Cautions & contraindications powerpoint voice over version 2

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

Massage SafetyMassage Safety

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

Visit this website:Visit this website:

How to recognize a melanoma:How to recognize a melanoma:

http://dermnetnz.org/lesions/melanoma.htmlhttp://dermnetnz.org/lesions/melanoma.html