please read before you start

Contraindications

check this list before you start, and any time you're unwell

These sessions are real work on muscle, fascia and lymph flow. Please go through this list before you start.

The main rule: if you're not feeling well — a cold, a cold sore, a fever, anything like that — skip the session and come back another day.

Inflammation and infection

  • Purulent inflammation (any infection with pus)
  • Skin infections (cold sores, eczema, fungal infections, flat warts)
  • Acute ear, nose or throat conditions
  • A fever
  • An active cold or flu
  • Acute inflammation anywhere on the face

Cancer and systemic conditions

  • Cancer
  • Serious systemic conditions: autoimmune disease, diabetes, severe vascular disease, disorders of the endocrine system, systemic connective-tissue disease, collagen vascular disease and so on

Circulation and lymphatic system

  • Thrombophlebitis (an inflamed vein with a clot)
  • Swollen lymph nodes
  • Problems with blood flow to the brain (cerebrovascular disease)
  • High blood pressure that isn't controlled, or that has already affected the heart, kidneys, eyes or brain
  • Disorders of the lymphatic system
  • If you have vascular abnormalities or narrowing of the carotid arteries in the neck (carotid artery disease), where plaque reduces blood flow, speak to your doctor before doing any work on the neck

Thyroid

  • If the structure of the thyroid is altered (cysts, tumors, inflammation, nodular goiter, autoimmune thyroiditis / Hashimoto's), the sessions are only for you if your doctor approves them first
  • If you have an underactive thyroid (hypothyroidism) and it's well controlled, you can do the sessions
  • If the structure of the thyroid is unchanged and your hormone levels are within the normal range, you can do the sessions. We recommend having a thyroid ultrasound before you begin

Injuries and structural conditions

  • Spinal problems: birth defects, injuries, abnormalities or disease
  • A recent concussion or traumatic brain injury
  • Dislocation or partial dislocation of the lower jaw
  • Cosmetic surgery on the face or neck: please wait 6 months before taking part

Neurological and psychiatric conditions

  • Nerve pain in the face (neuralgia)
  • Inflammation of the facial or trigeminal nerve
  • Mental health conditions and certain neurological disorders

Degenerative conditions

  • Osteoporosis. In severe cases the sessions are contraindicated. If you have been diagnosed with osteoporosis, avoid direct, heavy pressure on the facial bones. Only very light, superficial massage is acceptable, working on muscle and soft tissue, without pressing deeply into the bone
  • Osteoarthritis
  • Rheumatoid arthritis

Dental problems

  • Advanced tooth decay
  • Recent dental surgery, an extraction or an implant — wait 3 to 4 weeks, or until your dentist gives you the go-ahead

Other

  • Pregnancy
  • Feeling generally unwell

About the jaw joint

Research from the US National Institutes of Health puts temporomandibular joint disorder (TMD) at somewhere between 5% and 12% of people — and many of them have no idea they have it. With age, muscle tension is joined by wear in the joint itself.

Some contraindications simply cannot be self-diagnosed: dislocation or partial dislocation of the lower jaw, osteoarthritis, rheumatoid arthritis, or brittle bones. The sessions can bring long-standing problems in the jaw joints to the surface, such as grinding, sharp pain, or the jaw clicking after an exercise.

Ideally, see a dentist, a TMJ or orofacial pain specialist, or a physical therapist who works with the jaw before you begin, to rule out acute inflammation, ongoing disease, temporomandibular joint disorder, rheumatoid arthritis, or advanced tooth decay. Ask them specifically whether you can do myofascial massage in the area around the ear and jaw, open your mouth wide, work on the tissue over the temporomandibular joints, and apply pressure to the bone.

And please: if you feel unwell or you're coming down with something, get better first. Come back to the sessions once you've recovered.

If you've gone through the whole list and nothing here applies to you, you're good to go.