Sports Massage Contraindications: Examples & What You Need To Know

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If you’re a sports massage therapist, it’s important that you know how to handle sports massage contraindications.

In this article, we will describe some common cautions and contraindications to sports massage, covering:

Before we start, if you're ready to deepen your existing knowledge and expand your sports massage therapist career opportunities, you can do this with our Level 3 Personal Trainer courses!

Want to know more about OriGym? You can download our course prospectus here.

What are Contraindications in Sports Massage?

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Contraindications in sports massage are pre-existing injuries or medical conditions that make it inadvisable for clients to undergo a massage treatment.

This is because the massage could be harmful or dangerous to the client, or could exacerbate the symptoms of their existing condition or injury.

Alternatively, the client may have an illness that is contagious, which could have a detrimental impact on you and your place of work.


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There are two types of systematic contraindications to sports massage, which are:

  • Total Sports Massage Contraindications- These are conditions or illnesses that prevent the client from receiving sports massage therapy.
  • Local Sports Massage Contraindications- A condition or illness restricts the areas of the body where massages can be received. You may need to refer your client to another professional to get confirmation that the treatment will be safe.


Examples of Sports Massage Contraindications

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Now that you know what they are, we are going to describe the cautions and contraindications to sports massage, giving you some of the most common examples to look out for.

Sports Massage Contraindications: Infections

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Whether viral, bacterial, or fungal, some of the most common sports massage therapy contraindications are infections.

Infections are likely to be transmitted from client to practitioner in two different ways:

  • Touch
  • Air

Infections Can Be Transferred Through Touch

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Sports massage is a hands-on treatment, and so you will come into close contact with clients. This means that if a client has any type of infection, they can pose a high risk to you.

Infections could then also be passed on to other clients who you may treat after you’ve come into contact with the bacteria, virus, or fungi.

In particular, fungal infections are contraindications for sports massage as fungi particles can easily attach themselves to your hands whilst you’re carrying out the treatment. 

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They can then be transmitted onto other surfaces and equipment within the room. To avoid this, you should:

  • Ensure that all equipment and surfaces are sterilised at all times
  • Thoroughly wash your hands immediately after and in between treatments
  • Wear gloves and masks where necessary.

Infections Can be Transmitted Via Air

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Another reason that infections are sports massage contraindications is because you can contract an infection simply by being in close proximity to a client, if the virus or bacterial infection is airborne.

You are then likely to pass this on to other clients who are being treated in the same room.

To minimise the risk of spreading infection, you should refuse to carry out massage treatments to clients suffering from any form of viral, fungal, or bacterial infection.

Sports Massage Therapy Contraindications: A High Temperature or Fever

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Fever becomes a contraindication for sports massage when it reaches 38 degrees Celsius or above. This temperature could signify that the client is fighting off an infection.

Having a sports massage with a high temperature can also disrupt the body’s natural defences, which may cause the illness to remain in the client’s system for longer, requiring more aggressive treatment in the long run. 

As a total sports massage contraindication, any client suffering from a high fever should therefore be refused treatment completely.

Sports Massage Contraindications: Skin Conditions

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There are a variety of skin conditions which could be considered contraindications of a sports massage, including:

  • Psoriasis
  • Eczema
  • Severe acne
  • Open sores
  • Cold sores

Whether a skin condition is a total or local sports massage contraindication depends on the type of condition that it is.

For instance, if it is caused by any of the previously mentioned infections, you should refuse treatment to prevent transmission, or opening skin up to further infection.

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Examples include boils, ringworm, and athlete’s foot.

If you feel that the skin condition is a local sports massage contraindication, it’s important to research what treatments, if any, are safe to be carried out on certain areas of the client’s body.

You should also obtain a medical note, confirming that it is safe for your client to receive massage therapy.

Sports Massage Contraindications: Recent Strokes and Heart Attacks

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As one of the systematic contraindications to sports massage, you should refuse treatment to a client who’s recently had a stroke or heart attack, until they are through the acute phase of their condition.

This is because they are at a higher risk of suffering from another episode within the first few months after suffering from either condition. 

You should not conduct treatment and part of your role as a sports massage therapist is to receive confirmation from a medical professional, and a signed disclaimer from the client, to declare they are aware of the risks of such sports massage therapy contraindications. 

Contraindications for Sports Massage: Myositis Ossificans

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Myositis Ossificans is a condition where bone tissue forms within the muscle. This could be as a result of a bad contusion or muscle rupture.

This is another of the key cautions and contraindications to sports massage, as massage may cause more damage to the surrounding soft tissue.

Overstretching can make the injury worse, making things more painful, as well as stimulating further bone formation and preventing recovery.

If you would like to expand your knowledge on Sports Massage Therapy, you can read our article on Sports Massage Therapy Aftercare.

Contraindications to Sports Massage: Pregnancy

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There are a number of important sports massage therapy contraindications to consider when it comes to pregnant women. These include:

  • Eclampsia or preeclampsia
  • Varicosities, due to organs pressing on arteries and veins
  • Hyperkyphosis or hyperlordosis due to poor posture
  • Edema
  • Compression syndromes
  • Gestational diabetes

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In general, women who are pregnant should not have massage treatment unless performed by a certified prenatal massage expert.

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If you’re finding this article helpful, and want to know how you can boost your sports massage career, check out our other articles below:

Sports Massage Therapy Contraindications: Diabetes

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In general, there are still benefits to sports massage for people with diabetes. However, there are a few sports massage contraindications for diabetes clients to consider.

For instance, the time of the client’s last insulin injection and the site of the injection should be checked, to ensure that their insulin levels are controlled.


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If insulin levels are uncontrolled, or there are unhealthy tissues present (such as ulcers or unhealed skin lesions), these are considered to be contraindications for sports massage, and treatment should be refused.

If insulin levels are controlled, massage treatment should avoid the injection site. This is because massage moves fluids around the body, which could increase the rate of insulin absorption.

Learn more about Sports Massage Therapy by discovering its Psychological and Physiological effects.

Contraindications of a Sports Massage: Blood Clots

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As well as sports massage contraindications such as diabetes, blood clots are another risk to look out for.

This is because massage can loosen blood clots, which could cause them to migrate to the brain, lungs, or heart.

If the client is aware of any clots present, a doctor should be consulted beforehand to ensure that they won’t be impacted by the massage.

Contraindications in Sports Massage: Cancer

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Cancer is considered one of the key contraindications of a sports massage because cancer can spread through the lymphnodes. Sports massage is aimed at draining the lymph nodes and directing toxins to these parts of the body so that they're easier to flush out.

Those with cancer are at a huge risk if this happens as you're potentially contributing to the spread of the cancer as well as pushing toxins into already weakened areas of the body.

Clients with cancer are advised to avoid public spaces, such as massage studios, to ensure that their body is not put through the unnecessary stress that a massage could create.

This is why this is one of the most important and dangerous sports massage contraindications.

Contraindications for Sports Massage Therapy: Recent Scarring

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Scarring is one of the sports massage therapy contraindications when it is less than 6 months old.

If scars are not given enough time to heal, massage could reignite the root cause of the scarring or worsen the condition.

With large areas of scarring, massage should be avoided until wounds are completely healed. Old scars should be inspected pre-massage, to ensure that they won’t cause any issues.

Sports Massage Contraindications: Soft Tissue Inflammation

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When massaged, inflamed tissue can become even more irritated and damaged, which is why they are one of the key contraindications of sports massage to be aware of.


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The same rules apply for inflammatory conditions such as rheumatoid arthritis and gout.

Sports Massage Therapy Contraindications: Open Wounds

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When a client presents the following, sports massage should not be performed on that area until the scar has properly formed:

  • Cuts
  • Grazes
  • Lacerations

This usually takes 1 to 2 weeks. Wounds any fresher than this should be considered as systematic contraindications to sports massage.

Contraindications to Sports Massage: If Clients Have Recently Consumed Drugs or Alcohol

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If a client has recently consumed drugs or alcohol, you should refuse all treatment until the substances wear off.

This is one of the key contraindications in sports massage, as drugs and alcohol can significantly affect blood pressure and heart rate, which increases risk of complications from massage.

What to Do If a Client Has Sports Massage Contraindications

Whether a client comes to you with sports massage contraindications such as diabetes, inflammation, or pregnancy, you should always follow these steps to protect both the client and yourself.

#1 Identify any Cautions and Contraindications to Sports Massage

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Firstly, it’s important to assess each client individually, on a case-by-case basis, to allow you to identify and address any contraindications that they may have.

Your job description as an SMT will include these initial assessments including testing mobility and performing a postural assessment.

To help you carry out a full investigation, and to comply with common insurance policy conditions, we would advise using a client questionnaire as part of the consultation process.

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This should cover most widespread illnesses and disorders, and should have space to list any known conditions that may not be listed on the form.

You should also ask for the patient’s medical history, and record any information on their consultation record.

#2 Assess the Severity of the Sports Massage Contraindications

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The next step to take is to decide whether these contraindications for sports massage are local or total.

These should be considered under the full list of contraindications, to help you make an informed decision on whether or not to undergo treatment.

This will also help you to decide whether you need to get some confirmation from a medical professional first, to ensure that the client is safe to have a sports massage.

#3 Treating a Client with Contraindications to Sports Massage

If you find any local sports massage therapy contraindications from the consultation process, the patient should be made aware of any risks that could occur as a result of treatment going ahead.

You should also consider how to adapt the practice to make it comfortable for the client, and to avoid causing any further damage to the affected area.

Another crucial step is to keep a record of the contraindication, so that you have evidence before the massage that you have identified and considered it as part of your client’s treatment plan, in case anything does go wrong.

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You may also need to consult a medical practitioner, and obtain a doctor’s note of approval before giving any treatment.

If the contraindications of a sports massage treatment are found to be total, you should always advise your client that the treatment cannot be carried out.


Why Is It Important to Identify Sports Massage Contraindications Before Treatment?

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It is important to always identify and describe cautions and contraindications to sports massage before providing treatment to clients, in order to:

  • Protect Clients- Taking contraindications into account may help to prevent further infection, pain, or damage to your client, as well as to other clients that you may treat.
  • Protect Yourself- It's important that you don’t expose yourself to infection, which you could spread throughout your place of practice.
  • Protect Your Practice- If you cause any illness or pain due to an undisclosed sports massage contraindication, you could put yourself at risk of legal action being brought against you.

What Can Happen if a Client Does Not Disclose Sports Massage Contraindications?

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There are several reasons that a client may not disclose a medical condition, which may be one of the contraindications of a sports massage that we have discussed. 

For instance:

  • Not everyone is willing to share their medical history
  • Some clients may not be aware of the impact that their condition could have on treatment
  • They may not yet have been diagnosed with the condition


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If you do go ahead with treatment and one of the systemic contraindications to sports massage causes your client harm, pain, or injury, then they are liable to make a claim against you.

Insurance claims can be time consuming to resolve, will cause stress, and are likely to impact your reputation as a sports massage therapist.

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This will also cost you in the long term, as it may increase your insurance premiums in future.

Therefore, it’s important to always invest in an insurance plan that will protect you if a compensation claim is brought against you at any point.

To avoid this from happening, ensure to keep your medical records up to date, including evidence that you have attempted to identify any possible contraindications for sports massage before treatment.

Before You Go!

Don’t forget, you can continue developing your knowledge to expand your client base with our Level 3 Personal Trainer courses which has plenty of information about some of the key contraindications and how to deal with them.

You can also find out more about this and other courses by downloading our free course prospectus!

Written by Rebecca Felton

Content Writer & Fitness Enthusiast

Graduating from the University of Liverpool with a first-class degree in English, Rebecca’s combined passions for fitness and writing are what brought her to OriGym. Rebecca is a keen gym-goer and specifically enjoys lifting weights. Outside of fitness and writing, Rebecca enjoys cooking, reading, and watching the football.

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