Health Precautions for Massage Therapists
A Clinical Pearl by Ruth Werner, BCTMB


As massage therapists, we work in closer proximity to our clients than most other healthcare providers. Only surgeons and dentists work as closely, and think of what they wear to work. Under typical circumstances, most massage therapists don’t use gloves, masks, and protective clothing.

This comes at a price. Close physical contact with our clients may expose us to a wide assortment of pathogens that can cause potentially dangerous infections.

Six Health Facts for Massage Therapists

The good news is that with some baseline knowledge, we can stay safe and healthy – ready to provide a lifetime of great massage. Check out the six facts below to refresh your knowledge of health precautions and communicable diseases.

1. Universal and Standard Precautions Reduce the Risk of Exposure

Massage therapists can practice any of the standard precaution protocols developed to reduce the risk of exposure to blood-borne infections. Start by analyzing what surfaces and equipment your client touches with each visit; then make sure that another client doesn’t touch that same item until it has been cleaned.

2. Bacteria Are Shared Easily

Bacteria are stronger now than they were even a few years ago, and species like methicillin-resistant staphylococcus aureus (MRSA) can cause long-term problems. Other easily shared bacteria can cause impetigo, pinkeye, and – if the immune system is weak – infection of the lymph or blood. Ask yourself:

  • Does your client have an undiagnosed, untreated skin infection? If yes, refer your client to their doctor and reschedule.
  • Do you or your client have open, uncovered lesions (think hangnails, scabbed over bug bites and the like)? If you find one, cover it and/or avoid direct contact.

3. Herpes Exposure is Prevalent Amongst American Adults

Lots of massage therapists are nervous about contracting herpes simplex from clients, but the simple truth is that most American adults test positive for previous exposure to this virus. This means we are already carrying protective antibodies. So if your client has an active cold sore and they can’t reschedule, simply avoiding the area and practicing good hygiene is a safe choice. It is possible to pick up a secondary herpes infection site, but it doesn't happen readily.

4. The Cold and Flu Are Low-Risk Viruses

These viruses can be airborne or carried from surfaces on our hands to our eyes, nose, or mouth. Catching a cold or flu is tremendously inconvenient and costly in time and lost earnings. However, if we start with a strong foundational level of health, most of us are not at risk for serious complications. That said, pneumonia is a frequent result of respiratory infections for people with weak systems, and it is the leading cause of death by infection in the United States.

5. Dangerous Infections Can Be Avoided with Standard Precautions

Hepatitis B and C, along with HIV/AIDS are among the most dangerous communicable diseases seen in the United States. The good news for massage therapists is that these viral infections are spread only through the exchange of intimate fluids: blood, semen, breast milk, and vaginal secretions. Appropriate boundaries and standard hygiene precautions ensure that these infections are not a health hazard for massage therapists.

6. Good Health is Your Best Protection

We are role models for our clients. When we are conscientious about getting good quality sleep, eating healthy foods, and exercising, we demonstrate that such things can be done. Moreover, these behaviors give us a resilient, resistant baseline that pathogens cannot easily overcome.

In summary, despite being more likely to face exposure to certain infections, massage therapists can protect their health using a basic knowledge of contagious diseases and appropriate precautions. With peace of mind, we confidently – and safely – provide our clients with highest-level of massage therapy services.


Below, Ruth Werner shares important facts about the communicability of herpes simplex in a short video from her course, Public Health Part 1: Immune System, Herpes, HIV/AIDs, Hepatitis.


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About Ruth Werner, BCTMB:
Ruth Werner is a member of the American Massage Therapy Association, the International Fascia Research Society, and the Alliance for Massage Therapy Education. She has written numerous articles for massage trade journals and several books on subjects ranging from ethics to pharmacology. Ruth Werner is the author of the textbook, A Massage Therapist's Guide to Pathology, and writes a column for Massage and Bodywork Magazine called Pathology Perspectives.


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