Initially, your massage therapist will only work above the cast, and will take care to not disturb the healing bone. Eventually, when the cast is removed, massage therapy will continue to restore the health of the tissue by increasing circulation, restoring function and strength, and reducing any scar tissue.

Considerations for treatment

It is highly recommended that your physician provide a written recommendation for massage, and your therapist probably won't agree to treat you until your doctor has given the green light.

In all likelihood, you will also be seeing a physical (physio) therapist. It's a good idea to provide written permission for your mill creek massage therapist to collaborate with your other health care professionals to ensure the best possible care and treatment outcome.

Before your massage therapist begins to treat you, he or she will want to verify the following information:

? your physician has approved massage therapy

? are you on any type of medication? (anti-inflammatory, analgesic, anti-coagulant, antibiotics).

? what is your general health - for example, consider age, fitness prior to injury, nutrition (your MT may refer you to a nutritionist, as proper nutrition impacts the healing process), lifestyle (i.e. do you smoke?)

? are there any open wounds which must be addressed? (i.e. with a compound fracture)

? Will treating the affected limb with massage therapy stress and disrupt the healing of bone, muscle, skin or nerve tissue?

? is there any neurological or vascular impairment in the area which prevents the use of certain massage techniques or modalities?

? do you have any plates, wires or pins? If so, hydrotherapy over the site will be contraindicated.

? the most important consideration is to avoid stressing and interfering with healing tissue. Any pressure or traction applied to the affected bone is contraindicated.

? have other types of injuries been sustained, such as sprains or contusions? (in all likelihood, there will be other injuries)

? muscle atrophy from disuse will be present when the cast is removed. Provided that the injury is not an avulsion fracture, the development of atrophy can be reduced by the use of isometric contractions at the appropriate time with cast on. If an avulsion fracture is present, avoid isometric contractions, as this may disrupt the healing bone.

? tissue under the cast will be fragile when the cast is removed, so extra care must be taken when massaging this tissue