System Features Relevant to MT
- Circulatory contraindications are among the most critical in massage therapy. Any condition involving active blood clots (DVT, pulmonary embolism) is an absolute contraindication to local or general massage due to the risk of clot dislodgement.
- Blood pressure awareness is essential. Hypertensive clients may need lighter pressure, slower transitions from prone to supine, and monitoring for dizziness. Hypotensive clients require careful repositioning to prevent orthostatic episodes.
- Edema assessment distinguishes between benign fluid retention and signs of serious pathology. Pitting edema, lymphedema, and lipedema each require different approaches — some benefit from manual lymphatic drainage while others contraindicate it.
- Hematologic conditions such as hemophilia, sickle cell anemia, and thalassemia affect clotting, oxygen transport, and tissue fragility. Pressure must be reduced to avoid bruising or triggering a pain crisis.
- DVT screening (Homans' sign awareness, unilateral calf swelling, warmth, redness) should be part of every intake assessment, especially for post-surgical, immobilized, or pregnant clients.
Condition Articles
Heart and Blood Pressure
- Angina Pectoris
- Arrhythmias
- Chronic Congestive Heart Failure
- Heart Valve Disease
- Hypertension
- Myocardial Infarction (MI)
- Myocardial Infarction - Acute (Emergency)
- Orthostatic Hypotension
- Pericarditis
- Post-Myocardial Infarction Recovery
- Shock
Arterial Conditions
- Acute Arterial Occlusion
- Aneurysm
- Atherosclerosis
- Peripheral Artery Disease (PAD)
- Raynaud Disease and Raynaud Phenomenon
Vascular and Thromboembolic
- Deep Vein Thrombosis (DVT)
- Pulmonary Embolism
- Pulmonary Hypertension
- Thrombophlebitis
- Varicose Veins
Edema and Lymphatic
Hematologic
Key Takeaways
- Active blood clots (DVT, PE) are absolute contraindications to massage — always screen for unilateral swelling, warmth, and calf tenderness.
- Blood pressure status affects positioning, transition speed, and pressure depth throughout the treatment session.
- Edema must be differentiated by type before treatment — lymphedema may benefit from MLD, while pitting edema from cardiac failure requires medical clearance.
- Hematologic conditions (hemophilia, sickle cell) require reduced pressure to prevent bruising, tissue damage, or pain crises.
- Clients on anticoagulant medications bruise easily and need lighter pressure regardless of diagnosis.
- Post-2001 medication update: Direct oral anticoagulants (DOACs) such as apixaban (Eliquis) and rivaroxaban (Xarelto) have largely replaced warfarin as first-line anticoagulant therapy. Unlike warfarin, DOACs have no routine blood monitoring (no INR), so therapists cannot rely on lab values to gauge bleeding risk. Always ask about anticoagulant use during intake. See Post-2001 Drug Classes for details.