Clinical Considerations and Contraindications

The Wilbarger brushing protocol should be learned properly before being taught to clients. Patricia Wilbarger and her daughter Julia Wilbarger have training programs available, and the protocol is specific about brush type, pressure, sequence, and the critical importance of pairing brushing with joint compressions immediately afterward. The compressions are not optional — they consolidate the regulatory effect of the brushing and prevent the neurological “rebound” arousal that can occasionally occur when brushing is done without them.20

Clients with tactile defensiveness — and many RSD clients have this, as hyperreactivity often extends across sensory modalities — may initially find the brushing protocol uncomfortable or activating. This is itself diagnostically meaningful and clinically important to track. Start with lighter pressure and shorter duration, always moving toward organized, predictable, non-threatening input. The goal is never to overwhelm. The goal is to provide just enough organized sensory input to give the nervous system something coherent to respond to.

The MELT Method is gentle by design and appropriate for most adults, but clients with active inflammatory conditions, recent injuries, or osteoporosis should consult with their physician or a certified MELT practitioner before beginning. Foam rolling should not be used on varicose veins, areas of acute injury, or directly on the spine. For vestibular interventions, clients with vestibular disorders, benign paroxysmal positional vertigo (BPPV), or a history of traumatic brain injury should proceed cautiously and ideally under the guidance of a vestibular physical therapist.