Elements and Performance Criteria

RANGE STATEMENT

The Range Statement relates to the unit of competency as a whole. It allows for different work environments and situations that may affect performance. Add any essential operating conditions that may be present with training and assessment depending on the work situation, needs of the candidate, accessibility of the item, and local industry and regional contexts.


Remedial massage principles refers to:
Principles and practices of the remedial massage therapy framework:
relevant code of ethics or code of conduct documents/policies, regulations and guidelines state/territory or local massage therapy organisations and/or associations
relevant national, state/territory or local government regulations and guidelines
accepted preventative practices adopted by self or peers to minimise safety hazards and risks in the same or similar situations
current and past good practice demonstrated by self or peers in the same or similar situation


Contraindications to treatment and possible complicating factors may include:
Massage therapists are not expected to diagnose any conditions but must be able to recognise the indications and contra-indications of conditions
Massage is contra-indicated in all infectious diseases suggested by fever, nausea and lethargy until a diagnosis is received and recommended by a medical practitioner
Always refer for diagnosis when symptoms do not have a logical explanation. Indications for referral include:
pain local, sharp, dull, achy, deep, surface
fatigue
inflammation
lumps and tissue changes
rashes and changes in the skin
edema
mood alterations, eg depression, anxiety
infection
changes in habits such as appetite elimination or sleep
bleeding and bruising
nausea, vomiting or diarrhoea
temperature-hot or cold
Endangerment sites are areas where nerves and blood vessels lie close to the skin and are not well protected:
anterior triangle of the neck
posterior triangle of the neck
axillary area
medial epicondyle
lateral epicondyle
area of the sternal notch and anterior throat
umbilicus area
twelfth rib dorsal body
sciatic notch
inguinal triangle
popliteal fossa


Massage techniques:
To be performed in a variety of positions, ie standing, seated, prone, supine and side recumbent lying, and through clothing as well as conventional table massage. This may include:
Passive joint movement techniques
joints are moved through their range of movement, ie to the point of mild tissue resistance
Passive soft tissue movement
technique is applied with palmer surfaces of the hand, heel of hand and/or fingers
jostling: shaking of the muscle from origin to insertion
Gliding techniques
effleurage: broad superficial strokes using the entire palmer surface of the hands to cover large surface areas of the body are exhibited
longitudinal stroking: deep gliding movement is applied in the direction of the muscle fibres through focal pressure using fingers, palm, heel of hands, forearm and/or knuckles
transverse gliding
cross over stroke: pulling and pushing of the tissue using the hands in a criss-cross manner is exhibited
Kneading
technique is applied with palm surface of the hand, heel of hand and/or fingers
soft tissue is mobilised with rhythmical circular rolling, squeezing or pulling movements
Friction techniques
superficial tissue is moved over an underlying structure in circular, longitudinal or transverse directions
deep repetitive movements of short amplitude are applied usually with thumbs, fingers and knuckles
friction techniques are believed to be beneficial in releasing adherent/scar tissue
Continued:
Massage techniques:
(continued)
Compressive techniques
digital pressure
compression: successive and rapid pressure - a series of short duration compressions, is applied to soft tissue between two structures, ie underlying bone structures and therapist's hand, or hand to hand
percussion: cupping, tapping, hacking, pummelling and flicking are applied rhythmically using the hands
Petrissage
Temperature therapy
conduction, eg heat packs and immersion baths
radiation, eg ray lamps
friction
topical applications
Deep tissue massage techniques
Myofascial tension technique
Techniques conducted on superficial and/or deep tissues to:
lengthen tissue
reduce adhesions
increase range of movement
decrease compartment pressure
restore elasticity
Manual lymphatic drainage
Trigger point release techniques
apply digital ischemic pressure and/or apply stretching after treatment. it incorporates ischemic pressure and stretching
Stretching techniques
contract-relax
dynamic stretching
hold-relax
muscle energy technique
proprioceptive neuromuscular facilitation stretching
static stretching


Client constitution refers to:
Age, fragility
Fitness
Mental attitude
Muscle tone
Tolerance of pain


Client compliance refers to:
Ability to follow instructions or suggestions
Willingness/motivation to follow instructions or suggestions


Discrepancies may include:
Client is unaware of the immediate danger of their condition
Client is over anxious about their condition
Client is unaware of maintaining causes acting on their condition
Practitioner is unaware of some implications of the client's condition
Practitioner and client have different views of what the main problem is


Discussion may include:
Face to face discussion
Electronic communication
Telephone discussion


Practitioner responsibilities may include:
Isolating the sick person
Provide advice on public health matters
Commitment to the treatment plan
Discussing relevant contra-indications or potential complications to treatment
Review of treatment plan


Clientresponsibilities may include:
Following instruction/advice during and post treatment
Advising practitioner of any relevant contra-indications or potential complications to treatment
Advising practitioner of compliance issues
Commitment to the treatment plan


Treatment evaluation strategies may include:
Discussion and review of response to treatment
Reviewing achievement of treatment goals
Monitoring time frame for achieving treatment goals

EVIDENCE GUIDE

The evidence guide provides advice on assessment and must be read in conjunction with the Performance Criteria, Required Skills and Knowledge, the Range Statement and the Assessment Guidelines for this Training Package.

Critical aspects for assessment and evidence required to demonstrate this competency unit:
The individual being assessed must provide evidence of specified essential knowledge as well as skills
Observation of performance in the workplace or a simulated workplace (defined as a supervised clinic)
Consistency of performance should be demonstrated over the required range of situations relevant to the workplace
Where, for reasons of safety, space, or access to equipment and resources, assessment takes place away from the workplace, the assessment environment should represent workplace conditions as closely as possible
Assessment may contain both theoretical and practical components and examples covering a range of clinical situations
Assessment of sole practitioners must include a range of clinical situations and different client groups covering at minimum, age, culture and gender
Assessment of sole practitioners must consider their unique workplace context, including:
interaction with others in the broader professional community as part of the sole practitioner's workplace
scope of practice as detailed in the qualification and component competency units
holistic/integrated assessment including:
working within the practice framework
performing a health assessment
assessing the client
planning treatment
providing treatment


Context of and specific resources for assessment:
An appropriately stocked and equipped clinic or simulated clinic environment
Relevant texts or medical manuals
Anatomical models
Relevant paper-based/video/electronic assessment instruments
Appropriate assessment environment


Method of assessment
Observation in the workplace
Written assignments/projects or questioning should be used to assess knowledge
Case study and scenario as a basis for discussion of issues and strategies to contribute to best practice
Explanations for plan preparations
Oral questioning and discussion
Clinical skills involving direct client care are to be assessed initially in a simulated clinical setting If successful, a second assessment is to be conducted during workplace application under direct supervision


Access and equity considerations:
All workers in the health industry should be aware of access and equity issues in relation to their own area of work
All workers should develop their ability to work in a culturally diverse environment
In recognition of particular health issues facing Aboriginal and Torres Strait Islander communities, workers should be aware of cultural, historical and current issues impacting on health of Aboriginal and Torres Strait Islander people
Assessors and trainers must take into account relevant access and equity issues, in particular relating to factors impacting on health of Aboriginal and/or Torres Strait Islander clients and communities


Related units:
This unit should be assessed in conjunction with the following related units:
HLTCOM404C Communicate effectively with clients
HLTREM504C Apply remedial massage assessment framework