Application
This unit describes the skills and knowledge required to assess the needs of clients presenting with soft tissue dysfunction, musculoskeletal imbalance or restrictions in range of motion (ROM). It requires the ability to gather client information, conduct specific tests and bring information together to develop a remedial massage treatment plan. There is a strong focus on functional anatomy.
This unit applies to remedial massage therapists.
The skills in this unit must be applied in accordance with Commonwealth and State/Territory legislation, Australian/New Zealand standards and industry codes of practice.
Elements and Performance Criteria
ELEMENT | PERFORMANCE CRITERIA |
Elements define the essential outcomes | Performance criteria describe the performance needed to demonstrate achievement of the element. |
1. Determine scope of client needs | 1.1 Explore and clarify client expectations 1.2 Provide clear information about scope and limits of services to be provided 1.3 Collect an accurate, relevant and organised health record, and document in a form which can be interpreted readily by other professionals 1.4 Recognise needs that are beyond scope of own practice and make referrals to other health care professionals as required 1.5 Identify and respond to any barriers to information gathering and assessment 1.6 Seek client information respectfully and sensitively, using purposeful, systematic and diplomatic questions 1.7 Manage information in a confidential and secure way |
2. Make a physical assessment | 2.1 Provide information about the physical assessment process and obtain client consent to proceed 2.2 Follow clinical and practitioner hygiene procedures 2.3 Respect client dignity and anticipate sensitivities 2.4 Seek client feedback on comfort levels 2.5 Assess client through palpation, observation and ROM testing 2.6 Identify variations from normal posture or structural function in relation to presenting symptoms 2.7 Analyse static and dynamic variables of posture through use of functional and special testing indicated by presenting condition 2.8 Use ongoing questioning with client to gain further information as required 2.9 Accurately document information from the physical assessment |
3. Develop treatment plan | 3.1 Correlate results of physical assessment with case history 3.2 Consider available medical information and incorporate into analysis within scope of own practice 3.3 Identify condition according to stage and related implications 3.4 Identify and respond to indications or contraindications for remedial massage 3.5 Determine optimum type, duration and frequency of treatments 3.6 Use professional judgement to draw substantiated conclusions about treatment needs 3.7 Establish expected treatment outcomes based on the remedial massage framework and evidence 3.8 Accurately document proposed treatment plan |
4. Confirm assessment and treatment plan with client | 4.1 Discuss assessment, its implications and rationale for treatment with the client 4.2 Assign and agree treatment priorities and expectations in consultation with the client 4.3 Schedule times and session lengths suited to the required techniques and sequences 4.4 Respond to client enquiries using language the client understands 4.5 Discuss referral and collaborative options with the client as required |
Evidence of Performance
The candidate must show evidence of the ability to complete tasks outlined in elements and performance criteria of this unit, manage tasks and manage contingencies in the context of the job role. There must be evidence that the candidate has:
performed the activities outlined in the performance criteria of this unit during a period of at least 200 hours of massage client consultation work
prepared for and managed at least 60 remedial massage musculoskeletal assessments - clients must include males and females from different stages of life with varied presentations
used remedial massage assessment techniques appropriately, including:
discussion
muscle strength and length tests
observation, including variations of posture
orthopaedic tests
palpation of prominent bones/structure and phasic and postural muscles
ROM tests
temperature
interacted effectively with clients:
clearly articulated information about services, treatment options and rationale
engaged clients in decision making
Evidence of Knowledge
The candidate must be able to demonstrate essential knowledge required to effectively complete tasks outlined in elements and performance criteria of this unit, manage tasks and manage contingencies in the context of the work role. This includes knowledge of:
legal and ethical considerations (national and state/territory) for client assessment:
codes of conduct
duty of care
informed consent
mandatory reporting
practitioner/client boundaries
privacy, confidentiality and disclosure
records management
work role boundaries:
working within scope of practice
presenting symptoms that require referral to a medical practitioner
work health and safety
referral options for practitioners:
professional health services including complementary health modalities
community resources and support services
types and availability of further medical testing
factors and barriers that may impact on assessment, including:
physical
psychological
cultural
factors that affect individual health status, including:
age
gender
constitution
lifestyle
diet
personal and medical history
values and attitudes
balance of rest and activity
physical environment
social environment
client information required for remedial massage assessment and the scope and depth of information needed around:
client expectations
client history and its components
client current state of health
signs and symptoms
onset
duration
location
quality and severity
non-verbal
protocols for performing physical massage assessments:
environment
equipment
client privacy
client instructions
remedial massage diagnostic techniques, how and when they are used:
discussion
muscle strength and length tests
observation, including variations of posture
orthopaedic tests
palpation of prominent bones/structure and phasic and postural muscles
ROM tests
temperature
contraindications to treatment and possible indications for referral:
weak bone/joint instability
neurological dysfunction
vascular disorders
lack of working diagnosis
pain of excessive nature or abnormal responses to treatment
patient non-compliance
anatomy:
body systems relevant to massage assessment
muscular physiology
nervous system, including myotomes, peripheral nerves, nerve impingements (both root and peripheral)
integumentary
skeletal
muscles – major muscle actions including individual actions, planes and synergistic groups:
temporalis
masseter
frontalis
pterygoids
longus colli
digastric
rectus capitis posterior
obliquus capitis superior
obliquus capitis inferior
splenius capitis
splenius cervicis
semi-spinalis capitis
scalenes
sternocleidomastoid
trapezius
levator scapulae
latissimus dorsi
supraspinatus
infraspinatus
teres major
teres minor
subscapularis
rhomboids
pectoralis major
pectoralis minor
serratus anterior
intercostals
serratus posterior superior
rectus abdominis
quadratus lumborum
psoas
transverse abdominis
internal/external obliques
erector spinae
semispinalis
multifidus
rotatores
gluteus maximus
gluteus medius
gluteus minimus
piriformis
gemellus superior/inferior
obturator internus and externus
quadratus femoris
quadriceps
sartorius
gracillis
pectineus
tibialis anterior
tibialis posterior
peroneals
flexor digitorum longus
flexor hallucis longus
hamstrings
adductor magnus
adductor longus
popliteus
gastrocnemius
soleus
extensor digitorum longus
extensor hallucis longus
deltoid
biceps brachii
triceps brachii
flexor carpi radialus
flexor carpi ulnaris
palmaris longus
pronator teres
brachioradialis
brachialis
extensor carpi radialis
supinator
anconeus
coracobrachialis
thenar muscle
skeleton:
bones of the body
major bony landmarks
surface anatomy and palpable bony landmarks
bone growth and remodelling
bony landmarks pertaining to muscles
joints:
joint classifications – fibrous, cartilaginous, synovial (glide, plane, ball/socket, saddle, hinge, condyloid, pivot)
joint actions
detailed joint anatomy for each major joint (shoulder, hip, sacroiliac, knee, ankle/foot, wrist, elbow, acromioclavicular, sternoclavicular, costal, spine, atlanto-occipital, temporomandibular)
accessory/secondary/coupled motions of joints
capsular restrictions and patterns
physiology:
soft tissue:
muscle contraction
muscle physiology (reflexes, chemistry, proprioceptors)
tendons and ligaments
fascia
hard tissue:
bone growth and development
abnormal bone growth
conditions commonly seen by massage therapists, including:
neck, back pain and headache
muscle, connective tissue and joint pain
arthritis
repetitive strain injuries and occupational overuse syndromes
postural problems
sports and activity related conditions
stress, anxiety and other mood related problems
treatment planning techniques and considerations
Assessment Conditions
Skills must have been demonstrated in the workplace or in a clinical environment that reflects workplace conditions. The following conditions must be met for this unit:
use of suitable facilities, equipment and resources, including:
health assessment/client consultation forms
private consultation area
adjustable height massage table
towels/sheets for draping
oils/balms
hot/cold packs
bolsters
modelling of industry operating conditions, including provision of services to the general public
clinic supervision by a person who meets the assessor requirements outlined below for at least 150 of the 200 hours of client consultation work
Assessors must satisfy the Standards for Registered Training Organisations (RTOs) 2015/AQTF mandatory competency requirements for assessors.
In addition, assessors must:
have current clinical experience working as a massage therapist providing services to the general public
hold practising membership of an Australian professional body that represents massage therapists
fulfil the continuing professional development requirements of the professional body to which they belong
Foundation Skills
The Foundation Skills describe those required skills (language, literacy, numeracy and employment skills) that are essential to performance.
Foundation skills essential to performance are explicit in the performance criteria of this unit of competency.