A build-up of plaque in artery walls. Care needs to be taken so that any thrombi are not dislodged.

Hardening of the arteries. Care is needed because there is usually some atherosclerosis and high blood pressure associated with this. No bodywork in advanced stages. Get medical clearance for your work if the client takes medication for circulatory problems.

Autoimmune diseases
The immune system produces antibodies against the body’s own tissues. Don’t work on acutely inflamed tissues.
a) Lupus – attacks the connective tissue mainly in the skin, kidneys, joints and heart. Contraindicated during acute flares.
b) Rheumatoid arthritis – immune system attacks the joints, and its associated muscles, tendons, ligaments and blood vessels; contraindicated during inflammatory stage. (Note: With “osteoarthritis” deep bodywork tends to be more successful).
c) Scleroderma (“hardened skin”) – a buildup of collagen fibers around organs (problems with absorption when around the small intestines) and
in the dermis of the skin; increasing stiffness at joints along with muscle weakness. Contraindicated during inflammatory phase.
d) Ankylosing spondylitis – inflammation of tissues around the spine causing the connective tissues of the sacrum and spine to solidify. Don’t work on areas of pain and inflammation in acute episodes.

Bipolar Disorder (manic -depressive)
During manic phase, deep bodywork could be contraindicated, since it could then increase the amplitude of the extreme mood-swings.

Borderline (as psychological diagnosis, originally understood as diagnosis for clients on the border between neurosis and full psychosis): Be careful. There have been (very) few reports about deep work triggering a psychotic episode. Full psychosis is in most cases a contraindication, and of course should be performed with supervision by a psychiatrist.

Connective tissue can often act as a barrier to the spread of cancer by encapsulating the cancerous cells. The problem is that deep work could theoretically cause the cancerous cells to metastasize (move through circulatory or lymphatic system to other places in the body). Usually okay if the person has a clean bill of health for 5 years. Pay special attention to lumps in abdomen, or lymph nodes in groin or armpit. (Lumps in abdomen could be hard feces. Client must monitor it: if no change after 3 days, perhaps have it examined). After mastectomy: check with doctor whether massage in the area (incl. the arm) is indicated. Sometimes it is not advisable to increase the lymphatic flow in that area.

Connective tissue disease: E.g. osteomyelitis, lupus, scleroderma: no deep work.

Be careful about tissue condition and loss of sensation. No deep work on area of recent insulin injection: could accelerate Insulin uptake.

Embolism or Thrombus
a) Venous emboli – usually land in the lungs causing pulmonary embolism.
b) Arterial emboli – can lodge themselves in the coronary arteries (heart attack); the brain (stroke), the kidneys, or the legs (phlebitis). Deep bodywork is contraindicated because of the risk of dislodging a thrombus. If you take blood thinners as a medical precaution against clotting, a medical clearance for any kind of deep tissue work affecting the circulatory system may be required.


May be indicated with a health practitioners consent.


Some types of headaches get worse with any kind of massage around the head/neck/shoulder area. This is quite common for migraines in the acute stage, probably due to infection and/or CNS over-stimulation. If you have previous experience with receiving massage as a remedial treatment, this can often tell whether it is helpful or not to work on your upper body. Tension headaches (which are usually more bilateral) tend to respond more positively.

Heart conditions

May be indicated if not restricted from exercise (if fingernails get purple or blue, massage may be contraindicated).

These are congenital benign tumors, made up of newly formed blood vessels. Different types, usually on the skin, yet sometimes also in brain and viscera. Especially in cases of known visceral type (e.g. hepatic hemangioma) no deep work in this area because of the severe danger of internal bleeding.

Herpes (and other potentially infectious skin conditions, including warts)
Any infected areas are contraindicated.

High blood pressure (extreme)
Deep work on uncontrolled high blood pressure patients may only be performed with medical supervision (deep bodywork often RAISES blood pressure).

Impaired elimination systems
Therapist will use caution with colostomies, Candida, kidney, and liver issues; carefully. More spacing between sessions may be required.

Intervertebral disc problems
With non-acute cases, therapist will avoid shearing motions and extreme bending. Don’t decompensate a stable system.
With acute cases, although bodywork can help creating space for the retreat of the tissue and to resolve some of the secondary compensations. Therapist work in and around the affected segment since local muscle spasms may have developed there as an important protection for the slipped disk.

Carefully performed deep abdominal work in female clients that use an intra-uterine device for birth control is ok. Trigger point therapy is contraindicated. It is possible that an I.U.D may become displaced, possibly leading to complications.

Menstruation (if strong)
If the client tends to have very strong menstruation symptoms with high amount of blood loss, any kind of deep tissue work or even massage in the area of pelvis, abdomen and thighs – if done around the days of the client’s period – can sometimes increase circulation and therefore the severity of the menstruation. Conclusion: Therapist will offer the client the option to cancel a session for that reason if the date collides with a strong period at the same time; or give only a very gentle movement awareness session which does not tend to increase circulation in the pelvic region.

Nose work, Other
For any intranasal work especially with regular cocaine users, nasal polyps, and nose surgery including cosmetic surgery, massage is contraindicated.

Pain medication
Communicate with your therapist about reduced pain sensations during the session. Your therapist will use caution regarding reduced sensation and greater possibility of tissue or nerve damage. (Same with paresthesia)

Rule of thumb: no deep work. Be aware: danger of triggering a miscarriage by strong myofascial work is greatest during first 3 months (especially through work around the pelvis, abdomen, adductors, medial legs, or feet). Later in pregnancy this gets less likely.

Varicose veins

Any Massage Therapy is always contraindicated.


If inflamed, it might get worse. Massage is contraindicated.

No deep work with:
* Abscess teeth (no intraoral work)
* Aneurysm
* Bone fractures or acute soft tissue injuries: wait for full healing (6 weeks – 3 months)
* Clients on Cortisone: (wait 2-3 months)
* Feverish clients
* Hemophiliacs
* Hodgkin’s disease (cancer of lymph system)
* Inflammatory conditions (includes such things as tendonitis and bursitis; contraindicated during acute stages; work peripheral to site possible when inflammation has subsided)
* Infectious conditions (with some exceptions, like HIV: get medical supervision)
* Leukemia
* Osteoporosis (usually found in post-menopausal women)
* Phlebitis: same risk as for ‘embolism or thrombus’
* Recent scar tissue (including regular or plastic surgeries): no work on this area until scarring process is complete (usually at least 6 weeks).

PS. This is not an exhaustive list. Other conditions may be contraindicated as the therapist deems fit.

Please note: if you are suffering from any of the aforementioned conditions (or think you may be) then you should consult your health care practitioner. The advice given here is only of a general nature and specific cases require specific treatment.



Any information, advice, recommendations, statements or otherwise contained herein, or in any other communication made by or attributed to™ and its representatives, whether oral or in writing, is not intended to replace or to be a substitute for medical advice offered by a trained physician or healthcare practitioner.