Contraindication or Caution?

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I get emails from time to time or messages from students who are wondering what they can deal with or warnings about various conditions. Here’s an example from last night:


Hey Robert, 


I have a new client that wants a Thai massage today (just noticed it’s midnight). She completed her intake form yesterday and stated she had suffered cerebral hemorrhage 38 yrs ago, left side got paralyzed and stiff. She exercises but limitations due to the stiffness. 

One part of the intake form and how she responded:Please describe your pain and if it is always present or just when you do a certain activity. Please describe the activity. (is it stabbing? aching? burning?) my left arm joint (shoulder) when I stretch. My left leg around hip joint when I bend.


I obviously need to discuss with her about her limitations and keeping an open dialogue throughout the session. Should I keep away from some stretches or ultimately leave up to the client and what she can handle? 

Thank you, Dedicated Student 

I think that stretching has very limited therapeutic benefit in most situations. Stretching in my experience is more about end range and that’s fine for healthy people. Mobilization is what I most often use and in cases of caution I’d say communicate verbally More with the client as you go.

Explore with them and understand that many contraindications are just cautions. Thai massage is no more harmful than any other form of massage when done within a range of pressure and mobility that a receiver can easily receive.

Go slow. Communicate. 🙂

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