there are any reasons why you should not be treated, i.e. if there is a contraindication.

Contraindications are categorised as systemic, local and modifications.

Systemic contraindications are classed as illnesses or conditions which are severe in nature, acute, contagious, anything undiagnosed and anything uncontrolled. Systemic means the condition affects the whole body: massage should not be carried out under any circumstances. An example here would be compartment syndrome (over-developed muscles cause pressure on blood and nerve vessels). The vascular system is already under great strain and is compromised – to massage would simply add to that and worsen the situation, even if massage is carried out elsewhere on the body.

A local contraindication, e.g. varicose veins, is something that affects a particular area of the body: massage is possible providing you do not work on the affected area. But, if the condition is undiagnosed then the first step is always to refer the client to their doctor.

Modifications require the therapist to have an awareness and understanding of the condition before proceeding. Take osteoporosis as an example, treatment will depend on the stage and severity of illness as undue mechanical force can worsen the situation; but percussion and tapotement could encourage new bone growth, giving vital strength to weakened bones.

Once your consultation is over with the therapist will know whether or not they can treat you that day. I have only had to refuse treatment to one client: they had a kidney infection which is a systemic contraindication.

Lynne

Pregnancy Massage: differences?

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I was recently asked what was different about a pregnancy massage to a 'normal' remedial massage. Well, the simple answer is, at first glance, not much; but there are a number of key differences which make it a markedly different treatment.

You use (on the whole) the same techniques, treat the client with the same respect, and can gain amazing results with such things as reducing joint pressure due to tight muscles, decreasing swelling and water retention and improving blood circulation and lymphatic drainage. A massage during pregnancy can help alleviate some of the stress and strain that the body is subjected to because of hormonal and postural changes (posture and the changes occurring during pregnancy will feature as a separate blog due to the volume of information I can write!). For the mum-to-be, this can mean better sleep (who doesn't want to sleep peacefully), relief from sciatica and a tremendous emotional boost (an important factor not to be underestimated).

The musculoskeletal and hormonal changes which a woman's body experiences while pregnant are not to be underestimated. The extra weight gained to accommodate pregnancy can put immense pressure on joints leading to back, shoulder and neck ache. Having good anatomy and physiological knowledge means that I can assess what muscles need working on. Knowing that the hormone relaxin is active during pregnancy is also vital; it affects collagen fibres (those in ligaments and tendons) by increasing the water content and elastic properties of those structures. This is entirely natural, it's the body's way of preparing for giving birth by allowing extra movement in joints which normally have very little movement, specifically around the birth canal. But what it also means is that other joints in the body are at risk of becoming lax. As a therapist I'm aware of this and adapt my treatments accordingly to give the client a safe treatment.

The same contraindications (reasons to modify or not massage) apply to pregnant clients. However, there are other important issues to be aware of, and this is the reason why a thorough consultation needs to be carried out prior to any treatment. In some cases I won't massage a client without permission from a GP – the best interests of the client's (and baby) health are paramount. Some issues that immediately spring to mind are gestational diabetes, high blood pressure, bleeding, history of miscarriage, pre-eclampsia....to name a few.

It's true that pregnancy is a complicated process involving many of the systems in the body (and all of these are interlinked via the systems in the body. Here's where good anatomy & physiology knowledge and awareness of possible complications make the difference between a good and a not so good therapist (or a potentially dangerous one). With good training and continual research therapists are able to offer excellent treatments to pregnant ladies at this wonderfully special time.

So, after all that's been said, why should you receive a massage while pregnant? My belief is that it is immensely beneficial both from a physical and psychological perspective. With a knowledgeable therapist you will be well looked after and the treatment will be designed to your needs – be that relaxation or relief from specific aches and pains. A bond, a trusting relationship will build with regular treatments where the focus is on time for the mum-to-be to adjust and relax; all important factors at such a precious and nurturing time.

Lynne