Questioni am currently training for my level 3 vtct swedish massage course and one of the assignments is as follows:
task 1 - to devise a consultation card
task 2 - to devise an appropriate after care card
task 3 - to help improve contraindication knowledge, i must investigate the following in detail: Bruising, swelling, recent operations, areas exhibiting loss of sensation, adverse reactions to a patch test, high/low blood pressure, dysfunction of the nervous system, over areas of recent fractures or sprains, recent haemorrhage, areas of scars, open cuts/abrasions, skin disorders, over areas with warts or moles, history of thrombosis.
i have to say how i would recognise the physical signs or symptons of them, if there are any, state why i would resrict or alter the massage
and state which contraindication would require a doctors note of approval.
i know its a lot to ask but ive searched the web for answers myself to no avail, and would appreciate your expert help, i am really loving the course as i am also practising for my Reiki 2, and see a real future in these therapies.
AnswerGreetings Lucy, and I appoligize for the time it took to respond (we have lost our computer to the computer gremlins.) I will go over each condition as you listed them. Please forgive me if I state things that you already know.
Bruising, easily recognized by the discoloration, is locally contraindicated (CI) because there is already some damage to the area. Massaging this bruise might be painful and slow down the time it takes to heal. The area around the bruise is fine for massage.
Swelling is CI since massage does increase the flow of the lymphatic system. This could add more fluid to an area that is already having trouble disposing of the fluid that is already there, increasing the pain and the chance for complications. Now, there is a type of massage, called lymphatic drainage, that is actually indicate for swelling (edema), since it helps return the fluid back to the body. This type of massage is usually done by itself, as any other form will shut down the lymphatic cappilaries that are needed to help drain the fluid away. The affected limb should be avoided, but the rest of the body should be fine for massage, as long as the edema is not caused by something like immenent heart failure.
Recent operations CI massage since the area might not be fully healed. Massaging it could reopen the incision, increase the potential for infection, and slow down the healing process. Also, while massage is great for the body, it is stressful, especially to a body that is healing from some major illness and/or surgery. Massage is usually okay once the scab falls off, as it indicates that the skin is whole.
Loss of sensation, called peripheral neuropathy, is CI simply because the client is unable to give back accurate feedback on pressure and pain. Since they cannot feel what you are doing, there is an increased chance of injuring them. This condition is common in advanced diabetes cases.
I assume the patch test would be for an essential oil. If they have a reaction to an EO, simply don't use it in the massage. If they have a reaction to the oil that you are using, you can substitute any other oil for them (I have even done massages with vegetable oil; it works pretty well.)
Untreated low blood pressure CI massage since a massage naturally lowers you BP, something that could be dangerous if it is already low. High BP actually indicates massage, for that reason. If the person has high or low BP and is being properly treated, they are fine for massage. I usually do advise cleints with slightly low or medicated high BP to get off the table very slowly, since they might get light headed when they get up.
Disfunctions of the nervous system are hard to define. If it is something like a seizure disorder, there is a risk that they could accidentally hurt you or themselves during a seizure. This is one area that it is helpful if you take special training to help get you comfortable with the conditions. I once massaged a man that had MD, and, while I could massage him, I would have felt a lot more comfortable if I had had some special training, especially with moving him onto, off of, and around the table.
Recent fractures and sprains are too weak to be worked on. Early on, they have not healed too much, so even a light pressure coujld reinjure the area. When the pain has faded from the injury, you can work carefully in the area, and stop at any discomfort.
The problems with recent haemorrhaging is the cause of it in the first place. It might be hard to tell if your client is experiencing something like that if it is internal. If it is caused by a condition like haemophelia, even light pressure might cause small tears that would take a long time to heal. If it is caused by a known condition, and they are physically fine at the time of the appointment, they should be fine for massage.
Areas for scar tissue are fine for massage, as long as the tissue under it has healed properly. A scar is simply a place where the fascia has grown faster than the skin, does not cause pain, and is not likely to tear during a massage.
Open cuts would be very painful to massage and would definately expose both you and the client to infection. Avoid all areas, including any redness around the cut, but you could massage other parts.
The same applies for skin conditions. Some things are contagious, like ring worm and empitigo, and you definately don't want those. If it something harmless like a port wine stain or a Karposi's sarcome (a skin cancer occasionally found on Jewish men and advanced AIDS patients), if it is not painful or contagious can get massage.
Warts are caused by a virus, are definately contagious, so they locally CI massage. Moles are simply raised and discolored groups of melanocytes, are not contagious, so they are fine to massage. This is one area to keep an eye on your client's for them. Most people have no idea what is growing on the backs, and since we see it all the time, we can be aware of changes to a mole that they do not know about. I once had to talk to a client of mine a bout a large mole on her back, one she had no idea that was getting bigger. I told her that she might want to get it checked out by her doctor. She did, and was glad that she did, as it was precancerous. Remember the ABCD's of cancer: if a mole is Assymetrical, if the Border is uneven, if the Color changes, or if the Diameter is larger than a pencil eraser, they might want to get it checked out.
A history of a thrombus does not necessarily CI a massage. If they are currently having a porblem with one, you would see swelling, pain, and bruising where the clot is blocking blood flow in the vein. This is a very dangerous condition, and it does not take a lot to potentially shift that clot. If it does get dislodged, it could travel to the heart, causing a myocardial infarction, to the brain causing a stroke, or to the lungs causing a pulmonary embolism. Usually, the client will be ordered to keep off of their feet until it disolves. Once they can get up and do normal things, like fly in an airplane, they shoulod be fine for massage. Even if there was no danger of the thrombus moving, usually they are on blood thinners, which CIs massage since it increases therisk of bleeding that cannot be stopped. This is definately one area that a note form the doctor would be helpful.
If at any time you are unsure of massaging a client with a special need, feel free to insist that you need a dr's permission. You are a health care worker, and we definately do not want to cause more pain or injury to our clients.
I do have an intake form that I use for all of my clients. I can, if you would like, send you a copy of it to use as a starting point for your own. Just send me your email to xopher425@aol.com, and, when I next get on a computer, I will forward it to you.
I am also planning on creating an after care card myself. I plan to put areas on the for the usual suggestions I have for clients, like stretches and increasing water intake. I also plan to have an area for their next appointment, to hlep encourage them to book it right then. If I ever get around to it, I would be happy to forward it to you if you'd like.
I hope this helps some, Lucy. Please feel free to write if you have any other questions. Also feel free to rate me on AllExperts.
Sincerely,
Christopher Hall
