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Blood Clots: Danger for Massage

About once a week, I have to turn a client away for medical reasons. This surprises a lot of people. To most, massages are lovely, relaxing sessions of pampering, and yes, they are! Why could anyone possibly be turned away? By far the most common reason I have to do this is a history of blood clots. No one is ever happy to hear this. Please read on if you or anyone you know has had a heart attack, stroke, or other blood clot related issues.

1.Towards the Heart

In modern and popular massage styles (pretty much everything available in the US), the majority of the work is done in the direction the heart. We therapists are not just affecting muscles, but also circulation as we work, and developers of these styles found this to be the most therapeutic.  We aid the return of unoxygenated blood, which has to work against the force of gravity. Unaided overtime, this can sometimes cause pooling or the development of abnormalities, so massage is great for the circulation. 

However, this movement of the blood can spell trouble if you have circulatory disorders, particularly a history of clots.

2. Breaking up Adhesions

Massage is intended to break up adhesions in the muscles (what you might call “knots”) and will use heavy pressure and kneading techniques to achieve this. This can also free clots in the area if they have developed.The majority of people have nothing to fear, as even with a clot history, it is not guaranteed to break one free. It is however so dangerous a prospect that even under small odds, it is not worth the risk. 

Again, unless you have a history of clots or ischemic attacks, you have nothing to worry about. Massage may actually help prevent them from forming.

3.Doctors Don’t Know

Doctors can’t know everything. It’s impossible. Most don’t know very much about massage if anything at all, and it’s not their fault. When I tell my clients they need a note from their doctor for their clot history, I give specific instructions. Their doctor needs to write a note clearing the patient from risk of blood clots. A lot of times they bring me a note that says “Patient is clear for massage.” This won’t do and I often have to turn them away a second time. The doctor will often write the note in confusion, not understand the risks, rendering the note useless and putting the client/patient in danger.

4. Some Therapists Don’t Care

If you have a history of blood clots, any therapist who will work on you without such clearance from a doctor should have their license revoked. They do exist, though, and some are very successful. When I turn a client away, they’re never happy, and I’m almost always sure they go find someone else who will work on them. Many therapists don’t care because the population in general doesn’t know about it. So even if something happened, they’d never connect the two. 

Also, the argument of “I’ve had plenty of massages and nothing happens” doesn’t really hold water. All it takes is one time and you could land yourself in the hospital with an embolism, stroke, heart attack, etc. IT’S NOT A RISK YOU SHOULD TAKE. 

5. What You Can Do

If you know that you have a history of blood clots, talk to your doctor to see what your current risk is. If your doctor clears you of clot risk, you are free to have massages as often as you’d like! If you are not cleared, be aware of this and do not pressure a practitioner into working on you. There are other therapies you can partake of with clots. A physical therapist or pain management specialist might be a better fit though and can counsel you through safely.

As always, massage practitioners/therapists are not doctors and do not diagnose or treat any condition. Please enjoy bodywork responsibly!  Thank you!