Where shouldn't you massage? Understanding contraindications for safety

September 25, 2025 •

4 min read

While massage offers significant therapeutic benefits, improper techniques or targeting sensitive areas can lead to serious harm. It is crucial to understand where shouldn't you massage to ensure a safe and effective experience, whether you are receiving bodywork from a professional or practicing self-massage.

Quick Summary

Certain body parts, especially those with vulnerable nerves, major blood vessels, or underlying medical conditions, should never be massaged deeply or at all to avoid causing injury or aggravating a health issue.

Key Points

Avoid Endangerment Sites: Steer clear of sensitive anatomical areas like the front of the neck, armpits, and the back of the knees, where vulnerable nerves and blood vessels are located.
Recognize Medical Contraindications: Fever, infectious diseases, blood clots, and certain cardiovascular conditions are absolute contraindications, meaning massage should be avoided entirely.
Use Caution with Local Conditions: For local issues like varicose veins, open wounds, or bruising, massage can proceed on other parts of the body but must avoid the affected area.
Seek Professional Expertise: Always consult a certified massage therapist, especially if you have pre-existing health conditions, as they are trained to identify risks and adapt techniques safely.
Communicate with Therapists: Maintain open communication with your massage therapist about your complete medical history and any recent changes in your health to ensure safe treatment.
Prioritize Safety in Self-Massage: When performing self-massage, stick to general muscle groups and avoid any deep pressure on potentially risky areas. Stop immediately if you feel pain.
Consult a Doctor for Clearance: If you have a serious medical condition like cancer, heart disease, or osteoporosis, obtain written clearance from a physician before receiving a massage.

Vulnerable areas and endangerment sites

Certain parts of the body are known as "endangerment sites" because they contain delicate and critical structures that can be harmed by direct pressure or aggressive manipulation. These areas must be treated with caution, even by trained professionals, and should be avoided entirely during self-massage.

The neck: a high-risk zone

The front and sides of the neck are particularly sensitive due to the presence of the carotid artery, jugular veins, and numerous nerves. The front of the neck, near the throat, is an absolute no-go area, as compressing major vessels can disrupt blood flow to the brain. The spinal column in the neck is also extremely delicate. Even firm pressure on the sides can trigger nerve responses or compress blood vessels.

The armpit (axilla) and inner upper arm

The axilla houses a high concentration of sensitive nerves, arteries, and lymph nodes. This area should be handled with extreme care. Similarly, the inner part of the upper arm contains superficial nerves that can be easily irritated, causing tingling or numbness with excessive pressure.

The back of the knee (popliteal fossa)

The popliteal area is located directly behind the knee joint and contains vital nerves and blood vessels that travel from the upper leg to the lower leg. Deep, focused pressure here is highly risky as it can damage these structures or even dislodge a deep vein thrombosis (DVT) clot.

The groin (femoral triangle)

The femoral triangle, where the leg meets the torso, contains the femoral artery and other critical structures. Applying deep pressure to this area can disrupt circulation and cause significant harm.

The abdomen

The abdominal cavity contains many soft, vital organs. While gentle, light massage on the abdomen can aid digestion, aggressive or deep tissue massage should be avoided. This is especially true for the upper abdomen, where the liver and spleen are located. For individuals with certain liver conditions or those who are pregnant, abdominal massage is strictly contraindicated.

Other high-risk areas

The eyeball: Never apply pressure directly to the eye. This may seem obvious, but accidental pressure can cause serious injury.
The lower back over the kidneys: The kidneys are sensitive organs located on either side of the spine, below the ribs. Excessive pressure in this area should be avoided.
The funny bone (ulnar notch): This sensitive area on the elbow contains the ulnar nerve, and firm pressure here will be intensely painful and is unnecessary for massage.

Medical contraindications: when to avoid massage entirely

In some cases, health conditions make massage of any kind unsafe until the condition has been resolved or a doctor has given clearance. These are known as absolute contraindications.

Infectious diseases and fever

If you have an infectious disease, such as a cold, flu, or contagious skin condition, massage is inappropriate. Massage increases circulation, which can spread the infection throughout the body or to the therapist. Fever is a sign that the body is fighting an infection, and massage could overtax the system.

Blood clots and blood disorders

Deep Vein Thrombosis (DVT), a condition where a blood clot forms in a deep vein, is a major contraindication. If a clot is dislodged by massage, it can travel to the lungs, causing a potentially fatal pulmonary embolism. Individuals on blood-thinning medications or with bleeding disorders should also exercise extreme caution.

Cancer and tumors

While specialized oncology massage can be beneficial for some cancer patients, general massage is often contraindicated without medical approval. The primary concern is potentially stimulating the lymphatic system and circulatory system, which could theoretically aid in the spread of cancer cells, although this is a subject of ongoing research. Oncology massage requires specific training and is highly modified.

Local contraindications: modify treatment for safety

Sometimes, massage is safe, but specific areas need to be avoided. These are local contraindications.


Condition	Why the Area Should Be Avoided	Safe Alternative?
Varicose Veins	Direct pressure can worsen the condition, cause discomfort, or damage fragile veins.	Gentle effleurage (light, gliding strokes) around the affected area, never directly on it.
Open Wounds or Cuts	Pressure can cause pain, introduce infection, or delay healing.	Massage can be performed on surrounding, healthy tissue, avoiding the injured area completely.
Severe Bruising or Hematomas	Deep pressure can increase bleeding and swelling, delaying recovery.	Light massage to the surrounding areas can help with circulation, but avoid the bruise itself.
Recent Surgical Sites	Fragile healing tissue and sutures need time to recover without mechanical stress.	After a doctor's clearance, gentle massage of surrounding areas can be used. Scar tissue massage may be appropriate later.
Undiagnosed Lumps or Bumps	The nature of the lump is unknown and should not be manipulated.	Avoid the lump entirely and seek medical advice.

Professional expertise vs. self-massage

When in doubt, always seek a certified massage therapist. Professionals are trained to identify and navigate these risks by taking a comprehensive client history and performing a physical assessment. They understand the distinction between total and local contraindications and know how to modify their techniques to ensure safety. For self-massage, the safest approach is to stick to general muscle groups, avoiding any sensitive or bony areas and stopping immediately if you feel pain or unusual sensations.

For more in-depth information on contraindications and the practice of massage therapy, consult a trusted resource like the American Massage Therapy Association (AMTA) website. Their resources can provide clarity on what to expect from a professional and how to ensure your own health and safety.

Conclusion

Understanding where shouldn't you massage is a vital aspect of health and safety that protects against injury and potential complications. From vulnerable areas like the neck and groin to systemic conditions like fever or DVT, recognizing contraindications is essential. Always communicate with your healthcare provider and massage therapist about your medical history, and prioritize safety over intense pressure to ensure a positive and therapeutic experience.

Frequently Asked Questions

Massaging the neck is high-risk because it contains sensitive structures like the carotid artery, jugular veins, and numerous nerves. Applying deep or aggressive pressure can disrupt blood flow to the brain or cause nerve issues, so it should be avoided, especially in the front and sides of the neck.

No, you should not get a massage if you have a fever or an infectious disease like the cold or flu. Massage increases circulation, which can spread the infection throughout your body and put the therapist at risk. It's best to wait until you are fully recovered before receiving a massage.

A local contraindication is a condition where a massage should be avoided on a specific area of the body, but can still be performed safely on other, unaffected areas. Examples include bruises, varicose veins, sunburn, or open wounds. A professional therapist will work around these spots.

Absolutely not. Deep tissue massage over a blood clot, such as DVT, is extremely dangerous. The pressure could dislodge the clot, causing it to travel to the lungs, which is a life-threatening medical emergency. Individuals with a history of blood clots must inform their therapist.

While prenatal massage is beneficial for many pregnant women, certain areas and techniques should be avoided. Specifically, deep sacral or abdominal work is often contraindicated, especially in the first trimester. It is crucial to see a therapist with specialized training in prenatal massage and to get a doctor's clearance.

Yes, it is generally recommended to avoid applying direct, firm pressure on bony prominences where there is little muscle or fat to protect against nerve compression. Examples include the kneecap, ankle bones, and elbow. Light massage can be used around these areas, but not directly on the bone.

If you have an undiagnosed lump or bump, it is a local contraindication and that area should not be massaged until you have seen a doctor. Manipulating the area could be harmful if the lump is part of an underlying medical condition. Always seek medical advice first.