Contra-actions to sports massage

A contra-action is a reaction which could occur in response to a massage.

Contra-actions can occur during or after a massage.

SMTs must make clients aware of possible treatment contra-actions during the informed consent procedure (before beginning and massage) and any precautions should be implemented to minimise the risk of contra-actions causing harm to an individual client. For example, this may mean adjusting the time of a massage booking or preparing an aftercare procedure (which is explained to the client at the time of booking).

Most contra-actions following the application of a relaxing massage are due to the effects of the parasympathetic nervous system. However, the SMT must also consider potential contra-actions that may occur as a response to an invigorating pre-, inter- or intra-event massage, and they may need to develop a separate procedure to ensure these are fully explained. Where possible, it would be beneficial to massage an athlete prior to a training session to test the results and effects before the actual competitive event (a trial run). The athlete could then consider how they respond to the massage and adaptions could be made to avoid any effect on performance.


Common contra-actions to sports massage include:


– Erythema (redness of the skin).

– Headaches following treatment.

– Passing water more frequently and increased thirst.

– Localised aches and pains.

– Increased fatigue and tiredness.

– Feeling emotional and tearful.

– Increased hunger.

– Increased perspiration.

– Localised bruising.

– Changes in blood pressure (usually a reduction which may lead to dizziness and nausea).

– Spots appearing.

– Allergic reaction to the massage medium.

– Changes to sleep patterns.


There are a number of physiological reasons why a client may experience a specific contra-action following a massage. The flushing of lymph through the system will encourage the clients body to pass more water so headaches, thirst and increased urination and perspiration may all be caused by this and any associated dehydration.

The relaxing effect of the parasympathetic nervous system on heart rate, blood pressure and the circulatory system, as well as the potential effect of increased blood pooling once the massage stops, could contribute to a headache. These effects could also be responsible for increased fatigue and changes to sleep patterns. The actual physical effects of the treatment and the mediums applied can cause contra-actions such as erythema, localised bruising, spots and allergic reactions.

An SMT’s procedures and practices should consider both informed consent and preparation for the after effects of any contra-actions.


Examples of responses to contra-actions:


– Ensuring that there is water available to rehydrate the client post massage would help to reduce the risk of headaches and thirst.

– Allowing the client sufficient time in a quite environment to relax and prepare to return to their life following a relaxing massage may help to prevent the risk of blood pressure changes.

– Recording negative after effects of specific mediums on client records and having alternatives available for future use could limit the future development of spots or allergic reactions. The SMT should ask the client to contact them if they notice any negative effects.

– Avoiding the application of deep tissue massages which may cause bruising before a client has a special event.

– Avoiding the application of deep tissue massages which may cause bruising before a client has a special event.

– Arranging sessions to fit in with a client’s lifestyle (e.g. relaxing massages should be booked at the end of the day where possible so the client does not have to return to work).


If a client reports any contra-action to a massage, the SMT must respond with professionalism, care and consideration. They must also consider the risk of this contra-action occurring in the future and put in place appropriate measures to minimise the risk (risk assessment).

<-- Return to Blog

Leave a Reply

Your email address will not be published. Required fields are marked *