1. Contra indications of Massage

2. (Absolute contraindications) : are conditions that make a particular form of treatment improper or undesirable.
(Relative contraindications): are conditions under which a particular form of treatment should be applied with special care or limitations.

3. Contra Indication
1.General contraindication Those condition in which massage cannot be delivered to any part of the body. 2.Local contra indication Those condition in which massage cannot be delivered to a specific part of the body.

4. General contraindication
Hyperpyrexia (fever ): it is one of sign of inflammation, all body tissue will be tender.
Renal failure/Renal Diseases: due the generalized edema in which massage therapy can not achieves the goal of treatment.
Cardiac failure/Cardiac diseases (cardiac arrhythmias): we can not apply percussion technique with them which may increase arrhythmais and it will reduce cardiac out put then pressure of oxygen will be reduced also which fatal to this patient.

5. Deep x – ray therapy : after exposure to radiotherapy
blood vessels become vasodilated.
Endothelial swelling.
If massage is delivered at this stage, it may result in hemorrhage inside the tissues.
Osteoporosis: bone disease characterized by the decrease in total body mass. The skeleton becomes fragile and may not tolerate to any kind of external force.
Elderly people, post menopause women, patient under steroid therapy.

7. Severe spasticity or Upper motor neuron (UMN)lesion: Certain muscles (spastic group of muscles) of those patient have relatively high, so with minimal amount of stretching during massage on these muscles will result in stimulation of muscle spindle that will lead to increase tone which may cause pain to the patient.
Hairy skin: Rubbing the hairy skin is extremely painful so it is considered as relative contraindication. Shaving of excess hair, or using large amount of conducting medium will help in solving the problem.
Patient preference: the social customs in most of countries does not allow the patient to take is cloth off especially when the therapist is from opposite gender. The patient fell embarrassed to expose his / her body to someone else.

8. Local contraindication
Acute inflammation: it is one of absolute contraindication. Massage in this stage will increase pain and swelling to injured part.
Skin infection(for both patient and therapist): with massage infection can be spread from one part to another, through therapist it might be transferred to another patients. Massage for infected skin is very painful to the patient.
Fracture: movement which done during application of massage may disturb the healing process. It delay hematoma formation and callus formation which may lead to mal-union or nonunion.
Varicose vein ( The veins get dilated due to incompetency of the valve): lead to venous congestion and the vein become non elastic. Apply massage on those patient may lead to hemorrhage and phlebitis. Also this vein become tender to pressure.

10. Thrombosis(DVT): condition that characterized by formation of fatty plaques inside the arterial lumen. Massage will lead to movement plaque to any where that may lead obstruction of this vessel completely. If this plaque reach to the brain, heart, or lung it may cause further complication as ischemia.
Myositis ossificans ( Callus formation in soft tissues)
Malignancy: massage lead to increase in lymphatic flow, so there is chance for tumor spreading.
Open wounds: massage is very painful over open wound and may cause damage for healed tissue thus delaying healing process.
Poisonous foci (snake bites): massage of this case will release the poison to the circulation leading to serious systemic effect

12. Enumerate the local and general contraindications for medical massage.
Assignment 1
Enumerate the local and general contraindications for medical massage.
Local contraindication
General contraindication