Medline citations from 1965 to 2003 were searched for cases relating significant injury to the practice of therapeutic massage. Eleven such cases were found from over 12 million medical citations. While this number is far too small for statistical analysis of injury patterns, six recommendations for training and practice were obtainable from these reports on mechanistic grounds. A conclusion of the general safety of massage follows from the paucity of report injury cases in conjunction with corroborative insurance statistics.