Elements and Performance Criteria

Factors which interfere with the effectiveness of treatment may include:
Other medical treatment being undertaken
Client/patient's physical and psychological readiness and/or wellness
Cultural factors
Contra-indications to treatment such as:
Pain-local sharp, dull, achy, deep, surface
Infection or infectious diseases
Fatigue
Inflammation
Lumps and tissue changes
Rashes and changes in the skin
Oedema
Mood alterations, eg. depression, anxiety
Changes in habits such as appetite elimination or sleep
Bleeding and bruising
Nausea, vomiting or diarrhoea
Temperature - hot/cold
Post massage activity
Age

Mode of administration may include:
Exposure of sections of body
Draping - rotating of exposure around the body
Use of oils and treatments
Requirement for feedback and interaction
Massage technique
Variations in application intensity
Requirement for specified positioning of client/patient

Reactions may include:
Pain and/or discomfort
Feedback - verbal, tactile, visual
Muscular spasms
Allergy to oils or treatments used
Temperature discomfort
Joint sounds (spontaneous cavitation)
Relaxation
Emotional release

Responses to reactions may include:
Adjusting treatment accordingly
Seeking appropriate expertise or referral
Discussing reaction with the client/patient
Adhering to clinic guidelines for response to accidents and emergencies
Using first aid procedures according to St Johns, Australian Red Cross or other appropriate first aid training
Maintaining a senior first aid certificate which is renewed at least every three years
Accessing local, emergency services

Consent for treatment refers to:
Informed consent according to the local and national regulations and legal guidelines
In the case of a minor or a ward of the state that an appropriate adult be present during any examination

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. These include but are not limited to:
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 palm surface of the hands to cover large surface areas of the body
Longitudinal stroking:
Deep gliding movement is applied in the direction of the muscle fibres through focal pressure using any of the following;
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
Kneading/petrissage
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
Compressive techniques
Digital pressure
Compression: successive and rapid pressure, ie 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
Temperature therapy
Conduction, eg heat packs and immersion baths
Radiation, eg ray lamps
Friction
Topical applications
Deep tissue massage techniques
Myofacial release: 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
Stretching
Stretching techniques
Static stretching
Dynamic stretching
Ballistic stretching
Proprioceptive Neuromuscular Facilitation stretching: contract-relax and hold-relax

Advise and resource the client/patient refers to:
Providing relevant literature or information materials
Referring client/patient to other information sources
Providing advice regarding self-care
Advising client/patient of suggested resources
Providng of details which help to fully inform patient/client of relevant information
Providing referrals to other health professionals
Availability of products required or suggested for treatment
Postural correction advice

Practical techniques that promote and maintain optimal health may include:
Postural improvement strategies eg ideal posture for activities
Discussion of causes of poor posture
Simple follow-up activities and/or strategies to work on between sessions
Activities and/or tasks to avoid
Self-massage techniques

Critical aspects of assessment:
Treatment plans are implemented to achieve optimal health, rehabilitation, or to improve quality of life which involve:
Treatment of a range of conditions/disease states
Demonstration of the application of all of the techniques listed under the range of variables:
Petrissage/kneading
Effleurage including cross over stroke, longitudinal stroking, gliding techniques
Passive joint movement techniques
Passive soft tissue movement
Friction techniques
Vibration
Compressive techniques including digital ischemic pressure
Percussion techniques
Temperature therapy
Deep tissue massage techniques
Myofascial release
Manual lymphatic drainage
Proprioceptive neuromuscular facilitation
Trigger point release techniques
Stretching techniques
Mobilising techniques
Treatment according to the individual, the condition and the presence of complicating factors. It must be the safest, most efficacious method that is also cost effective to the patient
A case requiring referral to another health care professional
Preparation of the patient for treatment according to massage principles
Provision of treatment
Complete documentation of all recommendations and client/patient responses
Review of treatment plan
All treatment or care delivered is consistent with legislative and regulatory requirements

Concurrent assessment and relationship with other units:
Communicate effectively with clients
Contribute to the control of infection
Work effectively within the health industry
OHS
First Aid

Underpinning knowledge and skills:
Knowledge of history, philosophy and beliefs of massage therapy within a health framework
Understanding of physiology and anatomy according to massage therapy
Knowledge of best practice massage therapy principles
Knowledge of structure and function of anatomical systems appropriate to massage therapy and the scope of practice
Understanding of the fundamental principles of biomechanics and functional anatomy
Ability to identify prominent bones/structure and phasic and postural muscles
Ability to palpate prominent bones/structure and phasic and postural muscles
Knowledge of the organisation of the body
Knowledge of the systems and regions of the body
Knowledge of the structure and function of the articular system.
Classification of joints and types and ranges of motion
Knowledge of the structure and function of the nervous system
Knowledge of regional anatomy
Knowledge of the structure and function of the lymphatic system
Knowledge of the structure and function of the respiratory system
Knowledge of the reproductive system
Knowledge of the endocrine system
Knowledge of the structure and function of the immune system
Knowledge of the structure and function of the cardiovascular system
Knowledge of pathology and symptomology
Knowledge of indications and contra-indications for massage
Knowledge of advanced assessment procedures and options allowing complex regional assessments
Skills in applying advanced assessment techniques
Demonstrated ability to comprehend common medical terminology
Ability to identify bone landmarks, structures and individual muscles through palpation
Knowledge of the situation and referral patterns of trigger points
Knowledge of the processes of biological maturation
Knowledge of the role of massage in enhancing growth
Knowledge of pain and chronic pain syndromes
Knowledge of the role of massage in alleviating depression and anxiety
Knowledge of the role of massage in enhancing attentiveness
Knowledge of the role of massage in immune disorders
Knowledge of the role of massage in auto-immune disorders
Knowledge of the processes of aging
Ability to gather and interpret information through the tactile senses
Knowledge of technical and practical knowledge of treatment
Ability to manage time throughout consultation and treatment
Ability to write referrals, appraisal letters for insurance companies and other documentation
Knowledge of ethical, legal and regulatory implications of treatment
Ability to use equipment and resources competently and safely
Ability to communicate effectively with client/patient/other health practitioners
Ability to transcribe assessment findings and treatment in a patient history using accepted medical terminology
Ability to identify and describe a treatment outcome using accepted medical terminology

Resource implications:
Resource requirements may include:
An appropriately stocked and equipped clinic or simulated clinic environment
Relevant texts or medical manuals
Relevant paper-based/video assessment instruments
Appropriate assessment environment
Demonstration model/client/patient

Method of assessment:
Assessment may include:
Practical demonstration
Simulations
Explanations of technique
Oral questioning and discussion
Case studies and scenarios

Context of assessment:
This unit is most appropriately assessed in the workplace or in a simulated workplace and under the normal range of work conditions. Assessment may contain both theoretical and practical components and examples covering a range of clinical situations and client groups.