What Areas Do Massage Therapists Avoid? A Professional Guide from The Mark of Massage

At The Mark of Massage in Castle Rock, Colorado, safety, ethics, and client comfort have been my top priorities since 2004—whether providing deep tissue for chronic relief, sports massage for recovery, trigger point therapy, prenatal support, hot stone relaxation, Esalen flow, or structural integration. Professional massage therapists follow strict guidelines to protect vulnerable areas of the body. These include strictly prohibited zones (never touched) and endangerment sites (areas of caution where deep or focused pressure is avoided or used only with extreme care due to nearby delicate structures like major arteries, veins, nerves, or organs).

Strictly Prohibited Areas (Never Massaged or Touched)

These are absolute “no-go” zones in therapeutic massage to prevent misconduct, injury, or violation of professional boundaries:

•  Genitals (including penis, scrotum, vulva, vaginal area, mons pubis, anus/rectal area): Direct touch here is prohibited and considered sexual misconduct. No exceptions in standard practice.

•  Breasts/Nipples (in most U.S. states, including Colorado): Breast massage is generally off-limits, especially nipples. Rare exceptions (e.g., post-mastectomy scar work or blocked milk duct in nursing clients) require physician referral, specific training, written consent, and never involve nipples.

•  Eyes: Direct pressure or rubbing the eyeballs is dangerous and avoided entirely—no exceptions.

These rules come from ethics codes (e.g., AMTA, NCBTMB) and state regulations—any violation can lead to license revocation.

Endangerment Sites (Areas of Caution)

These are regions where deep, sustained, or focused pressure (e.g., thumbs, elbows, or trigger point work) is avoided or used only lightly/distributed to prevent damage to superficial nerves, arteries, veins, or other structures. Light effleurage (gliding strokes) is usually fine if indicated, but therapists proceed with caution, use diffuse pressure, and communicate constantly.

Common endangerment sites include:

1.  Anterior (Front) Neck / Throat (including carotid triangle, suprasternal notch, jugular vein, carotid artery, vagus nerve): Deep pressure risks reduced blood flow, nerve damage, or baroreceptor stimulation (which can drop blood pressure dangerously).

2.  Popliteal Fossa (Back of the knee): Major veins/arteries and nerves pass here—deep pressure could compress them.

3.  Femoral Triangle / Inguinal / Groin Area (upper inner thigh): Femoral artery, vein, saphenous vein, and nerves—avoid focused pressure to prevent vascular or nerve injury.

4.  Antecubital Fossa (Inner elbow / “funny bone” area): Brachial artery, median nerve—deep work risks compression.

5.  Axilla (Armpit): Axillary artery/vein, brachial plexus nerves—handle lightly to avoid damage.

6.  Umbilical Area (Belly button region): Abdominal aorta is nearby beneath thin tissue—avoid direct pressure.

7.  Other Fragile Spots: Kidneys (lower back), lymph nodes (neck, armpits, groin), small/fracture-prone bones (e.g., xiphoid process, floating ribs), or bursae (e.g., trochanteric bursa).

In these zones, I use only light pressure, avoid tools/elbows, and stop immediately if there’s any discomfort. Draping always keeps private areas fully covered.

How This Applies at The Mark of Massage

Whether in-home (mobile within ~30 minutes of my home office at 216 Douglas Fir Ave, 80104) or in my private lower-level space (fully secluded sessions, occasional family sounds from upstairs outside the room), I follow these boundaries rigorously. During intake, we discuss preferences or concerns (e.g., “avoid inner thighs” or “gentle on neck”), and I adapt—your safety and trust come first.

If you’re ever unsure or uncomfortable, speak up—massage should always feel safe and therapeutic. Ready for a customized, boundary-respecting session? Contact The Mark of Massage today!

Sources for Verification (based on 2025–2026 professional guidelines and resources):

•  AMTA (American Massage Therapy Association): No genital/breast touch; strict boundaries (https://www.amtamassage.org/publications/massage-today/appropriate-guidelines-massage/)

•  MBLEx Guide: Endangerment sites include popliteal fossa, anterior neck, axillary region, femoral triangle (https://mblexguide.com/areas-of-caution-massage-therapy/)

•  Study.com & Massage Therapy Reference: Avoid pressure on umbilical area, inguinal/groin, antecubital fossa, suprasternal notch, eyes (https://study.com/academy/lesson/contraindications-areas-of-caution-for-massage-therapy.html)

•  Various ethics & training resources (e.g., ABMP, Quizlet flashcards): Consistent lists of vulnerable zones like neck, armpit, back of knee, groin (https://www.abmp.com/learn/course/taking-danger-out-endangerment-sites)

Your well-being is my priority—hope this clarifies things! 😊