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PRECAUTIONSPRECAUTIONS
&&
CONTRAINDICATIONS CONTRAINDICATIONS
for for
MASSAGEMASSAGE
(Unit 1 : Lecture 2)(Unit 1 : Lecture 2)
Precautions and ContraindicationsPrecautions and Contraindications
Precautions- Proceed with caution, be Precautions- Proceed with caution, be careful, monitor closely for responsecareful, monitor closely for response
Contraindications- DO NOT DO or Contraindications- DO NOT DO or strongly consider risk/reward involvedstrongly consider risk/reward involved
Why may massage produce harm?Why may massage produce harm?
Presence of disease or dysfunctionPresence of disease or dysfunction
Failure to avoid or modify techniqueFailure to avoid or modify technique
Inappropriate applicationInappropriate application
General PrinciplesGeneral Principles
Perform a thorough examinationPerform a thorough examination
Be aware of indications as well as Be aware of indications as well as precautions/contraindicationsprecautions/contraindications
ALWAYS ASK PERMISSIONALWAYS ASK PERMISSION
Tune into your patients responseTune into your patients response
Be aware of your moodBe aware of your mood
General PrinciplesGeneral Principles
Avoid Avoid HEAVYHEAVY pressure over sensitive pressure over sensitive areasareas
Communicate with your patient throughout Communicate with your patient throughout treatmenttreatment
Be aware of your anatomy and physiologyBe aware of your anatomy and physiology
Be aware that some patients have an Be aware that some patients have an aversion to touchaversion to touch
Case StudiesCase Studies
Danchik JJ, Yochum TR, Aspengren DD. Myositis Danchik JJ, Yochum TR, Aspengren DD. Myositis Ossificans Traumatica. Ossificans Traumatica. Journal of Manipulative and Journal of Manipulative and Physiological TherapeuticsPhysiological Therapeutics. 1993;16:605-614.. 1993;16:605-614.
Yeo TC, Choo MH, Tay MB. Massive Haematoma from Yeo TC, Choo MH, Tay MB. Massive Haematoma from Digital Massage in an Anticoagulated Patient: A Case Digital Massage in an Anticoagulated Patient: A Case Report. Report. Singapore Medical JournalSingapore Medical Journal. 1994;35:319-320.. 1994;35:319-320.
Kalinga MJ, Lo NN, Tan SK. Popliteal Artery Pseudo Kalinga MJ, Lo NN, Tan SK. Popliteal Artery Pseudo Aneurysm caused by an Osteochondroma: A Aneurysm caused by an Osteochondroma: A Traditional Medicine Sequelae. Traditional Medicine Sequelae. Singapore Medical Singapore Medical JournalJournal. 1996;37:443-445.. 1996;37:443-445.
Contraindications & PrecautionsContraindications & Precautions
Nature of listsNature of lists
Make sense of itMake sense of it
ContraindicationsContraindications
Physical Illness / nausea / fever >101.5FPhysical Illness / nausea / fever >101.5F
Severe Pain – IdentifySevere Pain – Identify
Acute conditions Acute conditions
Advanced respiratory, kidney or liver Advanced respiratory, kidney or liver failurefailure
Rashes, boils, open wounds, skin infectionRashes, boils, open wounds, skin infection
Metastatic cancer, including skin tumorsMetastatic cancer, including skin tumors
ContraindicationsContraindications
Haemophilla, haemorrhage, severe Haemophilla, haemorrhage, severe ecchymosisecchymosis
Whiplash within 24-48 hours: need X-rayWhiplash within 24-48 hours: need X-ray
Acute inflammatory disorder: acute RA, Acute inflammatory disorder: acute RA, local inflammation from recent traumalocal inflammation from recent trauma
ThrombophlebitisThrombophlebitis
Severe varicose veinsSevere varicose veins
ContraindicationsContraindications
Severe atherosclerosis- esp. ant. NeckSevere atherosclerosis- esp. ant. Neck
Unstable medical condition, including Unstable medical condition, including unstable hypertension, acute MI, unstable hypertension, acute MI, acute CVAacute CVA
AneurysmsAneurysms
FrostbiteFrostbite
PrecautionsPrecautions
Endangerment sitesEndangerment sites
Diminished sensation due to CVA, Diminished sensation due to CVA, diabetes, drugs, Etohdiabetes, drugs, Etoh
Medication useMedication use
Hyperaesthesia: RSDHyperaesthesia: RSD
RA- remission stageRA- remission stage
Immune system depression Immune system depression (transplant, AIDS, Chronic Fatigue)(transplant, AIDS, Chronic Fatigue)
PrecautionsPrecautions
Drug withdrawal & psychiatric conditionsDrug withdrawal & psychiatric conditions
Recent neurological injury- CVA, CHI, Recent neurological injury- CVA, CHI, SCI, presence of spasticity or tone SCI, presence of spasticity or tone changeschanges
OsteoporosisOsteoporosis
Facial Massage with contact lensesFacial Massage with contact lenses
Lymphedema- need trained specialistLymphedema- need trained specialist
Observation: Skin CancerObservation: Skin Cancer
Benign or MalignantBenign or Malignant
Three basic types:Three basic types:Malignant MelanomaMalignant Melanoma
Basal Cell CarcinomaBasal Cell Carcinoma
Squamous Cell CarcinomaSquamous Cell Carcinoma
Malignant MelanomaMalignant Melanoma
1:90-100 expected to develop1:90-100 expected to develop
Spreads horizontally or deepSpreads horizontally or deep
Common in people who have:Common in people who have:A large number of molesA large number of moles
Red/Fair hair, blue eyes, fair skin, frecklesRed/Fair hair, blue eyes, fair skin, freckles
A tendency to burn easilyA tendency to burn easily
A family history of malignant melanomaA family history of malignant melanoma
Early detection = Early cure (99%)Early detection = Early cure (99%)
Is it Malignant ?Is it Malignant ?
A = AsymmetryA = Asymmetry
B = BordersB = Borders
C = ColorC = Color
D = DiameterD = Diameter
E = EvolutionE = Evolution
** Most develop in early childhood and early ** Most develop in early childhood and early adulthoodadulthood
Other suspicious signsOther suspicious signs
InflammationInflammation
PainPain
ItchingItching
Crusting or BleedingCrusting or Bleeding
Satellite lesions: small brown changes Satellite lesions: small brown changes around the edge of a molearound the edge of a mole
Skin Tumors continued…Skin Tumors continued…
Basal Cell CarcinomaBasal Cell Carcinoma
Squamous Cell CarcinomaSquamous Cell Carcinoma
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