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There is some controversy on this topic between the medical community and the massage practitioners. There is no empirical data that the flow of blood changes after a massage, but no studies have been conducted about the flow of blood during a massage. From a practical point of view, mechanical manipulation of tissue will affect the venous blood flow during circulatory massage, as in Swedish massage. This can actually be seen and felt during the therapy. The effects on the cardiovascular system has been generally agreed upon to be significant enough that clearance from a doctor is necessary under certain circumstances. The list is a long one and includes; hypertension, varicose veins, mitral valve prolapse, pacemakers, stents, atherosclerosis, arteriosclerosis, angina, Aortic aneurysm etc.

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