CE INSTITUTE LLC BLOG

Pulmonary Embolism (PE) is a Bodywork and Massage Therapy Contraindication

Pulmonary Embolism (PE) is a Bodywork and Massage Therapy Contraindication

A pulmonary embolism (aka PE) is when a clump of material, usually a blood clot, obstructs an artery in the lungs.  

DVT & PE conditions are often underdiagnosed and serious, but preventable medical conditions.

It is important to know about DVT & PE because it can happen to anybody and can cause serious illness, disability, and in some cases, death. xiii

 

Deep Vein Thrombosis & Pulmonary Embolism Complications

The most serious complication of DVT happens when a part of the clot breaks off and travels through the bloodstream to the lungs, causing a blockage called pulmonary embolism (PE). If the clot is small, and with appropriate treatment, people can recover from PE. However, there could be some damage to the lungs. If the clot is large, it can stop blood from reaching the lungs - a fatal condition.

In addition, nearly one-third of people who have a DVT will have long-term complications caused by the damage the clot does to the valves in the vein called post-thrombotic syndrome (PTS). People with PTS have symptoms such as swelling, pain, discoloration, and in severe cases, scaling or ulcers in the affected part of the body. In some cases, the symptoms can be so severe that a person becomes disabled.

For some people, DVT and PE can become a chronic illness; about 30% of people who have had a DVT or PE are at risk for another episode.[i]

To learn more, please register for training at https://ceinstitute.com/

#massage #massagetherapy #massageprecautions #massagecontraindications

 

[i] Division of Blood Disorders National Center on Birth Defects and Developmental Disabilities. “Venous Thromboembolism (Blood Clots).” Centers for Disease Control and Prevention, 18 Apr. 2018, www.cdc.gov/ncbddd/dvt/facts.html.

 

 

 

Blood Clot Disorders can be a Bodywork & Massage Therapy Contraindication

Blood Clot Disorders can be a Bodywork & Massage Therapy Contraindication

Thrombosis

A local coagulation or clotting of the blood in a part of the blood circulatory system.

Thrombophlebitis

An inflammatory condition that causes a blood clot to form and block one or more veins, typically in the legs.

Superficial thrombophlebitis means that the blood clot occurs in a vein close to the surface of the skin. 

DVT (Deep Vein Thrombosis)

A blood clot within a deep vein, typically in the thigh or lower leg.

Signs/symptoms of the above conditions include:

  • Localized redness
  • Pain
  • Swelling
  • Numbness
  • Warmth/heat in localized area 

Contraindication:

Do not massage or work on someone who shows signs of a blood clot.

Refer for immediate emergency medical attention.

You may save a life!

To learn more, please register for training at https://ceinstitute.com/

#massage #massagetherapy #massageprecautions #massagecontraindications

 

 

Cardiovascular and Circulatory Issues in Massage Therapy and Bodywork Services

Cardiovascular and Circulatory Issues in Massage Therapy and Bodywork Services

Compromised circulatory issues or issues with the blood can be a massage therapy service precautions or contraindication, depending on the medical issue.  For example, massaging a client with a DVT (deep vein thrombosis) is contraindicated while general cardiovascular disease may be a simple massage precaution, depending on the severity of the disease. 

It is always best to seek approval and/or direction for services from a medical physician if you are unsure if the services will negatively impact a client’s circulatory issue or medical condition.  Most light bodywork and gentle passive movements may be okay with select cardiovascular issues, but it is always best to be safer than sorry by checking with a physician first.

Compromised cardiovascular, blood and circulatory issues could include:

  • Anemia
  • Aneurysm
  • Atherosclerosis
  • Cardiovascular disease
  • Congenital heart disease
  • Congestive heart failure
  • Coronary artery disease
  • Low blood pressure
  • Peripheral artery disease
  • Recent heart attack of stroke
  • Thrombophlebitis
  • Uncontrolled high blood pressure
  • Varicose veins

To learn more, please register for training at https://ceinstitute.com/

#massage #massagetherapy #massageprecautions #massagecontraindications

 

 

Bone Spurs aka Osteophytes in Massage Therapy Practice

Bone Spurs aka Osteophytes in Massage Therapy Practice

Bone Spurs aka Osteophytes:

  • Are Usually Smooth in Texture
  • May Not be Painful
  • Commonly Caused by Osteoarthritis
  • Ligaments in an aging spine can thicken and calcify, resulting in bone “spur” formation

 

Arthritis or Any Swelling is Usually Considered a Massage Therapy Contraindication

- HOWEVER-

WebMD Lists “Massage Therapy” as the #1 Alternative Therapy to Treat Spinal Osteoarthritis in 2017

Spinal Osteoarthritis

  • Regularly occurs in spinal facet joints.
  • A degenerative joint disease.
  • Protective cartilage surrounding bones (providing cushioning) degenerates.
  • Can cause swelling and/or pain.
  • Treatment is geared toward relieving the symptoms of pain and increasing a person's ability to function.

There are several “non-pharmacological” treatments available for osteoarthritis:

  • Massage
  • Acupuncture
  • Heat or cold compresses, which refers to placing ice or heated compresses onto the affected joint (check with a physician about which option, or which combination of heat and cold options, is best for you.)
  • Transcutaneous electrical nerve stimulation (TENS) onto the affected area
  • Nutritional supplements

Always consult with client’s treating physician for significant medical conditions.

 

To learn more, please register for training at https://ceinstitute.com/

#massage #massagetherapy #massageprecautions #massagecontraindications

 

Varicose Veins are a Local Massage Therapy & Bodywork Contraindication

Varicose Veins are a Local Massage Therapy & Bodywork Contraindication

Varicose veins are swollen, twisted veins that can be seen just under the skin’s surface. These veins usually occur in the legs, but they also can form in other parts of the body.

Varicose veins are a common condition. They usually cause few signs and symptoms, so most clients do nothing about them. Sometimes varicose veins cause mild to moderate pain, blood clots, skin ulcers (sores), or other problems.


 

It’s important to never work directly on varicose veins or apply any pressure that could further disrupt blood flow.  This includes massage or body wraps over the affected area.  It is always best to seek approval and/or direction for services from a medical physician regarding medical conditions.

Sometimes, varicose veins can cause blood clots, pain, skin ulcers, dermatitis or other problems. Dermatitis (an often-itchy rash) can lead to bleeding or skin sores/ulcers when the skin is scratched or irritated.  Varicose veins also can lead to thrombophlebitis.

There are many treatments available for varicose veins which are quick and easy and do not require a long recovery.

To learn more, please register for training at https://ceinstitute.com/

#massage #massagetherapy #massageprecautions #massagecontraindications

 

 

The Massage Don't Dos and the "Cookie Cutter" Approach

The Massage Don't Dos and the "Cookie Cutter" Approach

As an instructor here at CE Institute LLC, I recently had a poor massage experience that felt like an appropriate teaching moment.  Without naming names, and while recognizing that massage is like ice cream flavors, some people may have different tastes, I felt it was important to document the experience here at so that practitioners could learn from it.

I went to a massage establishment where I have had reliably great massage appointments over the past year between two different therapists.  Both therapists were not available for my next appointment during my rigid schedule, so the receptionist recommended that I try their lead therapist as a substitute.  I agreed, and scheduled a 90 minute massage appointment which is what I standardly book.

Everything was perfectly normal when I arrived.  The establishment was tidy and clean. The staff were pleasant and professional. I was taken for my appointment on-time. Unfortunately I already had a slight headache when I arrived, but I figured that's a great time to receive a massage!  Massage has regularly helped relieve my headaches, so I felt this was perfect timing.
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The therapist didn't really ask much about my headache, and instead simply instructed me to lie face down in the face cradle to start the 90-minute appointment.  She seemed to approach the appointment in some form of cookie-cutter style where everyone gets the same thing, and according to her, she starts all of her appointments with back massage and the client pronated.  
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My headache was likely due to allergies, as I had some serious sinus pain, so lying face down in the face cradle wasn't appealing to me, but I did it anyway to simply observe what this lead therapist would do next.  I figured she might have some amazing trick or technique and I was willing to go along with her instructions, to a point.
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She also had the table warmer on, but because I'm menopausal, I asked her to remove the top blanket covering the sheet because I was way too hot with the table warmer. This was the first thing we did when she reentered the room.   
Once she removed the blanket, she then put what felt like a heavy towel over my head while I lay pronated, struggling to breath in the face cradle with a growing sinus-type headache.  It was astonishing to me that someone would cover my head with a heavy towel, despite knowing I was already too hot and suffering from head pain. 
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In my opinion as a massage instructor, this is a perfect example where a therapist is simply doing what they do to all clients in a "cookie-cutter style massage", regardless of the client's individual medical presentation.
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After the therapist removed the towel from my head at my request, she then started a back massage. She completely ignored my headache, while I continued suffering in the pronated position in the face cradle.  
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The back massage began with what felt like a firm patting session with lotion.  She would perform a stroke from either top to bottom or bottom to top, and while she had wonderful contact, when she reached the end of the stroke, she broke contact, lifted her hand off my body, and placed her hand back at the start of the last stroke and repeated this over and over again, until she moved onto the next stroke.  The constant broken contact literally felt like I was being patted like a dog, instead of receiving a massage.  This went on for over ten minutes, until I finally said something with an increasing headache in the pronated position.
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I told her I was uncomfortable with the pressure on my sinuses in the face cradle, and it felt like I had a very fast growing sinus headache. I requested to roll over into a supinated position, and perhaps even elevate my head a little above my shoulders to help the growing sinus pressure.  I also asked her if she wouldn't mind performing some facial and scalp massage first, to try to relieve the headache, for which she agreed.
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I do not want anyone to think we're writing about something trivial here - we'd just like to make the point that this felt like what some of us call a "cookie cutter" style of massage, where all clients are getting the same thing, without independent evaluation or a customized treatment for my medical situation, and it was pretty awful.  By the time I rolled over on the table into a supine position, my head was pounding so badly that I had to get up.  I was unable to finish receiving the massage because I had become nauseous and it started to feel like a roaring migraine. And while I can't say for medical certainty, I can say after decades of suffering with headaches and migraines, I likely escalated in pain so quickly due to the position I was placed in, without a second thought by this massage therapist.
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In our teachings, we instruct massage therapists to ask the following type of questions when a client presents with a headache::
  1. What type of headache do you have? Do you know, or do they all feel the same?
  2. Are you taking any medication for your headaches?
  3. Where are you experiencing pain? 
  4. Is there anything I can do to help you feel better? 
  5. Where would you like me to start the massage? 
  6. What position do you think you'd be most comfortable in? 
Any of these questions could have helped the therapist help me.  But she didn't do this.  She simply did what she said she does with every other client, which is not the most effective method to execute a quality professional massage.
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Obviously, I could have directed the therapist to do a better job than what she did; however, it's not the client's job to direct a therapist to do quality work. At no time should a therapist expect a client to tell them to do something that they should already know what to do.  In fact, some clients might think the therapist knows best and simply follow their directions unquestioned, despite a deteriorating medical situation such as what I experienced.  As such, it's critical for massage therapists to ask questions, and appropriately respond to answers and feedback. 
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A massage for a geriatric client, a massage for a professional athlete about to enter a sports competition, and a massage for a teacher with a sinus headache will all require something different.  It's up to the therapist to determine what each individual client needs, and then execute a customized treatment plan for each individual client, even when it's just for one appointment.  Afterall, this is the therapist's opportunity to acquire another client, because if she was able to appropriately treat my headache, I'd likely book another massage appointment when I had another headache.  
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Massage therapists must ask questions and determine what would be best for the client, rather than treat every client in the same manner.  Not everyone is going to like the same exact massage, and in my particular case, it probably made me sicker than how I initially presented at the beginning of the appointment.
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We understand that the massage therapy industry has a very high burnout rate; however, repeatedly providing the same thing over and over again, in some type of cookie cutter style treatment will likely add to that burnout feeling and effect. We are not robots, but when massage therapists behave like robots, and simply do overly repetitive work, it's no wonder that they would burn out from this.  To avoid burnout and become a better practitioner, a massage therapist should always professionally interact with a client to determine their needs, and then provide a service that will truly benefit the client.  
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If clients wanted a one-style fits all cookie cutter approach, then they'd probably buy a massage chair from Sharper Image. Robotic massage equipment can provide the same treatment over and over again.  Instead, most massage clients seek services from therapists for a more customized human experience, and we hope in sharing this experience, that is what more massage clients will hopefully receive.   
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This was written by CE Institute LLC staff.  Names have been purposely ommitted to protect the privacy of all individuals involved.

CE Institute LLC Foot Reflexology Zone Chart

 

 

 

 

 

Accessory Bones of the Feet

How to Apply an Aromatherapy Essential Oil Patch Test

The following is a brief video massage therapy instructor demonstration of how to apply an aromatherapy essential oil patch test. This would similarly be used for Alohatherapy™ practices as well.

Do not practice aromatherapy or massage without formal licensed training.

For professional aromatherapy training, please visit and register for class at: https://ceinstitute.com/collections/aromatherapy

 

 

 

 

How to Setup a Hydrocollator Unit with Instructor Demo in Sports Massage

The following is a brief video that shows incorporating myofascial release with thermal therapy  and hydrocollator unit setup (ES1) for sports massage.

Do not practice hands-on massage, services or healthcare unless you are a licensed practitioner.

For professional myofascial release training, please visit and register for class at: https://ceinstitute.com/collections/myofascial-release

For professional sports massage training, please visit and register for class at: https://ceinstitute.com/collections/sports

 

 

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