vtct level 5 diploma in sports massage therapy (qcf) of... · the vtct level 5 diploma in sports...

AF50030F_v5

VTCT Level 5 Diploma in Sports Massage Therapy (QCF)

Operational start date: 1 April 2010Credit value: 37Guided learning hours (GLH): 230Qualification number: 500/8554/2

Statement of unit achievementBy signing this statement of unit achievement you are confirming that all learning outcomes, assessment criteria and range statements (if/where applicable) have been achieved under specified conditions and that the evidence gathered is authentic.

This statement of unit achievement table must be completed prior to claiming certification.

Unit code Date achieved Learner signature

Assessor initials

IV signature (if sampled)

Mandatory units

UV50388

UV50389

2

The qualification

Introduction National Occupational Standards (NOS)

The VTCT Level 5 Diploma in Sports Massage Therapy (QCF) has been designed to provide experienced practitioners currently working in sport and active leisure, with the requisite understanding and complex skills and techniques to work as an advanced sports massage practitioner. You will be equipped to work with clientele ranging from recreational sport and active leisure enthusiasts to professional sports persons and elite athletes.

Throughout this qualification, you will develop an advanced understanding of the biological basis for complex massage/soft tissue methods and the impact of nutrition and hydration on the effects of treatment. The effectiveness of complex massage/soft tissue methods will also be evaluated, as will research undertaken on the use of these methods in sport and active leisure.

You will develop the understanding and skills required to carry out and analyse comprehensive subjective assessments of clients. You will undertake detailed biomechanical assessments, test and analyse the integrity of the muscular and neurological systems and develop complex treatment strategies based on sound clinical reasoning and evidence-based research. You will also develop the understanding and skills to prepare, apply and evaluate a range of complex sports massage/soft tissue methods to prevent and manage injuries.

You will cover a range of complex client presentations and carry out advanced objective assessments (i.e. neurological testing) with competence. The purpose of including these elements is not to provide you with the knowledge, understanding and skills to diagnose and treat clients presenting with medical pathology, but to recognise serious pathology so that immediate referral to a medical/healthcare professionals can be made.

This qualification is accredited on the Qualifications and Credit Framework (QCF) and has been mapped to the following NOS:

• CNH22 - Plan, evaluate and apply complex massage/soft tissue methods

• CNH7 - Provide massage therapy to clients• CNH1 - Explore and establish the client’s

needs for complementary and natural healthcare

This qualification is approved and supported by Skills for Health, the sector skills council for health.

2

Prerequisites

There are no formal prerequisite qualifications that you must have prior to undertaking this qualification. However it has been designed for experienced practitioners, including osteopaths, physiotherapists, sports therapists and sports massage practitioners.

Your centre will have ensured that you have the required knowledge, understanding and skills to enrol and successfully achieve this qualification.

3

Progression

On successful completion of this programme, you will be equipped with the requisite understanding and skills to work independently with elite athletes and professional sports persons. This qualification also provides progression opportunities to higher education in sports-related disciplines.

3

This qualification is recognised by the Sports Massage Association (SMA). Upon successful completion of this qualification you will be eligible to apply for memebership.

Professional membership

4

Qualification structure

Mandatory units - 37 creditsVTCT unit code

Ofqual unit reference Unit title Credit value GLH

UV50388 R/601/4191 Advanced anatomy, physiology and assessment for sports massage 14 80

UV50389 Y/601/4192 Planning, applying and evaluating complex sports massage/soft tissue methods 23 150

Total credits required - 37

4

All mandatory units must be completed.

5

Guidance on assessment

5

This book contains the mandatory units that make up this qualification. Optional units will be provided in additional booklets (if applicable). Where indicated, VTCT will provide assessment materials. Assessments may be internal or external. The method of assessment is indicated in each unit.

Internal assessment (any requirements will be shown in the unit)

Assessment is set, marked and internally verified by the centre to clearly demonstrate achievement of the learning outcomes. Assessment is sampled by VTCT external verifiers.

Assessment explained

VTCT qualifications are assessed and verified by centre staff. Work will be set to improve your practical skills, knowledge and understanding. For practical elements, you will be observed by your assessor. All your work must be collected in a portfolio of evidence and cross-referenced to requirements listed in this record of assessment book.

Your centre will have an internal verifier whose role is to check that your assessment and evidence is valid and reliable and meets VTCT and regulatory requirements.

An external verifier, appointed by VTCT, will visit your centre to sample and quality-check assessments, the internal verification process and the evidence gathered. You may be asked to attend on a different day from usual if requested by the external verifier.

This record of assessment book is your property and must be in your possession when you are being assessed or verified. It must be kept safe. In some cases your centre will be required to keep it in a secure place. You and your course assessor will together complete this book to show achievement of all learning outcomes, assessment criteria and ranges.

External assessment (any requirements will be shown in the unit)

Externally assessed question papers completed electronically will be set and marked by VTCT.

Externally assessed hard-copy question papers will be set by VTCT, marked by centre staff and sampled by VTCT external verifiers.

6

Creating a portfolio of evidence

As part of this qualification you are required to produce a portfolio of evidence. A portfolio will confirm the knowledge, understanding and skills that you have learnt. It may be in electronic or paper format.

Your assessor will provide guidance on how to prepare the portfolio of evidence and how to show practical achievement, and understanding of the knowledge required to successfully complete this qualification. It is this booklet along with the portfolio of evidence that will serve as the prime source of evidence for this qualification.

Evidence in the portfolio may take the following forms:

• Observed work• Witness statements• Audio-visual media • Evidence of prior learning or attainment• Written questions• Oral questions• Assignments• Case studies

All evidence should be documented in the portfolio and cross referenced to unit outcomes. Constructing the portfolio of evidence should not be left to the end of the course.

Many frequently asked questions and other useful information are detailed in the VTCT Candidate’s Handbook, which is available on the VTCT website at www.vtct.org.uk/students. Other questions should be addressed to the tutor, lecturer or assessor.

6

Evidence of sports massage

To achieve this qualification, you must successfully undertake and record at least300 hours of sports massage as part of unit UV50388.

Three hundred hours of sports massage practice must be documented in your portfolio of evidence. Evidence must demonstrate application of all massage methods that make up this qualification, and must be undertaken on a range of clients in different environments.

7

Unit assessment methods

This section provides an overview of the assessment methods that make up each unit in this qualification. Detailed information on assessment is provided in each unit.

Mandatory units External Internal

VTCT unit code Unit title Question

paper(s) Observation(s) Portfolio of evidence

UV50388 Advanced anatomy, physiology and assessment for sports massage 0

UV50389Planning, applying and evaluating complex sports massage/soft tissue methods

0

7

Unit glossary

8

Description

VTCT product code

All units are allocated a unique VTCT product code for identification purposes. This code should be quoted in all queries and correspondence to VTCT.

Unit title The title clearly indicates the focus of the unit.

National Occupational Standards (NOS)

NOS describe the skills, knowledge and understanding needed to undertake a particular task or job to a nationally recognised level of competence.

Level

Level is an indication of the demand of the learning experience; the depth and/or complexity of achievement and independence in achieving the learning outcomes. There are 9 levels of achievement within the Qualifications and Credit Framework (QCF).

Credit valueThis is the number of credits awarded upon successful achievement of all unit outcomes. Credit is a numerical value that represents a means of recognising, measuring, valuing and comparing achievement.

Guided learning hours (GLH)

The number of hours of teacher-supervised or directed study time required to teach a qualification or unit of a qualification.

Observations This indicates the minimum number of competent observations, per outcome, required to achieve the unit.

Learning outcomes

The learning outcomes are the most important component of the unit; they set out what is expected in terms of knowing, understanding and practical ability as a result of the learning process. Learning outcomes are the results of learning.

Evidence requirements This section provides guidelines on how evidence must be gathered.

Observation outcome

An observation outcome details the tasks that must be practically demonstrated to achieve the unit.

Knowledge outcome

A knowledge outcome details the theoretical requirements of a unit that must be evidenced through oral questioning, a mandatory written question paper, a portfolio of evidence or other forms of evidence.

Assessment criteria

Assessment criteria set out what is required, in terms of achievement, to meet a learning outcome. The assessment criteria and learning outcomes are the components that inform the learning and assessment that should take place. Assessment criteria define the standard expected to meet learning outcomes.

Range The range indicates what must be covered. Ranges must be practically demonstrated in parallel with the unit’s observation outcomes.

UV50388Advanced anatomy, physiology and assessment for sports massageThe aim of this unit is to develop an advanced understanding of the biological basis for complex massage/soft tissue methods. The effectiveness of complex massage/soft tissue methods will also be evaluated, as will research undertaken in this field.

You will develop the understanding and skills required to carry out and analyse comprehensive subjective and objective assessments of clients, and will develop complex treatment strategies based on sound clinical reasoning and evidence-based research.

UV50388_v10

GLH

Credit value

Level

Observation(s)

External paper(s)

80

14

5

2

0

UV50388

Advanced anatomy, physiology and assessment for sports massage

11

On completion of this unit you will:

Learning outcomes

1. Be able to undertake biomechanical assessments in sport and active leisure

2. Be able to palpate structures of the musculoskeletal system

3. Be able to assess the integrity of the musculoskeletal system

4. Be able to recognise neurological conditions that warrant urgent referral

5. Understand the advanced anatomy and physiology relevant to complex sports massage/soft tissue methods

6. Understand the components of a subjective assessment

7. Understand sports specific postures and gaits

8. Understand the effects of complex massage/soft tissue methods on the body and mind

9. Be able to evaluate the research undertaken on complex massage/soft tissue methods in sport and active leisure

evidence. Professional discussion may be used as supplementary evidence for those criteria that do not naturally occur. Assessed observations should not be carried out on the same day for the same learning outcome. There should be sufficient time between assessments for reflection and personal development. You need to meet the same standard on a regular and consistent basis. Separating the assessments by a period of at least two weeks is recommended as competence must be demonstrated on a consistent and regular basis.

4. Range All ranges must be practically demonstrated or other forms of evidence produced to show they have been covered.

5. Knowledge outcomes There must be evidence that you possess all the knowledge and understanding listed in the Knowledge section of this unit. In most cases this can be done by professional discussion and/or oral questioning. Other methods, such as projects, assignments and/or reflective accounts may also be used.

6. Tutor/Assessor guidance You will be guided by your tutor/assessor on how to achieve learning outcomes and cover ranges in this unit. All outcomes and ranges must be achieved.

7. Sports massage practice Three hundred hours of sports massage must be documented in your portfolio of evidence. Evidence must demonstrate application of all massage methods that make up this qualification and must be undertaken on a range of clients in different environments.

8. External paper There is no external paper requirement for this unit.

Evidence requirements

1. Environment Evidence for this unit may be gathered within the workplace or realistic working environment (RWE).

2. Simulation Simulation is not permitted in this unit.

3. Observation outcomes Competent performance of Observation outcomes must be demonstrated on at least two occasions. Assessor observations, witness testimonies and products of work are likely to be the most appropriate sources of performance

Achieving observations and range

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Achieving observation outcomes Achieving range

Your assessor will observe your performance of practical tasks. The minimum number of competent observations required is indicated in the Evidence requirements section of this unit.

Criteria may not always naturally occur during a practical observation. In such instances you will be asked questions to demonstrate your competence in this area. Your assessor will document the criteria that have been achieved through professional discussion and/or oral questioning. This evidence will be recorded by your assessor in written form or by other appropriate means.

Your assessor will sign off a learning outcome when all criteria have been competently achieved.

The Range section indicates what must be covered. Ranges should be practically demonstrated as part of an observation. Where this is not possible other forms of evidence may be produced. All ranges must be covered.

Your assessor will document the portfolio reference once a range has been competently achieved.

Evidence of sports massage practice

Three hundred hours of sports massage practice must be carried out to achieve this unit.

Your assessor will complete the table below when 300 hours of sports massage practice have been completed and are documented in your portfolio of evidence.

Date achieved Assessor initials

Outcome 1

Observations

You can:

Observation 1 2 OptionalDate achieved

Criteria questioned orally

Portfolio reference

Assessor initials

Learner signature

*May be assessed through oral questioning.

Be able to undertake biomechanical assessments in sport and active leisure

a. Use tests to measure leg lengths

b. Carry out plumb-line assessments of postures in standing

c. Analyse movement

d. Carry out observational analyses of gait

e. Communicate biomechanical findings, identifying strengths, areas for improvement and indications for massage/soft tissue methods (as appropriate)

UV50388 13

Outcome 2

You can:

Be able to palpate structures of the musculoskeletal system


a. Palpate key bony landmarks relevant to complex sports massage/soft tissue methods

b. Palpate joint lines commonly used in sport and active leisure activities

c. Palpate the origins, insertions, bellies and tendons of the muscles commonly used in sport and active leisure activities

d. Palpate ligaments and bursae important to sport and active leisure activities

UV5038814



Portfolio reference

Assessor initials

Learner signature

Outcome 3

You can:


Be able to assess the integrity of the musculoskeletal system

a. Measure active and passive joint range of movement

b. Use tests to measure isometric muscle strength through range

c. Use tests to assess the integrity of joints commonly used in sport and active leisure

d. Use tests to assess muscle lengths

e. Communicate musculoskeletal findings, identifying strengths, areas for improvement and indications for complex massage/soft tissue methods (as appropriate)

UV50388 15



Portfolio reference

Assessor initials

Learner signature

Outcome 4

You can:

Be able to recognise neurological conditions that warrant urgent referral


a. Carry out assessments of sensation for the upper and lower limbs

b. Assess muscle strength for neurological weakness

c. Test deep tendon reflexes using a reflex hammer

d. Communicate neurological findings, identifying indications for complex massage/soft tissue methods (as appropriate)

UV5038816



Portfolio reference

Assessor initials

Learner signature

Range

*You must practically demonstrate that you have:

UV50388 17

Palpated a minimum of 12 bony landmarks Portfolio reference

Adductor tubercle

Bicipital groove

Capitate

Cuboid

Cuneiforms

Deltoid tuberosity

Gluteal tuberosity

Hamate

Head of fibula

Infraglenoid tubercle

Lister’s tubercle

Lunate

Manubrium

Navicular

Occipital protuberance

Peroneal trochlea

Pisiform

Sustentaculum tali

Radial styloid process

Scaphoid

Spinous process T12 and 12th rib

Trapezium

Trapezoid

Triquetrum

Ulnar styloid process

Xiphoid process

It is strongly recommended that all range items are practically demonstrated. Where this is not possible, other forms of evidence may be produced to demonstrate competence.


UV5038818

Palpated a minimum of 8 joint lines Portfolio reference

Ankle

Acromioclavicular

Elbow

Hip

Knee

Radioulnar

Sacroiliac

Shoulder

Sternoclavicular

Wrist



UV50388 19

Palpated a minimum of 12 muscles Portfolio reference

Brachialis

Brachioradialis

Coracobrachialis

Diaphragm

Extensor carpi radialis longus

Extensor carpi radialis brevis

Extensor digitorum longus and hallucis longus

Flexor carpi radialis

Flexor carpi ulnaris

Flexor digitorum longus

Iliacus

Pectoralis minor

Peroneals

Plantaris

Psoas major

Rhomboids

Sartorius

Scalene anterior and middle

Scalene posterior

Serratus anterior

Splenius capitis/cervicis

Subscapularis

Sternocleidomastoid



UV5038820

Palpated a minimum of 10 ligaments Portfolio reference

Anterior talofibular

Anterior tibiofibular

Calcaneofibular

Deltoid

Long plantar

Posterior talofibular

Posterior tibiofibular

Short plantar

Annular

Radial collateral

Ulnar collateral

Medial collateral

Lateral collateral

Patellar

Coronary

Inguinal

Sacroiliac

Acromioclavicular

Sternoclavicular

Capsular ligament of the shoulder



UV50388 21

Palpated a minimum of 4 bursa Portfolio reference

Calcaneal

Deep infrapatellar

Pes anserine

Prepatella

Subcutaneous infrapatellar

Olecranon

Subacromial

Trochanteric

Measured range of movement at a minimum of 3 joints Portfolio reference

Ankle

Elbow

Hip

Knee

Shoulder

Wrist

Measured the isometric muscle strength of a minimum of 4 muscle groups (record muscle groups measured below) Portfolio reference



UV5038822

Used a minimum of 10 tests to assess the integrity of joints (record tests used below) Portfolio reference

Used a minimum of 5 tests to assess the length of muscles (record tests used below) Portfolio reference



UV50388 23

Assessed sensation of the upper and lower limbs using a minimum of 3 methods (record methods used below) Portfolio reference

Assessed all myotomes Portfolio reference

C1 – T1

L1 – S2

Tested all deep tendon reflexes Portfolio reference

Biceps brachii

Triceps

Patellar

Tendo calcaneus


Achieving knowledge outcomes

Developing knowledge

UV5038824

You will be guided by your tutor and assessor on the evidence that needs to be produced. Your knowledge and understanding will be assessed using the assessment methods listed below*:

• Projects• Observed work• Witness statements• Audio-visual media • Evidence of prior learning or attainment• Written questions• Oral questions• Assignments• Case studies• Professional discussion

Where applicable your assessor will integrate knowledge outcomes into practical observations through professional discussion and/or oral questioning.

When a criterion has been orally questioned and achieved, your assessor will record this evidence in written form or by other appropriate means. There is no need for you to produce additional evidence as this criterion has already been achieved.

Some knowledge and understanding outcomes may require you to show that you know and understand how to do something. If you have practical evidence from your own work that meets knowledge criteria, then there is no requirement for you to be questioned again on the same topic.

*This is not an exhaustive list.

Knowledge

Outcome 1

Be able to undertake biomechanical assessments in sport and active leisure

You can: Portfolio reference /Assessor initials*

f. Describe the biomechanical findings that warrant urgent medical and/or health care, or require collaborative working with other sports professionals

*Assessor initials to be inserted if orally questioned. Requirements highlighted in white are assessed in the external paper.

UV50388 25

Outcome 3

Be able to assess the integrity of the musculoskeletal system


f. Explain the different types of joint ‘end-feel’

g. Describe the musculoskeletal findings that warrant urgent medical and/or healthcare professional referral, or require collaborative working with other sports professionals


UV5038826

Outcome 4

Be able to recognise neurological conditions that warrant urgent referral


e. Outline the importance of a neurological examination

f. Describe the pathways of nerves through the upper and lower limbs

g. Explain dermatomes, myotomes and reflexes and their assessment processes

h. Describe the neurological findings that warrant urgent medical and/or healthcare professional referral


UV50388 27

Outcome 5

Understand the advanced anatomy and physiology relevant to complex sports massage/soft tissue methods


a. Outline the importance of sports massage practitioners having an advanced knowledge of anatomy, physiology and pathology

b. Explain the biological basis for complex massage/soft tissue methods

c. Explain the pathologies that may influence the complex massage/soft tissue methods used to prevent and manage sports injuries

d. Explain the impact of nutrition and hydration on sport and active leisure performance

e. Explain the importance of referral as a sports massage practitioner to medical and healthcare professionals

f. Explain the importance of collaborative working with other sports professionals


UV5038828

Outcome 6

Understand the components of a subjective assessment


a. Explain the importance and process of a thorough subjective examination

b. Explain yellow flags and their potential impact on prognosis

c. Explain red flags and the importance of urgent medical referral

d. Analyse responses from subjective examinations

e. Explain the process of clinical reasoning and stages of problem solving

f. Complete clinical reasoning forms for sport and active leisure clients


UV50388 29

Outcome 7

Understand sports specific postures and gaits


a. Explain the phases of the gait cycle

b. Outline the different methods used to analyse gait

c. Describe common foot deformities and their effects on gait

d. Describe common gait abnormalities

e. Explain postural alignments in sport and leisure activities

f. Explain postural deviations, conditions and types in the context of sport and active leisure


UV5038830

Outcome 8

Understand the effects of complex massage/soft tissue methods on the body and mind


a. Critically evaluate the physiological effects of massage/soft tissue methods

b. Explain the psychology of injury as it applies to massage/soft tissue methods

c. Critically evaluate the psychological effects of massage/soft tissue methods


UV50388 31

Outcome 9

Be able to evaluate the research undertaken on complex massage/soft tissue methods in sport and active leisure


a. Explain the concept of evidence-based practice

b. Critically evaluate research undertaken on the use of complex massage/soft tissue methods

c. Draw conclusions on the support for complex massage/soft tissue methods


UV5038832

Outcome 1: Be able to undertake biomechanical assessments in sport and active leisure

Unit content

This section provides guidance on the recommended knowledge and skills required to enable you to achieve each of the learning outcomes in this unit. Your tutor/assessor will ensure you have the opportunity to cover all of the unit content.

UV50388 33

Leg length testing: True leg length vs. apparent leg length, bent knee assessment, Trendelenburg gait, use of tape measures, bony landmarks (anterior superior iliac spine to medial malleolus – bone length discrepancy; umbilicus to medial malleolus – soft tissue).

Posture analysis in standing: Use of plumb line and other equipment, appropriate clothing, foot position, anterior/lateral/posterior observations, ideal alignment, segmental alignment and position (head, arms and shoulders, chest, abdomen, spine and pelvis (side view), hips, pelvis and spine (posterior view), knees and legs, toes and feet), symmetry, interpretation of observations, soft tissue involvement/causes (muscle weakness and shortness).

Movement analysis: Observational analysis of movement, analysis in specific sport and leisure activities, gait, posture, movement mechanics and techniques.

Observational gait analysis: Forwards and backwards walking, on even/uneven ground, slopes, stairs and running, defining ‘normal gait’, joint action throughout the phases of the gait cycle (pelvis, hip, knee, ankle and toes), deviations from the norm and possible causes, stride characteristics including cadence (stride frequency, velocity and stride length), stability and balance, muscle actions, possible causes (e.g. muscle imbalances).

Biomechanical findings: Interpretation of leg lengths/posture/gait, deviations from ‘normal’, possible causes of deviations, strengths and areas for improvement, indications for complex massage/soft tissue methods, involving other sports professionals including technical coaches and strength and condition specialists plus others, to inform clinical reasoning and treatment justification.

Urgent medical referral: Subjective history (red flags, signs and symptoms), gait/postural abnormalities, co-ordination problems, health care vs. medical referral.

Outcome 2: Be able to palpate structures of the musculoskeletal system

UV5038834

Bony landmarks: Key landmarks, usefulness of landmarks, actions/functions, bony landmarks to be palpated (see range).

Joint lines: Importance of joint line palpation, structures to palpate, joints to be palpated (see range).

Muscular palpation: Origins, insertions and muscle bellies, tendons and fascial tissue, muscles to be palpated (see range).

Ligament palpation: Ligaments to be palpated.

Foot and ankle – anterior talofibular, anterior tibiofibular, calcaneofibular, deltoid, long plantar, posterior talofibular, posterior tibiofibular and short plantar.

Forearm and hand – annular, radial collateral and ulnar collateral.

Knee – medial and lateral collateral, patellar and coronary.

Pelvis and thigh – inguinal, sacroiliac.

Shoulder and arm – acromioclavicular, sternoclavicular, capsular ligament of the shoulder.

Awareness of ligaments that cannot be palpated – e.g. anterior cruciate, posterior cruciate.

Bursae palpation: Bursa to be palpated.

Foot and ankle – calcaneal.

Knee – deep infrapatellar, pes anserine, prepatella and subcutaneous infrapatellar.

Shoulder and arm – olecranon and subacromial.

Hip – trochanteric.

Outcome 3: Be able to assess the integrity of the musculoskeletal system

UV50388 35

Joint end feel: Normal (hard, soft and elastic), abnormal (hard, springy, spasm and empty).

Range of joint movement: Normal movement ranges, use of bony landmarks, active and passive movements, joints to be measured, use of overpressures, reporting of end feel, instruments to measure (e.g. tape measure, goniometers, other instruments).

Isometric muscle strength: Muscles to be assessed (see range), through range of movement, technique, resistance applied, grading of strength.

Joint integrity tests:

Shoulder impingement – e.g. Hawkin’s-Kennedy test, Neers, painful arc and empty can test.

Acromioclavicular joint – e.g. scarf test, O’Brein’s (ACJ and superior labrum).

Rotator cuff integrity – e.g. resisted abduction with straight arms by side, resisted external rotation, hand behind back and lift-off test.

Biceps tendon integrity tests, deltoid – e.g. resisted abduction at 90 degrees.

Winged scapula test, shoulder instability – e.g. drawer test, apprehension and relocation tests.

Knee – e.g. anterior and posterior drawer tests, varus and valgus stress tests, patella-femoral glide and tap brush test.

Elbow – e.g. medial and lateral collateral ligament stress tests.

Pelvis – e.g. gapping and compression tests.

Hip – e.g. quadrant test, Trendenlenburg.

Ankle – e.g. anterior/posterior drawer sign and talar tilt, anterior drawer test.

Other tests – relevant to specific sport and leisure activity.

Muscle length tests: Muscle lengths to be assessed (levator scapulae, upper trapezius, sternocleidamastoid, pectoralis major (sternocostal and clavicular fibres), pectoralis minor, scalenes, erector spinae, quadratus lumborum, latissimus dorsi, piriformis, iliopsoas, rectus femoris, tensor fasciae latae, hamstrings, tibialis posterior, gastrocnemius, soleus, iliotibial band), tests that must be covered (Ober’s test, Faber’s test, Thomas’ test).

Musculoskeletal findings: Interpretation of musculoskeletal findings, false positives, false negatives, reliability, specificity and validity of tests, potential causes, strengths and areas for improvement, indications for complex massage/soft tissue methods, referral to medical/healthcare professionals.

Urgent medical referral: Subjective history (red flags, signs and symptoms), gait/postural abnormalities, tonal changes, co-ordination problems, health care vs. medical referral, outside scope of practice.

Outcome 4: Be able to recognise neurological conditions that warrant urgent referral

UV5038836

Note for tutors and assessors: The purpose of Outcome 4 is to equip practitioners with the skills to carry out basic neurological tests. It must be made clear to practitioners that these tests must only be used for screening the neurological system so that urgent referrals can be made to medical and/or healthcare professionals if abnormal neurology is detected. It is not the purpose of this outcome to provide practitioners with the skills to diagnose neurological conditions. If abnormal neurology is detected immediate referral must be made.

Treatment required by the massage practitioner will be advised by medical/healthcare professionals once they have conducted their own diagnostic neurological assessment.

Importance of neurological examination: To identify neurological abnormalities, use as a screening vs. investigative tool, differentiate between central and peripheral lesions, urgent referral of neurological abnormalities.

Pathways of nerves/nerve palpation: Brachial plexus, median nerve, radial nerve, sciatic nerve, common peroneal nerve, tibial nerve, superficial peroneal nerve, deep peroneal nerve, sural nerve.

Dermatomes, myotomes and reflexes: Definitions, purpose and value, procedures for systematic assessment, interpretation of information gathered, situations whereby urgent medical referral is required.

Assessment of sensation: Systematic procedure, dermatomes to be assessed including C3-T1 and L1-S2, methods to be assessed (light touch, deep pressure, two-

point discrimination, hot/cold sensation and proprioception), symmetry, positioning of client, interpretation.

Assessment of neurological weakness: Systematic procedure, myotomes to be assessed (C1-T1 and L1-S2), technique (positioning and application of resistance), use of grading scales, interpretation.

Reflex testing: Deep tendon reflexes (biceps brachii, triceps, patellar, tendo calcaneus), grading of the tendon response (absent, diminished, average, exaggerated and clonus), technique (application of force), interpretation.

Neurodynamic testing: Systematic approach, neurological red flag, technique, tests to be conducted including passive neck flexion, straight leg raise, prone knee bend, slump, upper limb tension tests (radial, ulnar and median nerve), normal responses, sensitising tests, interpretation.

Neurological findings: Interpretation of neurological findings, potential causes, areas for concern, indications for complex massage/soft tissue methods, referral to medical/healthcare professionals.

Urgent medical referral: Findings including altered dermatomes, myotomes, reflexes, subjective history (red flags, signs and symptoms), gait/postural abnormalities, co-ordination problems.

Outcome 5: Understand the advanced anatomy and physiology relevant to complex sports massage/soft tissue methods

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Importance of practitioner knowledge base: Application, selection and justification of massage methods/treatment plan, ability to link knowledge to practice, identification of pathology and early intervention, understand mechanism of injury, biomechanical understanding of sport/injury/area of stress, potential problem areas, high maintenance areas.

Biological basis: Biological level (systems working together – interrelated), cellular aspect (skin, subcutaneous tissue, innervations of the skin, connective tissue), fluid system dynamics (hydrostatic pressure and interstitial osmotic pressure related to oedema), immune response (increase in lymphocytes, effect on inflammation), endocrine response (hormonal response to massage (e.g. cortisol, vasopressin, oxytocin, adrenal cortical, endorphins)), neuroendocrine response.

Complex massage/soft tissue methods: Connective tissue massage, proprioceptive neuromuscular facilitation, myofascial techniques, soft tissue release, positional release/strain-counterstrain techniques.

Pathologies: Causes, mechanisms, signs/symptoms, testing for, complications if left unattended, treatment, rehabilitation and prevention, prognosis, acute, chronic, overuse, inflammatory process and role in injury (cells involved, cell roles), healing process (physiological level), collagen formation.

Skin – cuts, abrasions, chafing, sunburn, frostbite, allergies, athlete’s foot (tinea pedis), blisters, corns/calluses, plantar warts (verrucae), etc.

Head and neck – concussion, contusion, haemorrhage, fracture, neck strain, cervical nerve stretch syndrome, whiplash (neck sprain), wry neck (acute torticollis), herniated disc, cervical radiculitis, cervical spondylosis, teeth, eye, ear, nose, etc.

Hands and fingers – metacarpal fractures, ulnar collateral ligament sprain (gamekeeper’s/skier’s thumb), mallet finger, finger (sprain, dislocation), hand/finger (tendinopathy), etc.

Wrists and forearms – sprain, fracture, dislocation, carpal tunnel syndrome, ulnar tunnel syndrome, ganglion cyst, tendinopathy, etc.

Elbow – fracture, sprain, dislocation, triceps brachii tendon rupture, tennis elbow, golfer’s elbow, thrower’s elbow, elbow bursitis, etc.

Shoulders and upper arms – fracture (collar bone, humerus), dislocation of shoulder, shoulder subluxation, acromioclavicular/sternoclavicular separation, biceps brachii tendon rupture, muscle strain (biceps, chest), impingement syndrome, rotator cuff tendinitis/tendinopathy, shoulder bursitis, bicipital tendinitis, pectoral muscle insertion inflammation, adhesive capsulitis, etc.

Back and spine – strain, sprain, thoracic contusion, herniated/ruptured/bulging disc, stress fracture of vertebra, etc.

Chest and abdomen – fractured/broken ribs, flail chest, abdominal muscle strain, etc.

Hip, pelvis and groin – hip flexor strain, hip pointer, Gilmore’s groin, avulsion fracture, groin strain, osteitis pubis, stress fracture, piriformis syndrome, iliopsoas

Outcome 5: Understand the advanced anatomy and physiology relevant to complex massage/soft tissue methods (continued)

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tendinopathy, tendinopathy of the adductor muscles, snapping hip syndrome, trochanteric bursitis, Perthe’s disease, etc.

Upper thigh – femur fracture, quadriceps/hamstring strain, contusion of thigh, iliotibial band syndrome, quadriceps tendinopathy, myositis ossificans, etc.

Knee – medial/lateral collateral ligament sprain, O’Donoghue’s triad, anterior cruciate ligament sprain, meniscus tear, bursitis, synovial plica, Osgood-Schlatter syndrome, osteochondritis dissecans, patellofemoral pain syndrome, patellar tendinopathy, chondromalacia patellae, subluxing knee cap, etc.

Lower leg – fractures (tibia, fibula), calf strain, Achilles tendon strain, Achilles tendonitis, medial tibial pain syndrome, stress fracture, anterior compartment syndrome, etc.

Ankle – sprain, fracture, posterior tibial tendonitis, peroneal tendon subluxation, peroneal tendinopathy, osteochondritis dissecans, supination, pronation, etc.

Foot – fracture, retrocalcaneal bursitis, stress fracture, extensor and flexor tendinitis, Morton’s neuroma, sesamoiditis, impingement (footballer’s/ballet dancer’s ankle), bunions, hammer toe, turf toe, claw foot, plantar fasciitis, heel spur, black nail, ingrown toenail.

Impact of nutrition and hydration: Comparisons between a ‘normal’ and sport-performance diet, the case for supplementation, nutritional strategies to enhance performance in sport and leisure, importance of water intake and fluid dynamics, dehydration and performance degradation in sport and leisure, sports drinks, nutritional ergogenic aids.

Medical and healthcare professionals: For example GP, physiotherapists, dietician, strength and conditioning specialists, podiatrist.

Importance of referral: Professionalism, recognition of boundaries, work within scope of practice, build professional relationships, insurance boundaries, duty of care to client, best interest of client.

Importance of collaborative working: Multi-disciplinary approach, best interest of client, ensure inter-professional and client boundaries are respected, professionalism, enhance/maintain the reputation of sport massage therapists.

Outcome 6: Understand the components of a subjective assessment

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Importance of thorough subjective examination: Exclude red flags, identification of yellow flags, to provide fundamental basis of objective assessment, limited clear-cut diagnostic tests for range of conditions, signs and symptoms are of great value, the importance of managing the clinical presentation rather than a diagnosis, development of a working hypothesis, informing on/planning objective assessment.

Subjective examination process: Body mapping/chart (type and area of symptoms, depth, quality, intensity, abnormal sensation, relationship of symptoms), behaviour of symptoms (aggravating and easing factors, severity, irritability and nature (mechanical, neural or chemical), 24-hour behaviour, daily activities, stage of the condition, special questions (general health, drugs, steroids, anticoagulants, recent unexplained weight loss, rheumatoid arthritis, spinal cord or cauda equina symptoms, dizziness, recent x-rays, history of presenting condition (history of each symptomatic area, mechanism of injury, how and when it started, how it has changed, past/relevant medical history, previous history of same condition, effect of previous treatment), social and hereditary conditions (age and gender, home and work situation, dependants and leisure activities), pain scales.

Yellow flags: Psychosocial risk factors including sickness and pain behaviours, belief that pain and activity are harmful, low or negative moods, social withdrawal, compensation issues, treatment that does not fit best practice, problems at work, poor job satisfaction, overprotective family or lack of support, those at risk, preventative measures, assessing yellow flags,

management of yellow flags, consequences of missing/over-identifying psychosocial issues.

Red flags: Potentially serious conditions requiring urgent medical assessment including features of cauda equina syndrome (urinary retention, faecal incontinence, neurological signs and symptoms in the lower limb including gait abnormality, saddle para/anaesthesia and anal sphincter laxity), severe worsening pain, significant trauma, weight loss, history of cancer or fever, use of intravenous drugs or steroids, patients over 50 years old, severe unremitting night-time pain, pain that worsens when lying down, sleeper presentations (e.g. continual lower back pain, constipation).

Importance of urgent medical referral: Possibility of disability/damage/death.

Analysing subjective responses: Analyse individual responses to questions, interpret and explain responses, conditions and causes associated with individual responses, subjective information as a whole.

Process of clinical reasoning: The process by which clinical decisions are made, source of symptoms, mechanism of each symptom, working hypothesis, contributing factors, precautions and contra-indications, research of condition, management, prognosis.

Types of clinical reasoning: Procedural/interactive/conditional/narrative/pragmatic reasoning processes, developmental, strengthen reasoning skills with practice/time.

Stages of problem solving: Problem recognition, problem definition, analysing

Outcome 7: Understand sports specific postures and gaits

Phases of gait cycle: Loading response, mid-stance, terminal stance, pre-swing, initial swing, mid-swing, terminal swing, push-off.

Gait analysis methods: Observational and video analysis, motion capture systems, electromyography, force plates, electrogoniometry, in-shoe pressure sensors, kinematics vs. kinetics, strengths and weaknesses, effectiveness.

Foot deformities and their effects: Criteria for normalcy, pes planus (flat foot), pes cavus, rear foot valgus, rear foot varus, forefoot valgus, forefoot varus, hallux valgus, splay foot, claw toes, hammertoes, effects of deformities on gait.

Common gait abnormalities: Antalgic, ataxic, steppage, hemiplegic, jump, toe-toe, compensated, scissor, festinating, shuffling, spastic, drop foot, Trendelenburg, arthrogenic, causes of gait abnormalities.

Postural alignments: Ideal postural alignments of the head and neck, shoulder, thoracic region, lumbar region, pelvis and hip, knee and ankle and foot, segmental alignment, sport specific postures and adaptations, links with pathologies, biomechanical stresses.

Postural deviations, conditions and types: Forward head, excessive cervical lordosis, rounded (forward) shoulders, medial/lateral rotation of the shoulder, adducted and abducted scapulae, winged scapula(e), kyphosis and depressed chest, scoliosis, lordosis, swayback, flat-back, pelvic tilt and rotation, femoral anteversion and retroversion, genu varus and valgus, genu recurvatum (hyper-extended knees).

Outcome 6: Understand the components of a subjective assessment (continued)

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the problem, formulating goals, managing data, developing a solution, implementing the solution, evaluating the outcome, reflective practice and improvement.

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Outcome 8: Understand the effects of complex massage/soft tissue methods on the body and mind

Critically evaluate physiological effects: Events in the tissues, on the tissue layers, circulatory effects, effects on muscle, effects on connective tissue, neurological effects including effects on pain and sensation, reflexes and autonomic reflexes, autonomic nervous system, the facilitated segment, stress/strain curve, supporting evidence for specific complex massage/soft tissue methods.

Massage/soft tissue methods – connective tissue massage, proprioceptive neuromuscular facilitation, myofascial techniques, soft tissue release, positional release/strain-counterstrain techniques.

Psychology of injury: Principles and theories of psychology of injury, evidence, application in the context of sports massage, psychological considerations when treating injured clients, recovery

time, mood, affective response to complex massage/soft tissue methods.

Critically evaluate psychological effects: Relaxation, placebo, improved state of wellbeing, improved body awareness, supporting evidence for specific complex massage/soft tissue methods.

Outcome 9: Be able to evaluate the research undertaken on complex massage/soft tissue methods in sport and active leisure

Evidence-based practice: Defining, value, examples in sports massage/soft tissue methods.

Massage/soft tissue methods – connective tissue massage, proprioceptive neuromuscular facilitation, myofascial techniques, soft tissue release, positional release/strain-counterstrain techniques.

Evaluation of research: Review of research methodologies (problem/aims, patient or population, intervention, outcome measures, sample size, statistics used, power calculations, etc.), research

design (systematic review, meta-analysis, randomised controlled trial), sources (Cochrane reviews, periodicals, journals and online databases), appraisal tools, type (qualitative vs. quantitative), strengths and weaknesses of research, implications for future research.

Conclusions: Support for and against range of complex massage/soft tissue techniques, supported indications for use.

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Notes Use this area for notes and diagrams

UV50389Planning, applying and evaluating complex sports massage/soft tissue methods The aim of this unit is to provide you with the knowledge, understanding and practical skills required to prepare, apply and evaluate a range of complex massage/soft tissue methods that prevent and manage injury.

UV50389_v7

GLH

Credit value

Level

Observation(s)

External paper(s)

150

23

5

2

0

On completion of this unit you will:

Learning outcomes

Planning, applying and evaluating complex sports massage/soft tissue methods

1. Be able to work within agreed standards of practice

2. Be able to prepare for complex sports massage/soft tissue methods

3. Be able to assess clients for complex sports massage/soft tissue methods

4. Be able to devise complex sports massage/soft tissue strategies for clients

5. Be able to apply complex sports massage/soft tissue methods

6. Be able to evaluate the effectiveness of complex sports massage/soft tissue methods

7. Be able to produce, maintain and store client records

Assessed observations should not be carried out on the same day for the same learning outcome. There should be sufficient time between assessments for reflection and personal development. You need to meet the same standard on a regular and consistent basis. Separating the assessments by a period of at least two weeks is recommended as competence must be demonstrated on a consistent and regular basis.

4. Range All ranges must be practically demonstrated or other forms of evidence produced to show they have been covered.

5. Knowledge outcomes There must be evidence that you possess all the knowledge and understanding listed in the Knowledge section of this unit. In most cases this can be done by professional discussion and/or oral questioning. Other methods, such as projects, assignments and/or reflective accounts may also be used.

6. Tutor/Assessor guidance You will be guided by your tutor/assessor on how to achieve learning outcomes and cover ranges in this unit. All outcomes and ranges must be achieved.

7. External paper There is no external paper requirement for this unit.

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Evidence requirements

1. Environment Evidence for this unit may be gathered within the workplace or realistic working environment (RWE).

2. Simulation Simulation is not allowed in this unit.

3. Observation outcomes Competent performance of Observation outcomes must be demonstrated on at least two occasions. Assessor observations, witness testimonies and products of work are likely to be the most appropriate sources of performance evidence. Professional discussion may be used as supplementary evidence for those criteria that do not naturally occur.

Achieving observation outcomes Achieving range

Achieving observations and range

UV50389

Your assessor will observe your performance of practical tasks. The minimum number of competent observations required is indicated in the Evidence requirements section of this unit.

Criteria may not always naturally occur during a practical observation. In such instances you will be asked questions to demonstrate your competence in this area. Your assessor will document the criteria that have been achieved through professional discussion and/or oral questioning. This evidence will be recorded by your assessor in written form or by other appropriate means.

Your assessor will sign off a learning outcome when all criteria have been competently achieved.

The Range section indicates what must be covered. Ranges should be practically demonstrated as part of an observation. Where this is not possible other forms of evidence may be produced. All ranges must be covered.

Your assessor will document the portfolio reference once a range has been competently achieved.

46

Outcome 1

Observations

You can:



Portfolio reference

Assessor initials

Learner signature

*May be assessed by supplementary evidence.

Be able to work within agreed standards of practice

a. Apply professional standards of personal hygiene, dress and appearance

b. Ensure there is adequate public liability and professional indemnity insurance

c. Carry out equipment checks to ensure cleanliness and hygiene and that current health and safety requirements are met

d. Carry out risk assessments of equipment and treatment areas

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Outcome 2

You can:

Be able to prepare for complex sports massage/soft tissue methods


a. Follow approved guidelines for the presence of a chaperone, where necessary*

b. Prepare treatment areas and equipment to ensure comfort and dignity for clients

c. Prepare materials appropriate for planned massage/soft tissue methods

d. Demonstrate the correct procedures to obtain informed consent

e. Prepare client records as legally required

UV5038948



Portfolio reference

Assessor initials

Learner signature

Outcome 3

You can:


Be able to assess clients for complex sports massage/soft tissue methods

a. Carry out subjective assessments of clients

b. Carry out objective assessments of clients

c. Gather information relevant to the cautions and contra-indications to massage/soft tissue methods, responding appropriately

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Portfolio reference

Assessor initials

Learner signature

Outcome 4

You can:

Be able to devise complex sports massage/soft tissue strategies for clients


a. Devise combined massage and soft tissue strategies appropriate to client’s needs, their context and within your scope of practice

b. Present aims and objectives of agreed massage/soft tissue methods with clients

c. Present the nature, purpose and process of massage/soft tissue methods to clients with justification

d. Ensure clients understand the nature and purpose of the equipment to be used

e. Present suitable objective and subjective markers to measure the effects of massage/soft tissue methods with justification

UV5038950



Portfolio reference

Assessor initials

Learner signature

Outcome 5

You can:


Be able to apply complex sports massage/soft tissue methods

a. Demonstrate correct positioning of self and clients throughout the massage/soft tissue method

b. Prepare relevant body areas with due respect to clients’ dignity and informed consent

c. Apply massage/soft tissue methods correctly and consistently to meet the presentation and needs of clients

d. Adapt working practices to the area in which you are working

e. Demonstrate how to take account of the cautions and contra-indications to massage/soft tissue methods

f. Record and respond appropriately to visual and oral feedback during the delivery of massage/soft tissue methods

g. Provide clients with appropriate materials and assistance to remove the massage/soft tissue medium

h. Respond appropriately to pre-existing conditions and disease processes

i. Assess and manage risk throughout treatment

UV50389 51



Portfolio reference

Assessor initials

Learner signature

Outcome 6

You can:

Be able to evaluate the effectiveness of complex sports massage/soft tissue methods


a. Reassess clients, identifying any adverse reactions

b. Gain feedback on the effects of massage/soft tissue methods from clients

c. Analyse client feedback against the aims and objectives of massage/soft tissue strategies

d. Provide appropriate advice and opportunities for client questions and/or feedback

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Portfolio reference

Assessor initials

Learner signature

Outcome 7

You can:


Be able to produce, maintain and store client records

a. Explain massage/soft tissue methods used and the details that should be recorded

b. Produce records of massage/soft tissue sessions in the accepted format

c. Demonstrate the safe and secure storage of records according to legal requirements

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Portfolio reference

Assessor initials

Learner signature

Range


Collected all subjective information Portfolio reference

Personal details

History of presenting symptoms

Past medical history/previous injuries

Client reasons for seeking treatment

Sporting profile/training regimen

Lifestyle and diet

Carried out all objective assessments Portfolio reference

Observations (posture)

Observations (gait)

Palpations

Range of movement (active and passive)

Leg length

Muscle length

Muscle strength

Special tests

Joint integrity tests

Sensation tests

Neurological weakness

Reflexes


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Worked with all client groups Portfolio reference

Male

Female

Pre-adolescent (9-12 years)

Adolescent (13-19, in puberty)

Adult

Specific populations (pregnant women, older adults, people with disabilities, elite athletes)

Applied all complex sports massage/soft tissue methods Portfolio reference

Connective tissue massage

Proprioceptive neuromuscular facilitation

Myofascial techniques

Neuromuscular techniques

Soft tissue release

Positional release/strain-counterstrain techniques

Worked in all environments Portfolio reference

Massage room

In situ at sporting event


UV50389 55


Covered all contexts Portfolio reference

Injury management

Injury prevention

Problem solving (non-injury presentation)

Pre-existing conditions

Worked with all presentations Portfolio reference

Pain

Changes in muscle tone

Changes in joint range of movement

Pathological changes

Inflammation

Pre-existing conditions


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Achieving knowledge outcomes

Developing knowledge

You will be guided by your tutor and assessor on the evidence that needs to be produced. Your knowledge and understanding will be assessed using the assessment methods listed below*:

• Projects• Observed work• Witness statements• Audio-visual media • Evidence of prior learning or attainment• Written questions• Oral questions• Assignments• Case studies• Professional discussion

Where applicable your assessor will integrate knowledge outcomes into practical observations through professional discussion and/or oral questioning.

When a criterion has been orally questioned and achieved, your assessor will record this evidence in written form or by other appropriate means. There is no need for you to produce additional evidence as this criterion has already been achieved.

Some knowledge and understanding outcomes may require you to show that you know and understand how to do something. If you have practical evidence from your own work that meets knowledge criteria, then there is no requirement for you to be questioned again on the same topic.

*This is not an exhaustive list.

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Knowledge

Outcome 1

Be able to work within agreed standards of practice

You can: Portfolio reference

e. Clarify the accepted standards of practice

f. Describe how to conform to protocols for all forms of communication

g. Explain the importance of cleanliness and hygiene, dress and appearance, and the standards to be applied

h. Clarify relevant and current health and safety legislation

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Outcome 2

Be able to prepare for complex sports massage/soft tissue methods


f. Explain the importance of having a suitable chaperone present when working with children and vulnerable adults

g. Explain the importance of maintaining the dignity and comfort of clients throughout the massage/soft tissue process

h. Explain the correct materials to use for a range of massage/soft tissue methods

i. Explain the importance of obtaining informed consent prior to assessments and application of massage/soft tissue methods

j. Explain the importance of working within the boundaries of informed consent and maintaining confidentiality

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Outcome 3

Be able to assess clients for complex sports massage/soft tissue methods


d. Explain the importance of accurate client assessments and record keeping

e. Explain how to carry out subjective and objective assessments of clients

f. Critically evaluate the range of assessment methods used to gather information

g. Explain the importance of obtaining information on the possible cautions and contra-indications to massage/soft tissue methods before commencing any treatments

h. Analyse the cautions and contra-indications to massage/soft tissue methods

i. Explain the importance of recognising clients presenting with pre-existing conditions and problems

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Outcome 4

Be able to devise complex sports massage/soft tissue strategies for clients


f. Explain the indications for massage/soft tissue methods

g. Justify the importance of explaining the aims and objectives of massage/soft tissue methods to clients

h. Explain why it is important for clients to understand the nature and purpose of massage/soft tissue methods and the equipment used

i. Outline situations when the massage/soft tissue medium should be removed

j. Explain the content of massage/soft tissue mediums in relation to allergic reaction and contra-indications

k. Explain the possible adverse reactions to massage/soft tissue methods and their identification

l. Critically evaluate objective and subjective markers to measure the effects of massage/soft tissue methods

UV50389 61

Outcome 5

Be able to apply complex sports massage/soft tissue methods


j. Explain the importance of ensuring clients and practitioners are correctly positioned

k. Explain the preparation of body areas for a range of massage/soft tissue methods

l. Explain how a range of massage/soft tissue methods can be applied in relation to technique

m. Explain the application of massage/soft tissue methods to a range of conditions/situations

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Outcome 6

Be able to evaluate the effectiveness of complex sports massage/soft tissue methods


e. Clarify the importance of accurate client reassessment

f. Critically evaluate methods used for obtaining feedback from clients on the effects of massage/soft tissue methods

g. Explain why it is important to provide opportunities for further feedback

h. Explain the importance of evaluating the effectiveness of massage/soft tissue methods

i. Critically evaluate the objective and subjective markers used to measure the effects of massage/soft tissue methods

j. Critically evaluate the overall short and long-term effectiveness of massage/soft tissue strategies applied, suggesting improvements

UV50389 63

Outcome 7

Be able to produce, maintain and store client records


d. Explain the importance of accurate and confidential record keeping and storing records safely

e. Explain the importance and process of referral to relevant professionals when necessary

f. Produce reports/letters of referral for relevant health-care professionals

g. Explain the importance of following the directions of health-care professionals

h. Explain the legal requirements for the storage of information on clients and the systems used

i. Clarify when client records must be destroyed as legally required

UV5038964

Outcome 1: Be able to work within agreed standards of practice

Unit content

This section provides guidance on the recommended knowledge and skills required to enable you to achieve each of the learning outcomes in this unit. Your tutor/assessor will ensure you have the opportunity to cover all of the unit content.

UV50389 65

Accepted standards of practice: Roles and responsibilities of the sports massage practitioner, boundaries, limitations of the practitioner, professional associations (Federation of Holistic Therapists (FHT), Sports Massage Association (SMA), others).

How to conform to protocol for all forms of communication: Abide by relevant codes of ethics and practice, adhere to legislation/rules/regulations of working environment.

Importance of professional standards: Maximise treatment benefits, prevention of cross-infection, gives the client confidence in the practitioner, repeated business, potential for increased business, gain respect/trust/rapport, reputation, public confidence in the profession.

Professional standards: Personal hygiene, dress, appearance, attitude.

Insurance: Types and requirements, professional liability, public liability, personal injury, income protection, clinic and equipment, travel and car, claiming on insurance, dealing with claims against the sports massage practitioner.

Health and safety: Current legislation, legal responsibilities for health and safety (clinic, at events, on field of play), data protection legislation, employer’s liability (compulsory) legislation, first aid legislation, accident recording and reporting, evacuation procedures, maintenance (equipment, building), manual handling (control of substances hazardous to health

(COSHH), reporting of injuries, diseases and dangerous occurrences regulations (RIDDOR)).

Equipment checks: Couch (height, stability, position), visual checks of working area/resources, check for wear and tear, faults, cleanliness, possibility of contamination, check all necessary resources are available for clinic/event (covers, towels, mediums, cleansing resources).

Risk assessments: Components of risk assessment form, risk assessment process, managing risks, countermeasures and recommendations, assess risk of environment to ensure safety of practitioner, risk factors (space, environment, weather, obstacles, cross-infection, heat, noise, light, privacy, ventilation), hygiene (equipment and personal), assess risk in clinic/sporting locations/on the field of play, emergency plans, liaise in advance with event organisation/organisers (emergency procedures, first aid protocol), ensure work is within scope of practice.

Outcome 2: Be able to prepare for complex sports massage/soft tissue methods

UV5038966

Child protection and vulnerable adults: Child protection legislation, safeguarding children and vulnerable adults, principles to observe in relation to legislation, suitable chaperones, role of chaperones, importance of using chaperones, possible consequences of not having a chaperone present, protection for client and practitioner.

Importance of maintaining dignity of the client: Build rapport/trust/enhance the effectiveness of treatment.

Prepare area/equipment to ensure comfort and dignity: Ensure privacy, appropriate draping, use of supports, maintain comfort, give reassurance, answer questions, respond to verbal/non-verbal signs, maintain warmth, only expose treatment areas.

Client positioning – comfort, dignity, accessibility, use of supports, consider practitioner working posture, appropriate position to ensure effectiveness of treatment, appropriate position to ensure effective application of techniques.

Prepare materials/working area: Plinth, bench, chair, mat, mediums, towels, supports, blankets, other materials/equipment, appropriate paperwork, set-up is appropriate to available work area, risk assessment.

Informed consent: Define ‘informed’, purpose, importance of obtaining consent (prior to assessment, prior to treatment), practitioner explains nature and purpose of sports massage (risks, alternatives and effects), opportunity to withdraw.

Boundaries of consent: Examination and treatment confined to agreed informed consent.

Procedures to obtain informed consent: Verbal, consultation, records, signature of client, signature of chaperone/guardian for children/vulnerable adults.

Prepare records: Record consent, record client personal details, medical history, treatment objectives, subjective and objective testing, record techniques, effects, contra-actions, contra-indications, records should include acceptance or refusal of chaperone (if appropriate).

Outcome 3: Be able to assess clients for complex sports massage/soft tissue methods

UV50389 67

Importance of accurate client assessment: Identify aims and objectives of assessment, identify any contra-indications/cautions to massage, identify realistic outcomes, to give markers for evaluation of treatment, review of previous sports massage treatments, to form a hypothesis to guide and form the treatment plan, to comply with legislation/law.

Critically evaluate range of assessment methods: Critically evaluate subjective and objective information, range of assessment methods (subjective, objective), critically evaluate the validity/accuracy/reliability/time, equipment needed/cost (VARTEC) of assessment methods, strengths and weaknesses of subjective questions and objective assessment methods, value of using amalgamation of methods.

Subjective assessment: Body mapping/chart (type and area of symptoms, depth, quality, intensity, abnormal sensation, relationship of symptoms), behaviour of symptoms (aggravating and easing factors, severity and irritability, 24-hour behaviour, daily activities, stage of the condition), special questions (general health, drugs, steroids, anticoagulants, recent unexplained weight loss, rheumatoid arthritis, spinal cord or cauda equina symptoms, dizziness, recent x-rays), history of presenting condition (history of each symptomatic area, mechanism of injury, how and when it started, how it has changed), past medical history (relevant medical history), previous history of same condition, effect of previous treatment, social and hereditary conditions (age and gender, home and work situation, dependants and leisure activities), pain scales.

Objective assessment: Biomechanical (observations, posture, gait, functional testing, leg lengths), musculoskeletal (observations, palpation, active and passive range of movement, muscle strength, joint integrity testing, muscle length testing), neurological (observations, dermatomes, myotomes, reflexes, neurodynamic testing), indications for complex massage/soft tissue methods vs. referral to medical and/or healthcare professional.

Importance of obtaining information before commencing any sports massage: To ensure problem is within scope of practice, to ensure clients are referred accordingly, to help form treatment plan, to eliminate any possible dangers to client and practitioner, to gain informed consent, to identify any possible cautions and contra-indications.

Cautions and contra-indications: Possible dangers to client and/or practitioner, absolute contra-indications (GP consent, or no massage to be carried out), local contra-indications (avoid the area, but other areas can be treated), temporary contra-indications (may not treat this time but could in future, e.g. fever), contra-indications (acute trauma, tumour, open wounds, frostbite, acute soft tissue, circulatory disorders, fractures, bursitis, periostitis, myositis ossificans, infections, skin disorders, allergic conditions, areas of altered skin sensation), red flags (symptoms that may indicate serious pathology/disease or indicate the need for referral). N.B. this is not an exhaustive list.

Importance of recognising clients with pre-existing conditions and problems: May be outside the practitioner’s scope of practice, may pose a danger to client

UV5038968

or therapist, may need to obtain GP or specialist clearance before massaging, client may be receiving treatment and massage may interfere with treatment, adjustments may be needed to the planned sports massage strategy, pre-existing conditions may be a causal factor/influence.

Outcome 3: Be able to assess clients for complex sports massage/soft tissue methods (continued)

Outcome 4: Be able to devise complex sports massage/soft tissue strategies for clients

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Indications for complex sports massage/soft tissue methods: Part of general conditioning programme, injury prevention, maintenance, pre-event (aid pre-exercise preparation, prepare psychologically), post-event (aid post-exercise recovery), during events, post-travel, injury treatment, soft tissue dysfunction.

General indications for massage: Relaxation, anxiety reduction, stimulation, increase range of movement, increase tissue mobility/flexibility, decrease of muscle tone, enhance local circulation, remove waste products, enhance immune function, exercise recovery, inflammation management, nerve impingement, pain management, soft tissue dysfunction.

Devise complex sports massage/soft tissue strategies: Amalgamation of complex sports massage and soft tissue methods, give justification for strategy, meet aims and objectives of the treatment, meet client needs, strategy to be negotiated and agreed with client, agree short/medium /long term goals, if necessary refer/involve other healthcare professionals.

Present aims and objectives: Full information to be given to client to gain informed consent, client then knows exactly what to expect, clear up any misconceptions, ensures client is clear about possible outcomes, client is fully prepared for the treatment, ensure that client understands nature/purpose/effects/probable outcome/techniques/mediums/positions/equipment that are to be used, provide justification for chosen complex sports massage/soft tissue methods.

Removal of massage mediums: Allergic reaction, rash, potential interference of drug testing in sport, abide with rules of the sport, interference with performance, when using techniques that do not require a medium, when depth is required, when performing trigger point/neuromuscular techniques.

Properties/content of massage mediums: Types and properties (oils (vegetable, mineral, creams, lotions, gels, wax, talc), properties that may cause adverse reactions.

Adverse reactions to complex sports massage/soft tissue methods: For example rash/folliculitis/itching/redness/pain/inflammation/swelling/fever/headaches.

Markers to measure effects of complex massage/soft tissue methods: Objective and subjective markers, critically evaluate subjective and objective markers, markers (pain scales, measurements of swelling, muscle length/strength, muscle tone, measurement of an increase or decrease in the ability to perform an activity, range of movement, client feedback and appearance, satisfaction questionnaires).

Outcome 5: Be able to apply complex sports massage/soft tissue methods

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Importance of client positioning: For effective application of complex sports massage/soft tissue methods, for effective application on different body areas, for dignity and comfort of client, for practitioner to be able to maintain correct postural and manual handling techniques, practitioner access to area/client.

Correct positioning: With/without couch (bench, floor, mat, chair), working in team dressing rooms, working pitch side, working through towels/clothing, positioning (prone, supine, side lying, sitting, standing), adjust position as appropriate (maintain comfort/dignity of client, safety of practitioner, effectiveness of application).

Prepare relevant body areas for sports massage/soft tissue methods: Appropriate positioning for support, to ensure effectiveness of technique, draping, degree of exposure, exposure of massage area only, cleanse area if appropriate, use of massage medium or not.

Complex sports massage/soft tissue methods: Connective tissue massage (definition – a reflex therapy that influences cutaneovisceral autonomic reflexes), proprioceptive neuromuscular facilitation (including patterning movement), myofascial techniques (definition – a system of fascial work intended to release, stretch, and influence the orientation of the fascia), neuromuscular techniques (definition – the group of soft tissues techniques that effect a change in the neuroendocrine system with the aim of improving the local tension state of soft tissue), soft tissue release, positional release/strain-counterstrain techniques.

Application of complex sports massage/soft tissue methods: Working posture,

contour of hands, position of hands, correct alignment of practitioner joints, stance, depth of pressure, direction of movements, speed and rhythm of strokes in varying positions and environments, adaptation of techniques to suit client needs and in context of presenting conditions and delivery environment.

Adaptation of complex sports massage/soft tissue methods to a range of conditions/situations in which you are working: Pre-event, post-event, maintenance, post-travel, corrective, injury (stage of inflammation – acute, sub-acute, proliferation, regeneration), pre-existing conditions, disease processes, appropriate techniques to use, use of space and time, sports specific limitations and adaptations.

Working with cautions and contra-indications: Within scope of practice, dealing with pre-existing conditions and disease, recognising absolute contra-indications, working with local or temporary contra-indications, working with factors that require caution (e.g. low pain threshold, pregnancy, sub-acute injury, pre-existing conditions, disease), follow protocol for working with contra-indications and cautions.

Respond and record: Respond to client feedback (verbal, non-verbal), adverse reactions (visual and oral), change complex sports massage/soft tissue method as appropriate, change massage variable (technique, depth, pressure, speed, rhythm), practitioner observation of the effects of treatment, record the complex sports massage/soft tissue methods, note variations between planned and actual sports massage in records, record adverse reactions.

Outcome 5: Be able to apply complex sports massage/soft tissue methods (continued)

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Removal of massage medium: Assist with removal of mediums as appropriate, provide clients with appropriate materials to remove mediums, consider in clinic or sporting context, consider consequences of not removing the medium on the sport or performance, provide materials (wipes, cleansing agents, couch roll).

Respond appropriately to pre-existing conditions and disease processes: Work within scope of practice, refer to healthcare professional, adapt treatment/techniques as necessary, research of condition and medication.

Assess and manage risk: Ongoing risk assessment as circumstances change, anticipating and effectively taking steps to avoid and manage risk, precautions to take.

Outcome 6: Be able to evaluate the effectiveness of complex sports massage/soft tissue methods

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Importance of accurate client reassessment: Reasons why reassessment may be necessary, evaluation of sports massage aims and objectives, adverse reactions to sports massage, outcome, evidence for practice.

Reassessment of client: Identify any adverse reactions, use subjective and objective markers, measure effectiveness.

Gain feedback: Opportunities for feedback, before/during/after sports massage and subsequent sports massage, empowerment, rapport, verbal, written, non-verbal, contradictions in message received, measured against achievement of sports massage objectives.

Feedback opportunities: Client is part of the process, empowerment, rapport, critical treatment information, before/during/after treatment and subsequent treatment, verbal, written, importance of providing opportunities.

Critically evaluate methods for obtaining feedback: Questionnaire, survey, interview, informal discussion, providing opportunities throughout treatment, verbal and written forms, critically evaluate methods.

Analysis of feedback against aims and objectives: Interpretation, strengths and weaknesses of different elements of treatment, strengths and areas for improvement, reflective practice, inform on future treatment planning.

Importance of providing opportunities for further feedback: Involve client, empowerment, build rapport.

Provide appropriate advice: Give advice within scope of practice, possible

adverse reactions, rehydration, contra-actions (headache, fever, soreness, bruising, erythema, pain, stiffness), control of inflammation (protect, rest, ice, compression, elevation – PRICE), referral to other appropriate healthcare professionals/coaches if required.

Provide opportunities for client questions and/or feedback: Encourage feedback/questions, clarification on understanding.

Importance of evaluating effectiveness of sports massage soft tissue methods: Amalgamation of feedback, during sports massage reassessment and post-sports massage assessment, achievement of aims and objectives, future improvements to sports massage strategy.

Critical evaluation of objective/subjective markers: Carry out critical evaluation of subjective/objective markers, suggest adaptations, more appropriate markers.

Range of markers: Markers, outcome measures, validity and reliability of markers, effectiveness, application, appraisal.

Critical evaluation of short/long-term effectiveness of massage/soft tissue strategies: Carry out critical evaluation, suggest adaptations/improvements.

Outcome 7: Be able to produce, maintain and store client records

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Importance of accurate/confidential record keeping: Legal requirements, confidentiality, data protection, recording details of the sports massage and its effects, format (subjective, objective, analysis and plan (SOAP)), importance.

Producing records as legally required: Clear and accurate, in logical format, in legible writing, in permanent ink, completed within 24 hours of treatment, initialled when corrections are made, without judgmental statements, initialled and dated for each treatment, signed by practitioner on each page of records.

Importance and process of referral: Scope of practice, identification of relevant healthcare professionals, process of referral, referral letter to healthcare professional, assessment report, details of any sports massage or advice given, importance of referral.

Following healthcare professional’s advice: Professionalism, scope of practice, multi-disciplinary, optimum client care, why the advice of a healthcare professional must be followed, importance of adherence.

Storage of records: Paper and electronic records, legal requirements, company policy, data protection, when client records must be destroyed as legally required.

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Notes Use this area for notes and diagrams

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