The most common cause of shoulder pain is a problem with the rotator cuff muscles and tendons of the shoulder. Many clients think of the “rotator cuff” as a distinct unit, a single muscle or piece of connective tissue that can be torn or injured. Most do not realize the complexity of this joint.

Most people go to a doctor, who recommends rest and medication. While these to provide quick relief, they offer no long-term benefit in preventing re-injury. These injuries respond very well to soft tissue work, stretching and exercise. When a client comes to you with shoulder pain, you are in a unique position to offer rapid relief without medication or surgery.

Massage therapy is ideal for treating weakness in the rotator cuff and tightness in the shoulder. If you suspect bone spurs or problems with the actual anatomy of the acromion, you may not be able eliminate the underlying cause, but you can still provide improved movement and control of the shoulder joint.

You already know how beneficial massage therapy can be for a wide variety of ailments and conditions. You offer relaxation, pain reduction and therapy to your clients on a daily basis. And when a client calls to book an appointment, whether it’s a new client or one of your regulars, your automatic response is to say, “Yes, of course. What time would be good for you?”

However, there are times when you’re going to have to say “no” to a client, even if they insist that a massage is the only thing that will help them feel better. In your massage classes, you learned about contraindications to massage, but sometimes it’s easy to ignore those when a client is very insistent, or when you’re afraid of losing their business. Just remember that in some cases, massage can actually be detrimental to a client’s health. With some conditions, you can also put yourself at risk of contracting illness or disease.

One of your tasks in providing client education is to inform them of the contraindications to massage so that you can ensure that, if one of these conditions crops up, the client informs you before you begin the massage.

The best way to protect yourself and make sure you and your clients act in an ethical manner is to provide ongoing education. Remind your clients that there are times when massage is not appropriate.

Massage Contraindications

You may want to start with the definition of “contraindication.” “Contra” means against, as in contrary, and indications are signs that tell you what to do one way or the other. Therefore, contraindications are signs or signals indicating that massage should not be performed.

Imagine lying on a massage table on a chilly winter afternoon, your body cradled in warmth while a massage therapist uses smooth, hot stones and soothing oil to massage your cold, aching muscles. Does this sound like your idea of winter bliss?

Hot stone massage uses smooth stones heated in water to just the right temperature. The heat from the stones relaxes muscles and increases blood flow to the area being worked on. This boost in circulation and the relaxation of the muscles may also aid in stress reduction, and mental and emotional relaxation. The heat and the hardness of the stones allows the therapist to work more deeply without straining his or her joints, and yet the smooth, rounded planes of the stones assures that the therapist will not work too deeply.

Most therapists use basalt stones in a variety of sizes, shapes and weights, heated in water and then coated with oil. Other therapists may use smooth or slightly-textured river rocks. Crystals or smaller stones may also be placed on the chakra points on the front of the body. Cool stones, usually white quartz or marble, are also sometimes added for contrast therapy or headache relief.