Massage Therapy Licensing Exam (MBLEx) Pathology and Contraindications Summary

A fever is a sign that the body is fighting an infection. Massage should wait until the client is well, and the illness may also spread to others.

Wrong choices

• Use deep pressure to help the client sweat it out: Deep work can add stress to a body that is already fighting illness.
• Put hot packs on the client to raise body heat: Adding heat to a feverish body is not safe.
• Massage only the back and skip the legs: A fever affects the whole body, so avoiding one area does not help.

A clot in a deep vein can break loose and travel to the lungs, which can be deadly. Do not massage the area and send the client to a doctor right away.

Wrong choices

• Use deep friction to break up the clot: Pressure on a clot is dangerous.
• Stretch the calf muscles firmly: Stretching could also loosen the clot.
• Massage the calf gently toward the heart: Even gentle massage could loosen the clot and send it to the lungs.

A local contraindication affects only one area, such as a fresh bruise or a small cut. You avoid that spot but can work on the rest of the body.

Wrong choices

• A condition that needs extra deep pressure in that area: A contraindication is a reason to avoid or change massage, not to press harder.
• A condition that makes massage safer in that area: A contraindication points to a risk, not a benefit.
• A condition where no massage can be given at all: That describes an absolute (general) contraindication.

An injury that is still swollen, warm, and painful is in the acute inflammation stage. Avoid deep work on the area. Cold can help control swelling, and you can work on other parts of the body.

Wrong choices

• Use deep friction right on the sprain: Deep friction can add damage to fresh, inflamed tissue.
• Put a hot pack on the ankle: Heat can increase swelling in a fresh injury.
• Stretch the ankle firmly to restore movement: Firm stretching can tear the healing ligament.

Impetigo is a bacterial skin infection that spreads by touch. Do not massage while it is active.

Wrong choices

• Psoriasis: Psoriasis is an immune skin condition and does not spread to others.
• Eczema: Eczema is skin irritation and does not spread to others.
• Vitiligo: Vitiligo is a loss of skin color and does not spread to others.

Ringworm is a fungal infection that spreads by touch. Do not touch the area, and wash your hands well. A wide or spreading case is a reason to reschedule.

Wrong choices

• Rub lotion over the patch to soothe it: Touching the patch can spread the fungus to your hands and other clients.
• Use friction over the patch to break it up: Friction would spread the infection.
• Put a hot pack directly on the patch: Warmth and moisture help fungus grow.

Blood thinners slow blood clotting. Deep or strong pressure can cause bruises, so use lighter pressure.

Wrong choices

• Use deeper pressure to improve blood flow: Deep pressure can cause bruising or bleeding under the skin.
• Use only strong tapotement (tapping): Strong tapping can also cause bruising.
• Make no changes, because the medicine does not matter: Blood thinners make bruising more likely, so changes are needed.

Varicose veins are swollen, weak veins. Deep pressure can damage them, and a clot may be present. Use light pressure or avoid the area.

Wrong choices

• Use firm friction to break up the veins: Friction does not fix veins and can harm them.
• Use deep stripping strokes along the veins: Deep strokes can damage weak veins.
• Use heavy tapotement over the veins: Tapping can bruise or damage the veins.

With reduced feeling, the client cannot tell you when pressure or heat is too much. Use lighter pressure, avoid high heat, and look for cuts or sores on the feet.

Wrong choices

• Make no changes, because feeling does not matter: Reduced feeling makes injury more likely, so changes are needed.
• Use deeper pressure, since the client cannot feel it anyway: The client cannot warn you if the pressure causes harm.
• Put hot packs on the feet for a long time: The client may not feel a burn.

Mild muscle soreness is a common reason people come for massage. Fever and contagious illnesses such as the flu or chickenpox are reasons to reschedule.

Wrong choices

• Chickenpox with fresh blisters: Chickenpox is contagious while the blisters are fresh.
• A fever: A fever means the body is fighting illness, so the session should wait.
• The flu with active symptoms: The flu is contagious and makes the client feel unwell.