Elements and Performance Criteria

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
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 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 and stretching
Stretching techniques
Static stretching
Dynamic stretching
Ballistic stretching
Proprioceptive neuromuscular facilitation stretching
Contract-relax
Hold-relax
Muscle energy technique

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

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


Discrepancies may include:
Client/patient is unaware of the immediate danger of their condition
Client/patient is over anxious about their condition
Client/patient is unaware of maintaining causes acting on their condition
Practitioner is unaware of some implications of the client/patient 's condition
Practitioner and client/patient 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

Client/patient responsibilities 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

Critical aspects of assessment:
Demonstrated ability to identify treatment options and establish treatment regimes
Demonstrated ability to prepare treatment plans
Ability to identify bone landmarks, structures and individual muscles through palpation.
Ability to transcribe assessment findings and treatment in a patient history using accepted medical terminology
Knowledge of symptomology
Knowledge of possible obstacles to treatment
Knowledge of community resources and support services
Demonstrated communication and negotiation skills

Concurrent assessment and relationship with other units:
Communicate effectively with clients
Apply assessment framework

Underpinning knowledge and skills:
Awareness of critical information required for diagnosis and treatment according to massage therapy framework
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 nervous 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 structure and function of anatomical systems
Knowledge of the principles of human movement and biomechanics
Technical and practical knowledge of treatment
Knowledge of indications for massage
Knowledge of possible reactions and contraindications for massage
Ability to identify prominent bones/structures and major muscle groups through palpation
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 nervous 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
Ability to manage time throughout consultation and treatment
Demonstrated communication skills to gain and convey required information
Knowledge of ethical and legal implications of enquiry and treatment
Demonstrated ability to read medical reports
Demonstrated ability to comprehend common medical terminology
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
Ability to use equipment and technology effectively and safely

Resource implications:
Resource requirements may include:
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:
Assessment may include:
Practical demonstration
Simulations
Explanations for plan preparations
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.