Learner name:

Learner number:

J/506/9016

VRQ

USP50

Provided complex massage techniques for sports massage

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Statement of unit achievement

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VTCT is the specialist awarding organisation for the Hairdressing, Beauty Therapy, Complementary Therapy, Hospitality and Catering and Sport and Active Leisure sectors, with over 50 years of experience.

VTCT is an awarding body regulated by national organisations including Ofqual, SQA, DfES and CCEA.

VTCT is a registered charity investing in education and skills but also giving to good causes in the area of facial disfigurement.

USP50Provide complex massage techniques for sports massage

The aim of this unit is to develop the knowledge, understanding and skills to carry out a range of complex massage techniques, to include myofascial, proprioceptive neuromuscular facilitation (PNF), positional release and active isolated stretching. You will practise and explore the protocols to follow and be able critically to evaluate the effects and benefits of each technique.

Practically you will be able to prepare, apply and evaluate complex massage techniques, and locate the soft and bony structures associated with each treatment area. You will then be able to adapt the treatment plan based on the evaluation of the treatment.

You will expand your knowledge of basic aftercare for rehabilitation (mobility relevant to the client’s condition, proprioception and isometric strengthening) and understand the purpose, benefits, safety, contra-indications and side effects of each. You will be fully equipped to present clients with appropriate aftercare advice linked to their needs and goals.

You will also explore the concept of evidence-based practice in sport, critically appraise research papers and be able to draw conclusions on support for the use of sports massage.

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GLH

Credit value

Level

Observation(s)

External paper(s)

85

18

5

5

0

On completion of this unit you will:

Learning outcomes

Provide complex massage techniques for sports massage

1. Be able to apply complex massage techniques

2. Understand the principles of complex techniques used in sports massage

3. Understand aftercare methods to complement complex massage techniques for sports massage

4. Understand evidence based practice

5. Be able to evaluate research undertaken on sports massage

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 Your tutor/assessor must adhere to the ‘Assessment Guidance and Evidence Requirements’ for this unit. This can be found under documents on the relevant qualification page at www.vtct.org.uk. 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 allowed in this unit.

3. Observation outcomes Competent performance of Observation outcomes must be demonstrated on at least five occasions on a minimum of 5 different clients. 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.

4. Range All ranges must be practically demonstrated.

Achieving observation outcomes

Achieving observations

USP50

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.

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Tutor/assessor guidance

Best practice should be encouraged by giving students the opportunity to work on real clients and in real environments e.g. events. However, as this is not always possible and may create barriers to assessment, students may carry out treatments on peers in simulated environments.

Your tutor/assessor must adhere to the ‘Assessment Guidance and Evidence Requirements’ for this unit. This document will give guidance for the tutor/assessor on breadth and depth of content that must covered in this unit. This can be found under the documents tab on the relevant qualification page at www.vtct.org.uk.

Achieving range

The range section indicates what must be covered. Ranges should be practically demonstrated as part of an observation.

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

Learning outcome 1

Observations

You can:

Be able to apply complex massage techniques

a. Prepare clients for complex massage techniques

b. Position clients for comfort, dignity and maximal effectiveness

c. Locate bony and soft structures associated with treatment area

d. Demonstrate complex massage techniques

e. Monitor tissue response throughout treatments

f. Gain feedback from clients about the techniques throughout treatment

g. Adapt complex massage techniques to meet the needs of clients

h. Adapt own posture and position throughout application to ensure safe and effective application

i. Evaluate the effectiveness of complex massage techniques

j. Adapt treatment plan based on evaluation of treatments

k. Present aftercare advice to clients, providing opportunities for questions

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Observation 4 5 OptionalDate achieved

Criteria questioned orally

Portfolio reference

Assessor initials

Learner signature

Observation 1 2 3Date achieved

Criteria questioned orally

Portfolio reference

Assessor initials

Learner signature

*May be assessed by supplementary evidence.

Range

*You must practically demonstrate that you have:

Applied all techniques Portfolio reference

Myofascial

Positional release

PNF

Active Isolated Stretching

Used all aftercare methods Portfolio reference

Mobility relevant to condition

Proprioception

Isometric strengthening

USP506

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

Learning outcome 2

Understand the principles of complex techniques used in sports massage

You can: Portfolio reference

a. Describe a range of complex techniques used in sports massage, to include: • myofascial • positional release • PNF • active isolated stretching

b. Explain the protocols to follow for complex techniques used in sports massage, to include: • Myofascial • Positional release • PNF • Active isolated stretching

c. Critically evaluate the effects of each technique

d. Critically evaluate the benefits of sports massage for pre-existing conditions

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Learning outcome 3

Understand aftercare methods to complement complex massage techniques for sports massage

You can: Portfolio reference

a. Describe range of aftercare methods, to include: • mobility relevant to condition • proprioreception • isometric strengthening

b. Evaluate the purpose and benefits of each aftercare method

c. Explain the safe and effective use of each aftercare method

d. Explain contraindications and precautions for each aftercare method

e. Explain possible side effects and adverse effects of each aftercare method

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Learning outcome 4

Understand evidence based practice

You can: Portfolio reference

a. Explain the concept of evidence-based practice

b. Explain the importance of evidence-based practice in sports massage

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Learning outcome 5

Be able to evaluate research undertaken on sports massage

You can: Portfolio reference

a. Critically appraise research undertaken on the use of sports massage

b. Draw conclusions on support for the use of sports massage

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Learning outcome 1: Be able to apply complex massage techniques

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.

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Prepare clients: Informed consent, ensure privacy, reassure and answer questions, keep patient warm.

Position clients: Position and support patient as appropriate for techniques, drape for dignity, maintain dignity whilst moving patient.

Locate bony and soft structures: As relevant to techniques used and area being worked on.

Massage techniques: Myofascial release, positional release, PNF, active isolated stretching.

Monitor tissue responses: Visual, verbal, appropriate response, erythema, fasciculation, reflex response, relaxation of tissue, improvement in condition, muscular reaction, skin blanching.

Gain feedback: Verbal and non-verbal communication.

Adapt complex massage techniques: Increase or decrease pressure, shorten or lengthen treatment time, change patient position, release or increase stretch.

Adapt position and position: Support hands/digits, wrist alignment, correct posture, correct couch height, use of body weight.

Evaluate effectiveness: Reassessment results, patient feedback, verbal, questionnaire, subsequent treatment feedback, surveys, strengths, areas for improvement, inform future treatment plans, reflective practice.

Adapt treatment plan: Incorporate patient feedback, incorporate reassessment of outcome measures, use other techniques, further treatments, referral.

Present aftercare advice: Mobility, proprioception, isometric strengthening, within scope of practice, verbal, written, contra-actions, patient action in case of adverse effect, specific to techniques used, referral as necessary, encourage feedback/questions, clarify patient understanding.

Learning outcome 2: Understand the principles of complex techniques used in sports massage

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Complex techniques used in sports massage: Myofascial (fascial assessment, indirect, direct, superficial, deep, dry), positional release (Jones, strain/counterstrain), proprioceptive neuromuscular facilitation (PNF), CRAC (contract, relax, antagonist contract), active isolated stretching.

Protocols for complex massage techniques:

Myofascial;

Technique (myofascial - fascial assessment) – using hands to move tissue caudally, cephically, medially, laterally, diagonally to assess mobility of fascia and find point/s of restriction), active or passive.

Technique (myofascial - indirect) – superficial, light contact with fascia with relaxed hands, tissue moved to point of bind, moved towards direction of greatest ease, held for 3-5 minutes until tissues release, sustained pressure

Technique (myofascial - direct) – deep, work in direction of restriction, knuckles, elbows or tools may be used, work from superficial to deep layers of fascia, oblique angle

Contra-indications (myofascial) – malignancy, aneurysm, acute rheumatoid arthritis, advanced diabetes, severe osteoporosis, healing fractures, anticoagulant medication, cellulitis, DVT, oedema, varicose veins, local haematoma, skin hypersensitivity

Positional release:

Technique (positional release) – palpate to find tender point, apply direct pressure to point, move body into position of ease, hold

for 90 seconds, slowly lengthen muscle, repeat until normal muscle resting length is resumed.

Contra-indications for positional release – open wounds, sutures, healing fractures, hematoma, hypersensitivity, systemic or local infection, malignancy, aneurysm, acute rheumatoid arthritis, and pain during treatment positioning.

PNF;

Technique (PNF) – CRAC (passive stretch of agonist muscle, isometric contraction of agonist muscle against therapist resistance, passive stretch of agonist muscle, isotonic contraction of antagonist, stretch of agonist), breathing to enhance effect.

Contra-indications for PNF – bony block limiting ROM, recent fracture or surgery, acute inflammation or infection, sharp acute pain with stretching, haematoma, hypermobility, prior to high intensity exercise.

Active isolated stretching;

Technique (active isolated stretching) – identify muscle to be stretched, isolate muscle in relaxed state, gentle stretch to end of range, no longer than two seconds, repeat up to ten times, increase range with each stretch, return to relaxed state between each stretch, exhale on stretch, inhale on recovery, joint must be stabilised.

Contra-indications (active isolated stretching) – any of the following conditions in the area to be stretched, fractures, sprain or strain, herniated disk, degenerative joint disease, oedema, recent haemorrhage.

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Critically evaluate effects of techniques: Benefits, undesirable effects, alternatives, critique of proposed mechanism of effect.

Pre-existing conditions: Stroke, hyper/hypotension, angina, vertebral artery disease, haemophilia (mild), COPD, asthma, colitis/Crohn’s disease, diabetes, cancer, arthritis, Parkinsons disease, Motor Neurone disease, muscular sclerosis, whiplash, chronic fatigue syndrome, fibromyalgia, pregnancy.

Benefits of sports massage for pre-existing conditions: May alleviate symptoms, psychological benefits, may slow progression of disease, may provide pain relief, may maintain or increase mobility, may increase ability to perform activities of daily living, open microcirculation, relaxation.

Learning outcome 2: Understand the principles of complex techniques used in sports massage (continued)

Learning outcome 3: Understand aftercare methods to complement complex massage techniques for sports massage

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Aftercare methods:

Mobility relevant to condition – range of movement exercises in a pain free range of movement.

Proprioception – early proprioception exercises e.g. standing on one foot on the ground.

Isometric strengthening – basic isometric contractions through range of movement.

Purpose and benefit of aftercare methods:

Mobility relevant to condition – encourage release of synovial fluid, prevents adhesions, elongates soft tissue, stimulates nervous system, encourages circulation

Proprioception – promotes neuromuscular activity, regains control of joint, retrains afferent pathways, feed forward and feedback mechanism, stimulate mechanoreceptors, stimulate muscle spindles, stimulate Golgi tendon organs, restore balance.

Isometric strengthening – provides stabilisation strength, strength increased at angle of contraction only, muscular activity without joint movement.

Aftercare methods are meant as early stage rehab only, which supports and reinforces the practical work carried out by the therapist. Beyond this stage, clients should be referred to a suitable exercise professional to continue and build on their rehab e.g. Physiotherapist, Sports Therapist, Osteopath, Personal Trainer, Sports Rehabilitator.

Safe and effective use of aftercare methods:

Mobility relevant to condition – within a pain free range, start slowly under control, gradually build pace and range, static balance activities, regress as necessary.

Proprioception – remain within functional range of movement, high repetition/low resistance, environment safety, proper footwear, maintain good posture, regress as necessary.

Isometric strengthening – start at five second hold with five repetitions, work up to ten second hold with ten repetitions, inhale before contraction and exhale throughout, sub-maximal intensity, regress as necessary.

Contra-indications and precautions for aftercare methods:

Mobility relevant to condition – bony block limiting movement, acute inflammation or infection, acute pain.

Proprioception – elderly may have slowed reflexes, children under 16 have undeveloped nervous system, care to be taken with overweight patients, acute inflammation, post operatively, joint instability.

Isometric strengthening – unstable angina, uncontrolled hypertension (systolic blood pressure >160 mm Hg and/or diastolic blood pressure >100 mm Hg), uncontrolled dysrhythmias, arthritis, acute inflammation.

Side effects and adverse effects of aftercare methods:

Mobility relevant to condition – inflammation, oedema, aggravation of injury.

Proprioception – falling from the unstable base, over extending joint/limb/muscle

Learning outcome 5: Be able to evaluate research undertaken on sports massage

Critically appraise research: Define question, search for evidence, evaluate evidence (research methodologies, patient or population, intervention, outcome measure, sample size, control used, statistics), research design (systematic review, meta-analysis, randomised control trial), sources (Cochrane reviews, periodicals, journals, online databases), appraisal tools, qualitative, quantitative, strengths and weaknesses of research, implications for future use.

Draw conclusions: Research-based, evidence for and against use of sports massage, supported indications for use.

Learning outcome 4: Understand evidence based-practice

Evidence-based practice: Definition, research/evidence-based, expert opinion, patient-centred, appraisal of evidence, evaluate outcome, dynamic process, pre-appraised sources (practice guidelines, clinical protocols, plans of care).

Importance of evidence-based practice: Ensure best practice, identify most effective and safe practice, accountability.

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causing tissue damage or pain, aggravation of injury.

Isometric strengthening – increased blood pressure, possible rupture of blood vessels, aggravation of injury.

Learning outcome 3: Understand aftercare methods to complement complex massage techniques for sports massage (continued)