Elements and Performance Criteria

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.


Clientsmay include:
Athletes who:
are usually committed and self-motivated to return to optimal function and/or improve performance can be so motivated that unnecessary pain is tolerated in mistaken belief that 'no pain, no gain'
can be talented with various levels of motivation and commitment
may be beginner through to high performance level competitors
can be
female or male
with or without a disability or special needs
with or without social disadvantage
and/or from minority ethnic and cultural groups


Common musculoskeletal injuries may include but are not limited to:
Sporting injuries that may be divided into acute injuries and overuse injuries which include:
bones
acute
fracture
periosteal contusion
overuse
stress fracture
'bone strain', 'stress reaction'
osteitis/periostitis
apophysitis
articular cartilage
acute
osteochondral/chondral fractures
minor osteochondral injury
chondropathy, eg, softening, fibrillation, fissuring, chondromalacia
acute
dislocation
subluxation
overuse
synovitis
osteoarthritis
continued ...


Common musculoskeletal injuries (contd):
Ligament injuries:
acute
sprain/tear (grades I - III)
overuse
Muscle injuries:(and associated extrinsic and intrinsic fascia)
strain/tear (grades I - III)
contusion
cramp
acute compartment syndrome
overuse
chronic compartment syndrome
delayed onset muscle soreness
focal tissue thickening/fibrosis
Tendon injuries:
acute
tear (complete or partial)
overuse
tendinitis
paratendinitis/tenosynovitis
tendinosis
tendinopathy
Bursa injury:
acute
traumatic bursitis
overuse
bursitis
Nerve injury:
acute
neuropraxia
minor nerve injury/irritation
overuse
entrapment
increased neural tension
altered adverse neurodynamics
Skin injury:
acute
laceration
abrasion
puncture wound
overuse


Contraindications for massage may include:
Massage therapists are not expected to diagnose any conditions but must be able to recognise the indications and contraindications of conditions
Massage is contraindicated 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


Cryotherapy includes:
Application of fundamental forms of cryotherapy refers to
conduction, eg, cold packs, ice massage and immersion baths
convection, eg, cooling devices
Possible adverse reactions to topical applications of cryotherapy refers to
skin irritations
neural irritations
muscle cramps
Indications for cryotherapy refers to
acute injury
inflammation
Contraindications and precautions for cryotherapy refers to
any contraindication for massage
in particular
skin disorders
open wounds
Correct duration for cryotherapy refers to
adequate time to achieve cryotherapy goals without adverse reactions, eg, Huntington's response
usually 10 minutes


Industry standard massage therapy principles may include:
Relevant national, state/territory or local massage therapy organisations' and/or associations' Code of Ethics or Code of Conduct documents/policies, regulations and guidelines
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


Integration of various techniques may include:
The integration of
trigger point techniques
Proprioceptive Neuromuscular Facilitation stretching
deep transverse friction techniques
myofascial tension techniques
corrective exercise
stretching including static/dynamic and contract-relax protocols


Massage therapy setting refers to:
Any genuine work environment where massage therapy is provided
clinics
change rooms
open or enclosed areas at sporting events
accommodation venues
in transit, ie, on buses, planes


Other health professionals may include:
Practitioners who can competently make assessments regarding conditions that may potentially be complicated by the application of massage techniques
Medical practitioners
Physiotherapists
Chiropractors
Osteopaths
Other massage therapists with current competencies in modalities outside the scope of the practitioner, eg, specialising in oriental modalities
Naturopaths/homeopath therapists
Podiatrists
Yoga/relaxation/tai chi instructors
Dentists
Exercise therapists
Acupuncturists


Pre-event massage may include:
Integration of treatment techniques to assist the athlete/client with
Physiological warm-up
Psychological preparation including
where appropriate, stress release, ie, relaxation
where appropriate, to raise pre-event arousal levels


Post-event massage may include:
Integration of treatment techniques to assist the athlete/client with
physiological cool-down, ie, return to homeostasis
physiological recovery, ie, removal of lactic acid
where appropriate, psychological recovery, ie, emotional stress release
identify potential injuries and commence appropriate treatment
the restoration of range of motion/flexibility


Maintenance massage may include:
A package of massage therapy techniques designed to assist injury prevention, physiological recovery, tissue extensibility, muscle tone, ie, reduction of micro-tears in myofibrils


Self-management program may include
Assisting the client in areas such as
activities or tasks to avoid
warm-ups and cool downs
simple temperature therapy techniques
self-massage techniques


Self massage techniques may include:
Using athlete/client's own hands/forearms/knuckles to perform massage techniques
Using massage equipment and other appropriate self treatment aids to perform techniques such as
ice for ice massage
tennis ball for digital ischaemic pressure and trigger point work


Technique may include:
A singular massage therapy application, eg, gliding or digital ischemic pressure


Thermotherapy (or heat therapy) may include:
Application of fundamental forms thermotherapy refers to:
conduction, eg, heat packs and immersion baths
radiation, eg, ray lamps
friction
topical applications
Indications for thermotherapy refers to:
myofascial hypertonicity, ie, stiffness
fascial adherence
Contraindications and precautions for thermotherapy refers to:
any contraindication for massage
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
Continued


Thermotherapy (or heat therapy) (contd):
In particular:
skin disorders
open wound
acute injury
acute inflammation
vascular disorders
Correct angle and distance for indirect application of thermotherapy refers to:
safe and effective placement of the heat lamp
usually 10-20 minutes
in accord with manufacturer's instructions and directions
heat source perpendicular to area to be treated
minimum distance of 30cm from area to be heated
appropriate duration for thermotherapy is described
adequate time to achieve heat therapy goals without adverse reactions
Possible adverse reactions to topical applications of thermotherapy refers to:
burning
skin irritations
re-initiate internal bleeding


Treatment package/s may include:
The combination of the assessment process, techniques, modalities and attitudes to achieve prescribed outcomes
Incorporates the application of the
principles of relaxation massage, and/or
principles of remedial massage therapy
Can incorporate other modalities depending the current competencies of the therapist


Treatment plan/s may include:
Agreed duration, dependent on the performance parameters and within the scope of the therapists current competencies
Individualisation to the athlete/client's requirements
Referral of the athlete/client to an appropriate health practitioner in relation to areas/aspects in which the therapist is not currently competent
Sequence of events incorporating the application of advanced treatment packages negotiated between the therapist and the athlete/client leading to a desired outcome
Steps designed to return the athlete/client to optimal function

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:
Access to athlete/client
Massage therapy facilities in a massage therapy setting, or competition/activity setting
Massage therapy equipment


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
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 after or in conjunction with the following related units:
HLTAP501B Analyse health information
HLTREM502C Provide remedial massage treatment
HLTREM503C Plan the remedial massage treatment strategy
HLTREM504C Apply remedial massage assessment framework
HLTREM505C Perform remedial massage health assessment
HLTREM510B Provide specialised massage treatment