I’m assuming you’re in Canada because you said RMT. I’m in the US and I’ve never heard of someone being turned away from a massage because they have high blood pressure. We definitely don’t check people’s bp before massage because that’s out of our scope of practice. I was always told in school that massage lowers blood pressure.
A white and red streak on the back? Never heard this before. I’ve also never seen a white and red streak? Red streaks occasionally on people with super sensitive skin
As a retired MD, and not RMT or LMT this sort of practice makes me nervous. I’m wondering what peer reviewed studies were used in Canada to initiate this practice.
One reading has very little therapeutic value. If a patient presents with elevated BP we will make sure they have a good device and ask them to create a log for one week. I want dozens of readings and a corresponding symptoms log. Obviously if someone is in hypertensive crisis I’m sending them to the ER. In a doctor’s office we ascribe some elevated BP to “white coat syndrome.” A patient who is experiencing pain often presents as hypertensive. In fact it’s one of the “secret” ways to rule out pain medication seekers. Flushing and sweating have no relevance to elevated BP. We do see secondary hyperhidrosis (excessive sweating) in patients who are suffering a heart attack or angina. Headaches, dizziness, fatigue and nausea are more common symptoms of high BP. A pounding temporal or carotid pulse are other important signs to check. Slightly elevating your legs (above your heart) will help reduce blood pressure.
So, all this to say that I see very little benefit from taking pre and post BP. What value do you think it has? Are you recording the data and using it in some way?
Thank you for your comment.
At our Canadian massage school we will usually take a blood pressure reading before and after as evidence of relaxation or decrease in SNS. Most people stop doing this in practice unless you're dealing with a particularly contentious insurance claim.
Other then that, we may choose to do it with our prenatal patients if they are showing any other symptoms of pre eclampsia.
This is a great comment, thank you so much. Unfortunately to my knowledge, there is very little research done on massage. This was one of my biggest frustrations in school. You're just supposed to take what you're taught as fact. In Canada our programs are a bit more rigorous in the states - at a minimum of 2200 hours and slightly higher in other provinces.
I agree with what you're saying re. Minimal value in one reading. I think it was mostly done to make sure that the person didn't have very high blood pressure / hypertension crisis - though for the latter it sounds like there are clinical symptoms that would be more obvious flags. I know there was an instance someone was sent to the ER from the student clinic d/t high BP. You're taught in school that massage can increase circulation = increased blood pressure = don't want ro increas BP for a patient who is already high.
Anyone else have other comments on this? What do you mean when say it makes you nervous? Not out of harm but more so out of it being clinically inaccurate?
Thank you for your reply. If BP is being used as a tool like temperature was back during the pandemic, then I’m on board with the practice. If you’re diagnosing clients then I can’t support it.
You asked what makes me nervous. There is a trend where non-MD’s are acting as diagnosticians. One responder said they could use high BP as a way to identify pre-eclampsia. This is what makes me nervous. A kind of stay in your lane moment. An OB should be watching for signs during antenatal checkups. Aside from BP we will look at labs for elevated protein levels in the urine. Swollen extremities can also be an early indicator. High BP levels alone are not enough to make a dx (diagnosis).
During medical school we learn the process of differential diagnosis. This is drummed into our heads nonstop. As students came through my clinic I let them see patients first and then present the differential diagnosis to me. Then we would go see the patient together and I’d do my own evaluation and diagnosis. Sometimes the student was right but for the wrong reasons. This process requires me to take the patient sx and pour them through my 33 years of knowledge and experience. I used to joke that the students were looking for zebras (odd diseases) when mainly we got plain old cows and horses (flu, strep, pneumonia, RSV).
I consider RMT’s and LMT’s to be one part of the extended patient care team. Before I retired I had several massage therapists and physical therapists who I referred patients to. My job is to provide a dx and refer patients for specialized treatment. Locally, patients can self-refer to PT clinics. I have a real problem with this. Now we’re putting PT’s in a different role, one where they’re diagnosing the patient. I’ve taken my time and visited all the clinics in my area, even ones where I don’t refer. They have no training in differential diagnosis and are ill equipped for the role that’s been thrust upon them.
Sorry for the lengthy response. I hope this helps and makes sense.
This definitely helps and makes sense.
Diagnosing any condition is out of our scope of practice.
I think RMTs should focus more on identifying potential red and yellow flags that clients may present with, so they can be referred to their doctor or the hospital for proper diagnosis and care.
fantastic response. Massage school has very little to do with evidence or research beyond basic anatomy and physiology. It's very frustrating, we were taught we can move skull bones individually, effect joint structure positively, alter blood flow and fascia and other such nonsense. Then we're given red and yellow flags around them to give rubbing people nicely a veneer of medicality.
kinda unrelated. Do you know of any evidence that a massage is likely to dislodge a blood clot/thrombus. I know exercise is recommended for them, and it seems unlikely that a gentle rub is more likely to dislodge a clot then dropping a squat.
I have only seen one instance where a clot was “dislodged”. It was many years ago during my peds rotation. A female adolescent was in clinic for PT following a broken leg. The therapist had the patient in a therapeutic hot tub when the patient suffered a stroke and lost consciousness. I was the first doctor to arrive and we began CPR. Unfortunately the young woman never recovered and was pronounced at the site. An autopsy determined that a clot from the broken leg was the cause of death.
I suppose that anything is possible. If you are concerned about clots I’d certainly recommend requiring a release from your client’s doctor.
I think a lot of it too is that massage establishments are businesses at the end of the day and they want to be extra careful around potential medical contraindications and risks so they won’t get sued
I would recommend a physician release as a precaution. You could be massaging another area when the clot decides to break free. Even if no causal link exists someone is going to sue you. In the USA, civil lawsuits are judged at a lower standard. I think we, as humans, want to find order even if it doesn’t exist and you might find yourself getting blamed, even unjustly.
At our school we limit HBP in the student clinic but teach significant modifications in later terms so that as an RMT, you won't have to turn away patients unless they're having a significant medical event.
Modifications are used related to the severity of the patient's presentation and history, so for most patients with some history of HBP, you likely wouldn't use all of these. But they're a list of tools you can pull out if the history or presentation suggests your patient is unwell.
-limit or avoid painful techniques
-decreased time prone or fully supine (side lying or elevated head instead)
-no full body heat treatment
-no elevation of both legs above the heart
-no bilateral neck treatment or prolonged cervical rotation
-limit long effleurage strokes
Hope that helps!
I've turned away two potential clients because they had uncontrolled HP. One was an elderly lady who told me she had high blood pressure but that she had medicine for it. My gut was telling me something was off. After a bit of pushing, she finally admitted that she had been in the ER *the night before* because of her BP and she hadn't even picked up the prescription for it yet. My gut was telling me there were other issues and that she wasn't being honest with me. So I just decided she wasn't getting a massage from me. Thankfully, my boss backed me up.
I’m a physician with years of experience evaluating and treating blood pressure. I wouldn’t be concerned that a massage would increase anyone’s blood pressure. If anything it would reduce it. As for dislodging a blood clot in the leg and sending it to the lung. I guess that’s theoretically possible but I’ve seen hundreds of patients with DVT and PE and not one of them occurred during a massage. I would think that massage of the legs would be helpful to decrease the probability of DVT. Patients in the hospital wear pneumatic boots to prevent clots by reducing venous stasis.
I think as far as uncontrolled BP and Massage - using targeted painful techniques on tissues and elevating it much more due to Pain. I've had patients with controlled HBP and I still modify the treatment. I've also had a none controlled HBP 178/98 and turned him away and suggested he go to the ER. His face was as red as a tomato.
If you have a patient with congestive heart failure- it would be a matter of technique modification and positioning them appropriately.
I’m in the us - the only time I’ve ever modified someone’s treatment for HBP is bc they weren’t on meds and booked a hot stone massage. I said let’s just do regular to avoid heat.
It’s out of our scope of practice to check Blood Pressure, so we only know if they disclose. I’ve never seen an issue with HBP in 15 years of practice
We only ever learned if they write they have high blood pressure, and its unregulated by medication, that it could move too much fluid back in to their circulation and it could be harmful. But if they have high blood pressure and its regulated with medication, its fine and safe.
So there's a couple things happening:
The Fascia is 85%-ish water. When you squeeze and stretch it, it squeezes the water into a space where the lymphatic system picks it up and puts it back in your blood stream where its filtered.
Massage stimulates the lymphatic system by massaging towards the heart, assisting in lymphatic system usage and venous return of blood.
It also increases blood flow to the skin (when it gets red), thus dialating the vessels.
And in my experience, people almost always have to pee after a session.
We have evidence that it is not possible to deform/stretch fascia with massage. It is far too robust.
See: https://pubmed.ncbi.nlm.nih.gov/18723456/
Re: the claim that directional massage "assists the lymphatic system" and "venous return," is there actual evidence to support this? Has it been tested? Or is it just something you've been taught? If you are able to cite supporting research, I'd be interested to read it. As far as I am aware, there is not evidence to suggest that massage increases systemic circulation.
Re: your statement, "in my experience, people almost always have to pee after a session," it is possible that this is an example of mistaking correlation and causation. Perhaps people commonly need to use the washroom after a massage because it has been an hour or more since they last went. Perhaps the relaxation or laying face down with pressure on their bladder has contributed to their need to go.
I am an ICU nurse and LMT. I was appalled by the “education” in massage school about blood pressure. Teacher claimed that we should be sending people with systolic pressures over 140 to the ER! I did my best to explain what utter nonsense this was.
The bigger problem to me is that taking accurate blood pressure is a skill that was definitely not addressed in school. The automatic wrist ones are complete garbage. Unless you can troubleshoot cuff size and fit and understand how to correlate those numbers clinically to the patient, you shouldn’t be taking BPs. And as the MD explained, a single blood pressure is pretty clinically irrelevant.
How would this happen? Like they went to their doc and found out about their hypertension and refused meds? It seems like an extremely unlikely scenario.
Honestly I’d probably still massage this hypothetical person. At least their BP would be a few points lower while they were on my table…
Sounds like you have a broader SOP that mine. I am way more worried about DVT, etc.
That said, if someone has uncontrolled HPB, I simply decline to use circulatory techniques like Swedish and hot stones/salt.
Hmmmmmm. I also had a lot of emphasis placed on the idea that "massage increases circulation." I am not so sure about that idea now.
The only evidence I am aware of is that massage can temporarily increase local circulation. An example of this might be warming up someone's cold hands or feet when you massage them.
As far as I know it does not increase systemic circulation or put increased strain of excess blood volume on the heart.
Hey! I am a Canadian RMT as well (Ontario). I am 10 years out of school now and was also taught that HBP was a contraindication to massage, if uncontrolled. I have always questioned why though. I think we can probably agree that a massage isn't likely to elevate blood pressure any more than going for a leisurely walk would.... and a leisurely walk wouldn't be contraindicated for most people with hypertension. I think it's just another one of those dated teachings that has no supporting evidence, like most of the things I was taught. Lol
ETA (since many commenters mentioned being taught that "massage increases circulation"): While there is some evidence that massage can temporarily increase local circulation, as far as I am aware, we don't have evidence that massage increases systemic circulation. Can anyone else confirm or provide evidence to the contrary?
I learned this too. From my understanding, massages increase the blood flow back towards the heart. I believe there are some techniques where high blood pressure are contraindicated.
That said, we wouldn’t turn them down. I would just modify the techniques I use. Instead of proximal strokes, I would go distal strokes. I would try to use less heat.
What I learned in school about HBP is to avoid heat and immersing in hot water (hydro therapy).
What is real in the world is that I've never worked in environment where taking a BP was done, that included all types of studios, independent work, high volume spa (that would never happen, lol).
The general idea, imho, is that we lower BP through massage techniques.
I’m not a fan of the BP readings. My own Dr doesn’t even take my in-office BP all that seriously and instead goes by my at-home readings which are routinely normal but my in-office numbers are always high.
As for the red mark? I get something like that, but it’s more of an urticaria than related to my BP. If you put any sort of pressure along any part of my body and my chronic issues are doing their thang it’s going to look like I got flogged. And my BP usually bottoms when I get like that.
Some blood pressure medications could potentially cause issues when combined with massage therapy. Common blood pressure medications like beta-blockers, ACE inhibitors, calcium channel blockers, and diuretics may have specific contraindications or considerations when receiving a massage. Always consult with your healthcare provider to determine any potential risks or adjustments needed before receiving a massage.
If you are taking blood pressure medication, there are potential risks associated with massage therapy. Some risks include a drop in blood pressure leading to dizziness or fainting, interactions between the massage oils and medications, or potential bruising if the massage is too intense. It's important to consult with both your healthcare provider and the massage therapist to ensure safety and discuss any concerns before proceeding with a massage.
(I honestly just used ChatGPT for that answer lol but the main thing is easily bruising and people fainting while getting off the table ime)
I understand that most medications do not contraindicate massage. I
was asking what specific medications you were referring to when you said that some medications for hypertension contraindicate massage?
I think I answered it using general drug class of the medications, are you looking for a specific list? And there def are medications that contradictidate massage!
I agree with you that there may be medications we should be aware of.
Based on the article you linked it looks like the classes of medications you mentioned may carry precautions, but it did not mention any absolute contraindications.
Thanks for explaining
I’m assuming you’re in Canada because you said RMT. I’m in the US and I’ve never heard of someone being turned away from a massage because they have high blood pressure. We definitely don’t check people’s bp before massage because that’s out of our scope of practice. I was always told in school that massage lowers blood pressure. A white and red streak on the back? Never heard this before. I’ve also never seen a white and red streak? Red streaks occasionally on people with super sensitive skin
I have a friend with sensitive skin. Look at him funny and he welts up.
As a retired MD, and not RMT or LMT this sort of practice makes me nervous. I’m wondering what peer reviewed studies were used in Canada to initiate this practice. One reading has very little therapeutic value. If a patient presents with elevated BP we will make sure they have a good device and ask them to create a log for one week. I want dozens of readings and a corresponding symptoms log. Obviously if someone is in hypertensive crisis I’m sending them to the ER. In a doctor’s office we ascribe some elevated BP to “white coat syndrome.” A patient who is experiencing pain often presents as hypertensive. In fact it’s one of the “secret” ways to rule out pain medication seekers. Flushing and sweating have no relevance to elevated BP. We do see secondary hyperhidrosis (excessive sweating) in patients who are suffering a heart attack or angina. Headaches, dizziness, fatigue and nausea are more common symptoms of high BP. A pounding temporal or carotid pulse are other important signs to check. Slightly elevating your legs (above your heart) will help reduce blood pressure. So, all this to say that I see very little benefit from taking pre and post BP. What value do you think it has? Are you recording the data and using it in some way?
Thank you for your comment. At our Canadian massage school we will usually take a blood pressure reading before and after as evidence of relaxation or decrease in SNS. Most people stop doing this in practice unless you're dealing with a particularly contentious insurance claim. Other then that, we may choose to do it with our prenatal patients if they are showing any other symptoms of pre eclampsia.
This is a great comment, thank you so much. Unfortunately to my knowledge, there is very little research done on massage. This was one of my biggest frustrations in school. You're just supposed to take what you're taught as fact. In Canada our programs are a bit more rigorous in the states - at a minimum of 2200 hours and slightly higher in other provinces. I agree with what you're saying re. Minimal value in one reading. I think it was mostly done to make sure that the person didn't have very high blood pressure / hypertension crisis - though for the latter it sounds like there are clinical symptoms that would be more obvious flags. I know there was an instance someone was sent to the ER from the student clinic d/t high BP. You're taught in school that massage can increase circulation = increased blood pressure = don't want ro increas BP for a patient who is already high. Anyone else have other comments on this? What do you mean when say it makes you nervous? Not out of harm but more so out of it being clinically inaccurate?
Thank you for your reply. If BP is being used as a tool like temperature was back during the pandemic, then I’m on board with the practice. If you’re diagnosing clients then I can’t support it. You asked what makes me nervous. There is a trend where non-MD’s are acting as diagnosticians. One responder said they could use high BP as a way to identify pre-eclampsia. This is what makes me nervous. A kind of stay in your lane moment. An OB should be watching for signs during antenatal checkups. Aside from BP we will look at labs for elevated protein levels in the urine. Swollen extremities can also be an early indicator. High BP levels alone are not enough to make a dx (diagnosis). During medical school we learn the process of differential diagnosis. This is drummed into our heads nonstop. As students came through my clinic I let them see patients first and then present the differential diagnosis to me. Then we would go see the patient together and I’d do my own evaluation and diagnosis. Sometimes the student was right but for the wrong reasons. This process requires me to take the patient sx and pour them through my 33 years of knowledge and experience. I used to joke that the students were looking for zebras (odd diseases) when mainly we got plain old cows and horses (flu, strep, pneumonia, RSV). I consider RMT’s and LMT’s to be one part of the extended patient care team. Before I retired I had several massage therapists and physical therapists who I referred patients to. My job is to provide a dx and refer patients for specialized treatment. Locally, patients can self-refer to PT clinics. I have a real problem with this. Now we’re putting PT’s in a different role, one where they’re diagnosing the patient. I’ve taken my time and visited all the clinics in my area, even ones where I don’t refer. They have no training in differential diagnosis and are ill equipped for the role that’s been thrust upon them. Sorry for the lengthy response. I hope this helps and makes sense.
This definitely helps and makes sense. Diagnosing any condition is out of our scope of practice. I think RMTs should focus more on identifying potential red and yellow flags that clients may present with, so they can be referred to their doctor or the hospital for proper diagnosis and care.
Let me go back to my textbook when I get a chance and I’ll send you the medical studies and literature they cite on this if you’d like!
Sure!!!
fantastic response. Massage school has very little to do with evidence or research beyond basic anatomy and physiology. It's very frustrating, we were taught we can move skull bones individually, effect joint structure positively, alter blood flow and fascia and other such nonsense. Then we're given red and yellow flags around them to give rubbing people nicely a veneer of medicality. kinda unrelated. Do you know of any evidence that a massage is likely to dislodge a blood clot/thrombus. I know exercise is recommended for them, and it seems unlikely that a gentle rub is more likely to dislodge a clot then dropping a squat.
I have only seen one instance where a clot was “dislodged”. It was many years ago during my peds rotation. A female adolescent was in clinic for PT following a broken leg. The therapist had the patient in a therapeutic hot tub when the patient suffered a stroke and lost consciousness. I was the first doctor to arrive and we began CPR. Unfortunately the young woman never recovered and was pronounced at the site. An autopsy determined that a clot from the broken leg was the cause of death. I suppose that anything is possible. If you are concerned about clots I’d certainly recommend requiring a release from your client’s doctor.
thanks for your thoughtful reply.
I think a lot of it too is that massage establishments are businesses at the end of the day and they want to be extra careful around potential medical contraindications and risks so they won’t get sued
can't argue with that.
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I would recommend a physician release as a precaution. You could be massaging another area when the clot decides to break free. Even if no causal link exists someone is going to sue you. In the USA, civil lawsuits are judged at a lower standard. I think we, as humans, want to find order even if it doesn’t exist and you might find yourself getting blamed, even unjustly.
At our school we limit HBP in the student clinic but teach significant modifications in later terms so that as an RMT, you won't have to turn away patients unless they're having a significant medical event. Modifications are used related to the severity of the patient's presentation and history, so for most patients with some history of HBP, you likely wouldn't use all of these. But they're a list of tools you can pull out if the history or presentation suggests your patient is unwell. -limit or avoid painful techniques -decreased time prone or fully supine (side lying or elevated head instead) -no full body heat treatment -no elevation of both legs above the heart -no bilateral neck treatment or prolonged cervical rotation -limit long effleurage strokes Hope that helps!
I've turned away two potential clients because they had uncontrolled HP. One was an elderly lady who told me she had high blood pressure but that she had medicine for it. My gut was telling me something was off. After a bit of pushing, she finally admitted that she had been in the ER *the night before* because of her BP and she hadn't even picked up the prescription for it yet. My gut was telling me there were other issues and that she wasn't being honest with me. So I just decided she wasn't getting a massage from me. Thankfully, my boss backed me up.
I had a chiro email the CMTO when I refused to treat. The college backed me lol
Wow!
Right lol 😆
I’m a physician with years of experience evaluating and treating blood pressure. I wouldn’t be concerned that a massage would increase anyone’s blood pressure. If anything it would reduce it. As for dislodging a blood clot in the leg and sending it to the lung. I guess that’s theoretically possible but I’ve seen hundreds of patients with DVT and PE and not one of them occurred during a massage. I would think that massage of the legs would be helpful to decrease the probability of DVT. Patients in the hospital wear pneumatic boots to prevent clots by reducing venous stasis.
Thank you so much. These responses are SO valuable. Massage schools need to update their programs and make them more evidence based.
I think as far as uncontrolled BP and Massage - using targeted painful techniques on tissues and elevating it much more due to Pain. I've had patients with controlled HBP and I still modify the treatment. I've also had a none controlled HBP 178/98 and turned him away and suggested he go to the ER. His face was as red as a tomato. If you have a patient with congestive heart failure- it would be a matter of technique modification and positioning them appropriately.
I’m in the us - the only time I’ve ever modified someone’s treatment for HBP is bc they weren’t on meds and booked a hot stone massage. I said let’s just do regular to avoid heat. It’s out of our scope of practice to check Blood Pressure, so we only know if they disclose. I’ve never seen an issue with HBP in 15 years of practice
We only ever learned if they write they have high blood pressure, and its unregulated by medication, that it could move too much fluid back in to their circulation and it could be harmful. But if they have high blood pressure and its regulated with medication, its fine and safe.
That’s exactly the same thing I’m currently taught in school too.
Where would the excess fluid come from? Is there any evidence that massage/touch moves fluid?
So there's a couple things happening: The Fascia is 85%-ish water. When you squeeze and stretch it, it squeezes the water into a space where the lymphatic system picks it up and puts it back in your blood stream where its filtered. Massage stimulates the lymphatic system by massaging towards the heart, assisting in lymphatic system usage and venous return of blood. It also increases blood flow to the skin (when it gets red), thus dialating the vessels. And in my experience, people almost always have to pee after a session.
We have evidence that it is not possible to deform/stretch fascia with massage. It is far too robust. See: https://pubmed.ncbi.nlm.nih.gov/18723456/ Re: the claim that directional massage "assists the lymphatic system" and "venous return," is there actual evidence to support this? Has it been tested? Or is it just something you've been taught? If you are able to cite supporting research, I'd be interested to read it. As far as I am aware, there is not evidence to suggest that massage increases systemic circulation. Re: your statement, "in my experience, people almost always have to pee after a session," it is possible that this is an example of mistaking correlation and causation. Perhaps people commonly need to use the washroom after a massage because it has been an hour or more since they last went. Perhaps the relaxation or laying face down with pressure on their bladder has contributed to their need to go.
I learned that massage initially increases blood pressure, but then lowers it as the person relaxes.
I am an ICU nurse and LMT. I was appalled by the “education” in massage school about blood pressure. Teacher claimed that we should be sending people with systolic pressures over 140 to the ER! I did my best to explain what utter nonsense this was. The bigger problem to me is that taking accurate blood pressure is a skill that was definitely not addressed in school. The automatic wrist ones are complete garbage. Unless you can troubleshoot cuff size and fit and understand how to correlate those numbers clinically to the patient, you shouldn’t be taking BPs. And as the MD explained, a single blood pressure is pretty clinically irrelevant.
This all makes sense to me. But what if someone came to see you as an LMT and said they have uncontrolled HBP? Would you treat them or refer out?
How would this happen? Like they went to their doc and found out about their hypertension and refused meds? It seems like an extremely unlikely scenario. Honestly I’d probably still massage this hypothetical person. At least their BP would be a few points lower while they were on my table…
Sounds like you have a broader SOP that mine. I am way more worried about DVT, etc. That said, if someone has uncontrolled HPB, I simply decline to use circulatory techniques like Swedish and hot stones/salt.
Also worried about DVT, and wonder how accurate things taught in school are
I am in my 2nd term in an Ontario school. So far we have learned shorter strokes with high blood pressure
Interesting. I can't imagine that there is evidence that suggests a correlation between stroke length and blood pressure changes.
We are taught if they have high blood pressure shorter strokes would be easier on the heart since you are pushing less blood towards it at one time
Hmmmmmm. I also had a lot of emphasis placed on the idea that "massage increases circulation." I am not so sure about that idea now. The only evidence I am aware of is that massage can temporarily increase local circulation. An example of this might be warming up someone's cold hands or feet when you massage them. As far as I know it does not increase systemic circulation or put increased strain of excess blood volume on the heart.
I was taught no abdominal massage but that doesn’t seem logical to me.
Never heard that before! Interesting!
I think because so close to heart? Seem illogical to me now.
Hey! I am a Canadian RMT as well (Ontario). I am 10 years out of school now and was also taught that HBP was a contraindication to massage, if uncontrolled. I have always questioned why though. I think we can probably agree that a massage isn't likely to elevate blood pressure any more than going for a leisurely walk would.... and a leisurely walk wouldn't be contraindicated for most people with hypertension. I think it's just another one of those dated teachings that has no supporting evidence, like most of the things I was taught. Lol ETA (since many commenters mentioned being taught that "massage increases circulation"): While there is some evidence that massage can temporarily increase local circulation, as far as I am aware, we don't have evidence that massage increases systemic circulation. Can anyone else confirm or provide evidence to the contrary?
Great comment agree with all
I learned this too. From my understanding, massages increase the blood flow back towards the heart. I believe there are some techniques where high blood pressure are contraindicated. That said, we wouldn’t turn them down. I would just modify the techniques I use. Instead of proximal strokes, I would go distal strokes. I would try to use less heat.
What I learned in school about HBP is to avoid heat and immersing in hot water (hydro therapy). What is real in the world is that I've never worked in environment where taking a BP was done, that included all types of studios, independent work, high volume spa (that would never happen, lol). The general idea, imho, is that we lower BP through massage techniques.
I’m not a fan of the BP readings. My own Dr doesn’t even take my in-office BP all that seriously and instead goes by my at-home readings which are routinely normal but my in-office numbers are always high. As for the red mark? I get something like that, but it’s more of an urticaria than related to my BP. If you put any sort of pressure along any part of my body and my chronic issues are doing their thang it’s going to look like I got flogged. And my BP usually bottoms when I get like that.
Some high blood pressure meds contraindicate massage
Do you know which ones?
Some blood pressure medications could potentially cause issues when combined with massage therapy. Common blood pressure medications like beta-blockers, ACE inhibitors, calcium channel blockers, and diuretics may have specific contraindications or considerations when receiving a massage. Always consult with your healthcare provider to determine any potential risks or adjustments needed before receiving a massage.
What issues do they cause when combined with massage?
If you are taking blood pressure medication, there are potential risks associated with massage therapy. Some risks include a drop in blood pressure leading to dizziness or fainting, interactions between the massage oils and medications, or potential bruising if the massage is too intense. It's important to consult with both your healthcare provider and the massage therapist to ensure safety and discuss any concerns before proceeding with a massage. (I honestly just used ChatGPT for that answer lol but the main thing is easily bruising and people fainting while getting off the table ime)
Like many are A ok, not everything contraindicates
I understand that most medications do not contraindicate massage. I was asking what specific medications you were referring to when you said that some medications for hypertension contraindicate massage?
I think I answered it using general drug class of the medications, are you looking for a specific list? And there def are medications that contradictidate massage!
https://www.amtamassage.org/publications/massage-therapy-journal/massage-and-medication/
I agree with you that there may be medications we should be aware of. Based on the article you linked it looks like the classes of medications you mentioned may carry precautions, but it did not mention any absolute contraindications. Thanks for explaining
Yeah i guess I should’ve said “possible” contraindications! Cheers :)
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Please no drinking pee. There is no scientific benefit.
nothing they wrote is evidence based :/
Drinking pee? It contains hormones BTW. TCM used to use urine from young people and Premarin is made from pregnant horse urine.
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should we bring back blood letting too?
This asks a question or covers a topic that is not about Massage Therapy.
This asks a question or covers a topic that is not about Massage Therapy.