Massage Techniques and Contraindications
What this domain tests
This domain asks you to select the right technique for the right client and to recognize when massage must be modified, delayed, or avoided.
Concepts to master
- Core Swedish strokes: effleurage (gliding), petrissage (kneading), friction (circular or cross-fiber), tapotement (percussion), and vibration. Know the intent of each - relaxation, circulation, tissue mobilization, stimulation.
- Pressure and direction: toward the heart for venous return in general effleurage; cross-fiber friction for adhesion work; slower, deeper pressure for relaxation of hypertonic tissue.
- Contraindications - absolute: fever or acute infection, acute fracture, uncontrolled bleeding or clotting risk, suspected deep vein thrombosis, and open contagious skin conditions over the treatment area.
- Contraindications - local or modified: recent injury, bruising, varicose veins, areas of inflammation, and pregnancy precautions with appropriate positioning and pressure.
- Referral triggers: unexplained pain, swelling, numbness, or systemic symptoms warrant medical referral rather than massage.
- Documentation: note techniques used, areas treated, client response, and any adverse reactions.
Traps in questions
Two recurring traps: (1) the "more pressure is better" option - deep work is not automatically correct, especially over inflamed or vascular tissue; (2) confusing local versus absolute contraindications. A bruise means avoid that area, not cancel the session.
Rule of thumb
If the condition is systemic, infectious, or vascular, stop and refer. If it is local and non-infectious, modify the session and work elsewhere.
Worked example: A client reports a hot, swollen, painful calf after a long flight. This suggests possible deep vein thrombosis - an absolute contraindication. Do not massage the area; refer for medical evaluation.