Ep 553 – Herpes Simplex 2026: “I Have a Client Who . . .” Pathology Conversations with Ruth Werner

A school administrator and massage therapist wants guidance on how to respond to a student who is reluctant to work with clinic clients who report a history of herpes. Is this a significant risk for massage therapists?

The reality is that anyone with a history of herpes simplex can shed the virus intermittently, even without visible symptoms. However, the risk to massage therapists who follow proper hygiene and self-care protocols is extremely low. In that sense, herpes falls into the same category as other infections that may be transmitted through direct contact but are effectively managed with consistent hygienic practices. The key issue is not the client’s infection status; it is the therapist’s adherence to appropriate hygiene protocols.

Resources:

Ang, J.Y. et al. (2012) “A Randomized Placebo-Controlled Trial of Massage Therapy on the Immune System of Preterm Infants,” Pediatrics, 130(6), pp. e1549–e1558. Available at: https://doi.org/10.1542/peds.2012-0196. 

Contributors, W.E. (no date) Genital Herpes Treatment Options, WebMD. Available at: https://www.webmd.com/genital-herpes/genital-herpes-treatment-options (Accessed: March 7, 2025).

Globally, an estimated two-thirds of the population under 50 are infected with herpes simplex virus type 1 (no date). Available at: https://www.who.int/news/item/28-10-2015-globally-an-estimated-two-thirds-of-the-population-under-50-are-infected-with-herpes-simplex-virus-type-1 (Accessed: March 6, 2025).

Herpes simplex Information | Mount Sinai - New York (no date) Mount Sinai Health System. Available at: https://www.mountsinai.org/health-library/report/herpes-simplex (Accessed: March 6, 2025).

Herpes simplex virus (no date). Available at: https://www.who.int/news-room/fact-sheets/detail/herpes-simplex-virus (Accessed: March 6, 2025).

How many people have herpes? Myths, facts, and statistics (2020). Available at: https://www.medicalnewstoday.com/articles/how-many-people-have-herpes (Accessed: March 6, 2025).

Kaneko, H. et al. (2008) “Evaluation of mixed infection cases with both herpes simplex virus types 1 and 2,” Journal of Medical Virology, 80(5), pp. 883–887. Available at: https://doi.org/10.1002/jmv.21154.

Line is blurring between human herpes simplex viruses (no date) UW Medicine | Newsroom. Available at: https://newsroom.uw.edu/news-releases/line-blurs-between-human-herpes-simplex-viruses (Accessed: March 6, 2025).

Products - Data Briefs - Number 304 - February 2018 (2019). Available at: https://www.cdc.gov/nchs/products/databriefs/db304.htm (Accessed: March 6, 2025).

Ramchandani, M. et al. (2016) “Herpes Simplex Virus Type 1 Shedding in Tears, and Nasal and Oral Mucosa of Healthy Adults,” Sexually transmitted diseases, 43(12), pp. 756–760. Available at: https://doi.org/10.1097/OLQ.0000000000000522.

Rapaport, M.H., Schettler, P. and Bresee, C. (2012) “A Preliminary Study of the Effects of Repeated Massage on Hypothalamic–Pituitary–Adrenal and Immune Function in Healthy Individuals: A Study of Mechanisms of Action and Dosage,” Journal of Alternative and Complementary Medicine, 18(8), pp. 789–797. Available at: https://doi.org/10.1089/acm.2011.0071.

Usatine, R.P. and Tinitigan, R. (2010) “Nongenital Herpes Simplex Virus,” American Family Physician, 82(9), pp. 1075–1082.

(2025) “Herpes Simplex Treatment & Management: Approach Considerations, Medical Care, Consultations.” Available at: https://emedicine.medscape.com/article/218580-treatment (Accessed: March 7, 2025).

Host Bio:               

Ruth Werner is a former massage therapist, a writer, and an NCBTMB-approved continuing education provider. She wrote A Massage Therapist’s Guide to Pathology, now in its seventh edition, which is used in massage schools worldwide. Werner is also a long-time Massage & Bodywork columnist, most notably of the Pathology Perspectives column. Werner is also ABMP’s partner on Pocket Pathology, a web-based app and quick reference program that puts key information for nearly 200 common pathologies at your fingertips. Werner’s books are available at www.booksofdiscovery.com. And more information about her is available at www.ruthwerner.com.   

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Anatomy Trains is a global leader in online anatomy education and also provides in-classroom certification programs for structural integration in the US, Canada, Australia, Europe, Japan, and China, as well as fresh-tissue cadaver dissection labs and weekend courses. The work of Anatomy Trains originated with founder Tom Myers, who mapped the human body into 13 myofascial meridians in his original book, currently in its fourth edition and translated into 12 languages. The principles of Anatomy Trains are used by osteopaths, physical therapists, bodyworkers, massage therapists, personal trainers, yoga, Pilates, Gyrotonics, and other body-minded manual therapists and movement professionals. Anatomy Trains inspires these practitioners to work with holistic anatomy in treating system-wide patterns to provide improved client outcomes in terms of structure and function.    

                

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Precision Neuromuscular Therapy seminars (www.pnmt.org) have been teaching high-quality seminars for more than 20 years. Doug Nelson and the PNMT teaching staff help you to practice with the confidence and creativity that comes from deep understanding, rather than the adherence to one treatment approach or technique.

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Upledger CranioSacral Therapy addresses deep restrictions, supports neurological and fascial systems, and enhances whole-body function—by working with the body’s natural healing processes. 
 
For over forty years, Upledger Institute International has led the field of CranioSacral Therapy—setting the global standard for education and clinical application. With trained therapists in more than 120 countries, CST continues to evolve through ongoing clinical experience and alignment with current scientific understanding. 
 
CST integrates seamlessly into any manual therapy practice and supports common to complex and chronic conditions—orthopedic, neurological, pediatric, geriatric, and beyond. 
 
Learn from our International Teaching Team—experienced clinicians who help you develop your skills, expand your clinical reasoning, and achieve greater clinical outcomes. 
 
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Somatic Mindfulness helps massage therapists prevent physical and emotional burnout by integrating somatic principles into bodywork. Created by Fernando Rojas, LMT, PhD, Massage Hall of Famer, Master Somatic Therapist, Educator, and author of Embodied Presence & Attuned Touch, it teaches self-care as a professional skill so that the therapist’s own wellbeing becomes the method for creating the conditions for healing and clarity of purpose. Through continuing education workshops, somatic touch training, and mindful self-study, Fernando helps therapists work sustainably, communicate clearly, and rediscover meaning in their practice.

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