Massage Therapy Licensing Exam (MBLEx) Areas of Caution and Special Populations Summary

The popliteal fossa is the hollow behind the knee. A large artery, vein, and nerve pass close to the surface there, so avoid deep pressure.

Wrong choices

• Inside the elbow: The inside bend of the elbow is the cubital area.
• In the armpit: The armpit is the axilla.
• On the front of the upper thigh: The front of the upper thigh is the femoral triangle area.

At endangerment sites, nerves, arteries, and veins lie near the surface with little muscle or bone to protect them. Deep pressure there can cause harm.

Wrong choices

• The skin there cannot feel touch: The skin at these sites feels touch normally.
• The bones there are the largest in the body: Bone size is not what makes these areas risky.
• The muscles there are the thickest in the body: Thick muscles protect deeper structures; endangerment sites have little cover.

After the first trimester, side-lying with pillows is a common, comfortable position. It keeps weight off the belly and off the large veins.

Wrong choices

• Lying face down with no support: Lying face down puts pressure on the belly.
• Lying with the head lower than the feet: This position is uncomfortable and unsafe in pregnancy.
• Lying flat on the back for the whole session: Lying flat on the back for a long time can press on a large vein and lower blood flow.

Older adults may have thin skin and fragile bones. Use lighter pressure, enough lubricant, and avoid pulling the skin.

Wrong choices

• Use strong tapotement to wake up the skin: Strong tapping can bruise fragile tissue.
• Use extra-hot packs to warm the skin: Thin skin burns more easily.
• Use deep friction to strengthen the skin: Friction can tear thin skin.

The femoral triangle is on the front of the upper thigh, just below the groin. The femoral artery, vein, and nerve pass through it, so avoid deep pressure there.

Wrong choices

• Behind the knee: Behind the knee is the popliteal fossa.
• On the side of the neck: The side of the neck has the posterior triangle.
• On the back of the lower leg: The back of the lower leg is the calf.

The anterior triangle is the front of the neck. The carotid artery and jugular vein lie close to the surface there, so avoid deep pressure.

Wrong choices

• The femoral artery and the femoral nerve: These lie in the femoral triangle of the thigh.
• The sciatic nerve: The sciatic nerve runs through the buttock and back of the thigh.
• The ulnar nerve: The ulnar nerve runs along the inner elbow.

In later pregnancy, a large uterus can press on the inferior vena cava when the client lies flat on her back. This can lower blood flow to the heart and make her dizzy or faint.

Wrong choices

• The weight of the uterus can press on the carotid artery: The carotid artery is in the neck, far from the uterus.
• Lying on the back raises body temperature too much: Body position does not raise body temperature in this way.
• Lying on the back strains the knees: Knee strain is not the main concern in this position.

The axilla holds the brachial plexus (the main nerves to the arm), the axillary artery and vein, and many lymph nodes. Deep pressure there can harm these structures.

Wrong choices

• The femoral nerve, artery, and vein: These pass through the femoral triangle of the thigh.
• The carotid artery and the jugular vein: These lie in the front of the neck.
• The sciatic nerve and the popliteal artery: These are in the back of the thigh and knee.