NCBTMB Pathology and Contraindications 3 — Questions and Answers
Question 1: A client with acute thrombophlebitis in the right calf presents for massage. What is the correct action?
- Massage only the uninvolved leg
- Avoid massage entirely and refer to physician (Correct answer)
- Apply light effleurage distal to the clot
- Perform lymphatic drainage on the affected limb
Correct answer: Avoid massage entirely and refer to physician
Acute thrombophlebitis is a systemic contraindication because massage could dislodge the clot and cause a pulmonary embolism.
Question 2: Which skin condition is a local contraindication but NOT a systemic contraindication to massage?
- Psoriatic arthritis flare-up
- Impetigo lesion on the forearm (Correct answer)
- Systemic lupus erythematosus
- Acute rheumatoid arthritis
Correct answer: Impetigo lesion on the forearm
Impetigo is a localized bacterial skin infection requiring avoidance of that area only, while the rest of the body can be massaged.
Question 3: A client reports they finished radiation therapy for breast cancer six months ago and feel well. How should the therapist proceed?
- Decline all massage as cancer history is a permanent contraindication
- Obtain physician clearance before proceeding with massage (Correct answer)
- Proceed normally as six months post-treatment is considered safe
- Only perform energy work, avoiding all physical contact
Correct answer: Obtain physician clearance before proceeding with massage
Post-cancer clients require physician clearance to ensure massage is appropriate given their current health status and treatment history.
Question 4: Which of the following best describes a 'endangerment site' in massage therapy?
- Any area with visible varicose veins
- An area where nerves and blood vessels are superficial and vulnerable to pressure (Correct answer)
- A region with recent surgical scarring
- Any bony prominence that could be bruised
Correct answer: An area where nerves and blood vessels are superficial and vulnerable to pressure
Endangerment sites are areas where nerves, arteries, or organs are close to the surface and can be damaged by inappropriate pressure.
Question 5: A client with type 2 diabetes requests deep tissue massage on both feet. What is the primary concern?
- Increased blood glucose from the massage
- Peripheral neuropathy reducing ability to report pain or pressure (Correct answer)
- Risk of blood clots due to insulin use
- Diabetes causes fragile tendons prone to rupture
Correct answer: Peripheral neuropathy reducing ability to report pain or pressure
Diabetic peripheral neuropathy impairs sensation, so clients may be unable to accurately report if pressure is too intense, risking tissue damage.
Question 6: Massage over an area of acute muscle strain should be avoided primarily because it can:
- Increase lactic acid buildup in the tissue
- Worsen inflammation and delay the healing process (Correct answer)
- Cause the muscle to permanently shorten
- Spread the strain to adjacent muscle groups
Correct answer: Worsen inflammation and delay the healing process
During the acute phase of muscle strain, the inflammatory response is protective; massage can increase inflammation and impede healing.
Question 7: A client presents with pitting edema in both ankles. Which condition is MOST likely responsible that would contraindicate massage?
- Mild dehydration
- Congestive heart failure (Correct answer)
- Plantar fasciitis
- Chronic ankle sprains
Correct answer: Congestive heart failure
Bilateral pitting edema is a classic sign of congestive heart failure, which requires physician clearance before massage as it can stress the cardiovascular system.
NCBTMB Pathology and Contraindications 3
A client with acute thrombophlebitis in the right calf presents for massage.
What is the correct action?