Massage and Bodywork Licensing Examination MBLEx Pathology and Contraindications 1 — Questions and Answers
Question 1: A client discloses they are currently undergoing chemotherapy for breast cancer and their oncologist has cleared them for massage. Which approach is most appropriate?
- Perform full deep tissue massage as requested by the client
- Provide gentle, light-pressure massage while avoiding the treatment site and any ports or catheters (Correct answer)
- Decline to work with the client until chemotherapy is fully completed
- Focus exclusively on the feet and hands using reflexology techniques
Correct answer: Provide gentle, light-pressure massage while avoiding the treatment site and any ports or catheters
With oncologist clearance, massage is appropriate but must be modified: light pressure is used to avoid stressing compromised tissues and the immune system, and treatment sites, ports, and catheters are avoided as local contraindications to prevent injury or infection.
Question 2: Which of the following skin conditions would be considered an absolute contraindication, requiring the therapist to avoid massage entirely on the affected area and surrounding tissue?
- Mild psoriasis with dry, scaly plaques on the elbows
- Impetigo presenting with oozing, crusted lesions on the forearm (Correct answer)
- A healed surgical scar from an appendectomy performed two years ago
- Mild contact dermatitis on the back of the hand
Correct answer: Impetigo presenting with oozing, crusted lesions on the forearm
Impetigo is a highly contagious bacterial skin infection with open or oozing lesions, making it an absolute local contraindication. Massaging over it risks spreading the infection to other areas of the client's body and to the therapist.
Question 3: A client reports a recent diagnosis of rheumatoid arthritis currently in an acute flare. What is the most appropriate therapist response?
- Proceed with deep tissue work to break up adhesions around the inflamed joints
- Avoid massage entirely until the client provides a physician's note
- Postpone massage on the acutely inflamed joints but provide gentle, systemic relaxation massage to uninvolved areas (Correct answer)
- Apply heat packs to the inflamed joints before performing standard massage
Correct answer: Postpone massage on the acutely inflamed joints but provide gentle, systemic relaxation massage to uninvolved areas
During an acute RA flare, inflamed joints are a local contraindication — direct work would increase inflammation and pain. However, gentle relaxation massage to uninvolved areas is safe and beneficial, and heat should be avoided on acutely inflamed tissue.
Question 4: Which of the following conditions is characterized by abnormal cell growth forming a thrombus that can break loose and travel to the lungs, making massage a systemic contraindication?
- Varicose veins
- Deep vein thrombosis (DVT) (Correct answer)
- Lymphedema
- Raynaud's phenomenon
Correct answer: Deep vein thrombosis (DVT)
DVT involves a blood clot in a deep vein that can embolize to the lungs (pulmonary embolism) if dislodged. Massage anywhere on the body can increase circulation and risk moving the thrombus, making it a systemic contraindication until medically resolved.
Question 5: A client has type 1 diabetes and mentions they have reduced sensation in both feet. What is the primary concern that should guide the therapist's approach to the lower extremities?
- Increased risk of hypoglycemia triggered by massage-induced stress hormones
- Risk of undetected tissue damage due to neuropathy impairing the client's pain feedback (Correct answer)
- Contraindication for any work below the knee due to circulatory insufficiency
- Likelihood of edema formation in the feet requiring lymphatic drainage only
Correct answer: Risk of undetected tissue damage due to neuropathy impairing the client's pain feedback
Peripheral neuropathy from diabetes reduces or eliminates pain sensation in the feet. The client cannot reliably report discomfort or injury from excessive pressure, so the therapist must use lighter, more careful techniques and closely monitor tissue response.
Question 6: Which condition involves a backward displacement of the uterus and would require the massage therapist to modify positioning but does NOT constitute an absolute contraindication to massage?
- Placenta previa in the third trimester
- Retroversion of the uterus (Correct answer)
- Preeclampsia with severe hypertension
- Ectopic pregnancy
Correct answer: Retroversion of the uterus
Retroversion of the uterus (a tilted uterus) is a positional anatomical variation, not a pathological emergency. The therapist should avoid prone positioning if it causes discomfort but can otherwise perform massage safely with appropriate modifications. The other options represent serious medical conditions requiring physician clearance or contraindicate massage.
Massage and Bodywork Licensing Examination MBLEx Pathology and Contraindications 1
A client discloses they are currently undergoing chemotherapy for breast cancer and their oncologist has cleared them for massage.
Which approach is most appropriate?