VTCT Level 5 Certificate in Sports Massage Therapy

SP5C1F_v3

VTCT Level 5 Certificate in Sports Massage Therapy

Operational start date: 1 January 2015Credit value: 25 Total Qualification Time (TQT): 250Guided learning hours (GLH): 127Qualification number: 601/5325/8

Statement of unit achievementBy signing this statement of unit achievement you are confirming that all learning outcomes, assessment criteria and range statements (if/where applicable) have been achieved under specified conditions, and that the evidence gathered is authentic.

This statement of unit achievement table must be completed prior to claiming certification.

Unit code Date achieved Learner signature

Assessor initials

IQA signature (if sampled)

Mandatory units

USP49

USP50

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The qualification

Introduction

National Occupational Standards (NOS)

The VTCT Level 5 Certificate in Sports Massage Therapy is aimed at experienced massage therapists who wish to develop massage skills, knowledge and understanding.

This qualification will enable you to work with non-acute recent injuries and pre-existing conditions for restorative and corrective purposes, with focus on posture, gait, ligamentous and neural conditions.

Through this qualification you will develop an in depth understanding of, and use a range of complex assessment methods and complex massage techniques. Assessment will include subjective assessment and build on prior knowledge looking more deeply at yellow and red flags and their implications.

Objective assessment will include posture (including myofascial reading e.g. anatomy trains), gait analysis, range of movement, isometric testing and a variety of special tests. Special tests will include testing of ligaments, labrum, cartilage and for indications of impingement and dislocation.

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This qualification is regulated on the Regulated Qualifications Framework (RQF) and has been mapped to the following NOS:

• CNH22

This qualification is approved and supported by Skills for Health, the sector skills council for Healthcare.

Prerequisites

You must have completed the VTCT Level 4 Certificate in Sports Massage Therapy or equivalent in order to undertake this qualification.

Learners who wish to undertake this qualification must also achieve the VTCT (ITEC) Level 2 Award in Infection Prevention (COVID-19) for Complementary Therapies and Sports Massage qualification or a regulated equivalent.

Your centre will ensure that you have the knowledge, understanding and skills required to enrol and successfully achieve this qualification.

You will also develop your knowledge of the neurological system and be able to recognise neurological presentations. This will include exploration of pathophysiology (ligamentous and neural) of all the major joints.

Practically you will carry out sports massage using a range of complex techniques, to include myofascial, positional release, proprioceptive neuromuscular facilitation (PNF), and active isolated stretching. This will include critical evaluation of the effects and benefits of each technique. You will also be able to provide aftercare methods that will complement your massage treatment, to include mobility, proprioception and isometric strengthening. In addtion you will explore the concept of evidence-based practice, understand the importance of evidence-based practice in sport and be able critically to appraise research undertaken on the use of sports massage and be able to draw conclusions.

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Progression

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On completion of this qualification you will be able to gain employment as a Level 5 Sports Massage Practitioner using a variety of soft tissue and assessment techniques. You will be able to work with recent non-acute injuries and pre-existing conditions. This may include working in clinics, for sporting teams or as a mobile therapist. This may be in an employed or self-employed context.

Additional information

There are a number of professional associations (PA’s) that offer membership to qualified (post-graduate) sports massage therapists. Individual PA’s often have their own membership entry requirements that can include:• A minimum period of time over which a course qualification is completed• The method of course delivery• A logbook to evidence student practice hours• A First Aid qualification• An annual log of Continuing Professional Development (CPD) hours

This list is not exhaustive and you are advised to check the requirements of any specific professional association.

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Qualification structure

Mandatory units - 25 creditsVTCT unit code

Ofqual unit reference Unit title Credit

value GLH Level

USP49 H/506/9010 Conduct complex assessment for sports massage 7 42 5

USP50 J/506/9016 Provided complex massage techniques for sports massage 18 85 5

Total credits required - 25

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All mandatory units must be completed.

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Guidance on assessment

This book contains the mandatory units that make up this qualification. Optional units will be provided in additional booklets (if applicable). Where indicated, VTCT will provide assessment materials. Assessments may be internal or external. The method of assessment is indicated in each unit.

Internal assessment (any requirements will be shown in the unit)

Assessment is set, marked and internally quality assured by the centre to clearly demonstrate achievement of the learning outcomes. Assessment is sampled by VTCT external quality assurers.

Assessment explained

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VTCT qualifications are assessed and verified by centre staff. Work will be set to improve your practical skills, knowledge and understanding. For practical elements, you will be observed by your assessor. All your work must be collected in a portfolio of evidence and cross-referenced to requirements listed in this record of assessment book.

Your centre will have an internal quality assurer whose role is to check that your assessment and evidence is valid and reliable and meets VTCT and regulatory requirements.

An external quality assurer, appointed by VTCT, will visit your centre to sample and quality-check assessments, the internal quality assurance process and the evidence gathered. You may be asked to attend on a different day from usual if requested by the external quality assurer.

This record of assessment book is your property and must be in your possession when you are being assessed or quality assured. It must be kept safe. In some cases your centre will be required to keep it in a secure place. You and your course assessor will together complete this book to show achievement of all learning outcomes, assessment criteria and ranges.

External assessment (any requirements will be shown in the unit)

Externally assessed question papers completed electronically will be set and marked by VTCT.

Externally assessed hard-copy question papers will be set by VTCT, marked by centre staff and sampled by VTCT external quality assurers.

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Creating a portfolio of evidence

As part of this qualification you are required to produce a portfolio of evidence. A portfolio will confirm the knowledge, understanding and skills that you have learnt. It may be in electronic or paper format.

Your assessor will provide guidance on how to prepare the portfolio of evidence and how to show practical achievement and understanding of the knowledge required to successfully complete this qualification. It is this booklet along with the portfolio of evidence that will serve as the prime source of evidence for this qualification.

Evidence in the portfolio may take the following forms:

• Observed work• Witness statements• Audio-visual media • Evidence of prior learning or attainment• Written questions• Oral questions• Assignments• Case studies

All evidence should be documented in the portfolio and cross-referenced to unit outcomes. Constructing the portfolio of evidence should not be left to the end of the course.

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Unit assessment methods

This section provides an overview of the assessment methods that make up each unit in this qualification. Detailed information on assessment is provided in each unit.

Mandatory units External Internal

VTCT unit code Unit title Question

paper(s) Observation(s) Portfolio of Evidence

USP49 Conduct complex assessment for sports massage 0

USP50 Provided complex massage techniques for sports massage 0

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Unit glossary

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Description

VTCT product code

All units are allocated a unique VTCT product code for identification purposes. This code should be quoted in all queries and correspondence to VTCT.

Unit title The title clearly indicates the focus of the unit.

National Occupational Standards (NOS)

NOS describe the skills, knowledge and understanding needed to undertake a particular task or job to a nationally recognised level of competence.

LevelLevel is an indication of the demand of the learning experience; the depth and/or complexity of achievement and independence in achieving the learning outcomes.

Credit valueThis is the number of credits awarded upon successful achievement of all unit outcomes. Credit is a numerical value that represents a means of recognising, measuring, valuing and comparing achievement.

Guided learning hours (GLH)

The activity of a learner in being taught or instructed by - or otherwise participating in education or training under the immediate guidance or supervision of - a lecturer, supervisor, tutor or other appropriate provider of education or training.

Total qualification time (TQT)

The number of hours an awarding organisation has assigned to a qualification for Guided Learning and an estimate of the number of hours a learner will reasonably be likely to spend in preparation, study, or any other form of participation in education or training. This includes assessment, which takes place as directed - but, unilke Guided Learning, not under the immediate guidance or supervision of - a lecturer, supervisor, tutor or other appropriate provider of education or training.

Observations This indicates the minimum number of competent observations, per outcome, required to achieve the unit.

Learning outcomes

The learning outcomes are the most important component of the unit; they set out what is expected in terms of knowing, understanding and practical ability as a result of the learning process. Learning outcomes are the results of learning.

Evidence requirements This section provides guidelines on how evidence must be gathered.

Observation outcome

An observation outcome details the tasks that must be practically demonstrated to achieve the unit.

Knowledge outcome

A knowledge outcome details the theoretical requirements of a unit that must be evidenced through oral questioning, a mandatory written question paper, a portfolio of evidence or other forms of evidence.

Assessment criteria

Assessment criteria set out what is required, in terms of achievement, to meet a learning outcome. The assessment criteria and learning outcomes are the components that inform the learning and assessment that should take place. Assessment criteria define the standard expected to meet learning outcomes.

Range The range indicates what must be covered. Ranges must be practically demonstrated in parallel with the unit’s observation outcomes.

USP49Conduct complex assessment for sports massage

The aim of this unit is to develop the knowledge, understanding and skills to be able to undertake complex assessments on clients for sports massage. This will include identification of neural conditions, postural and gait analysis, range of movement testing, isometric tests and special tests (specifically to identify ligamentous and neural problems). Yellow flags and their potential impact on prognosis and the importance of urgent medical referral for red flags will also be addressed.

USP49_v1

GLH

Credit value

Level

Observation(s)

External paper(s)

42

7

5

5

0

On completion of this unit you will:

Learning outcomes

Conduct complex assessment for sports massage

1. Be able to undertake assessment of sports specific postures and gait

2. Be able to conduct complex assessment methods for sports massage

3. Be able to devise a sports massage treatment plan from information gathered

4. Understand neurological presentations

5. Understand sports specific posture and gait

6. Understand the principles and practice of complex assessment methods for sports massage

4. Range All ranges must be practically demonstrated or other forms of evidence produced to show they have been covered.

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 not allowed in this unit.

3. Observation outcomes For Learning Outcome 1 competent performance of Observation outcomes must be demonstrated on at least one occasion. For Learning Outcomes 2 and 3 competent performance of Observation outcomes must be demonstrated on at least five occasions on a minimum of 5 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.

Achieving observation outcomes Achieving range

Achieving observations and range

USP49

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.

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.

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Tutor/assessor guidance

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.

Learning outcome 1

Observations

You can:

Observation 1 Optional OptionalDate achievedCriteria questioned orallyPortfolio referenceAssessor initialsLearner signature

*May be assessed by supplementary evidence.

Be able to undertake assessment of sports specific postures and gait

a. Carry out gait analysis

b. Interpret findings identifying strengths and areas for improvement

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Learning outcome 2

You can:

Be able to conduct complex assessment methods for sports massage

a. Carry out subjective assessments of clients

b. Obtain consent for objective assessment

c. Carry out objective assessments of clients

d. Analyse subjective and objective findings

e. Complete clinical reasoning forms

f. Record clients’ information in accordance with professional practice requirements

g. Store clients’ information as legally required

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Observation 4 5 OptionalDate achievedCriteria questioned orallyPortfolio referenceAssessor initialsLearner signature

Observation 1 2 3Date achievedCriteria questioned orallyPortfolio referenceAssessor initialsLearner signature





Learning outcome 3

You can:

Be able to devise sports massage treatment plans from information gathered

a. Devise treatment plan

b. Explain rationale for chosen massage strategies

c. Present massage strategies and rationale to clients

d. Obtain consent to treatment

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Range

*You must practically demonstrate that you have:

Carried out complex assessment on all joints of the body Portfolio referenceAnkle

Knee

Hip

Shoulder

Elbow/wrist/hand

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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 4

Understand neurological presentations

You can: Portfolio reference

a. Describe the pathways of peripheral nerves

b. Define the characteristics of: • dermatomes • myotomes

c. Explain the organisation of dermatomes

d. Describe common causes of neurological damage

e. Describe common peripheral neuropathy patterns

f. Describe presentations that warrant neurological testing

g. Describe the pathophysiology of common neurological injuries/soft tissue dysfunction

h. Explain the importance of referral for neurological testing

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Learning outcome 5

Understand sports specific posture and gait


a. Explain the phases of the gait cycle

b. Outline the different methods used to analyse gait

c. Describe foot deformities and their effects on gait

d. Describe gait abnormalities

e. Explain how postural deviations can effect sporting performance

f. Understand the principles of sports specific posture analysis

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Learning outcome 6

Understand the principles and practice of complex assessment methods for sports massage


a. Critically evaluate the range of complex assessment methods used to gather information: • subjective • range of movement (active, passive) • resisted (isometric) • postural analysis • special tests (ligamentous, neural)

b. Explain yellow flags and their potential impact on prognosis

c. Explain red flags and the importance of urgent medical referral

d. Explain the process of clinical reasoning and stages of problem solving

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Learning outcome 1: Be able to undertake assessment of sports specific postures and gait

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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Gait analysis: Walking (front, rear, side view), base width, swing width, step length, stride length, abnormalities, pelvic tilts, pelvic hitch, movement in the lumbar spine, hip, knee and ankle, pronation, supination, strike.

Interpret findings: Identify abnormalities, propose cause, analyse outcomes of objective testing, understand aetiology, strengths, areas for improvement, plan intervention, referral if necessary.

Learning outcome 2: Be able to conduct complex assessment methods for sports massage

Carry out subjective assessments: General information (name, address, age, sport, hobbies, GP, occupation), body mapping chart (type and area of symptoms, depth, quality, intensity, abnormal sensation, relationship to symptoms), history of presenting condition (mechanism of injury, behaviour of symptoms, aggravating and easing factors, severity, irritability) and nature (mechanical, neural or chemical), 24 hr behaviour patterns, pain scales, daily activities, stage of condition, previous medical history (contra-indications, red flags, pre-existing conditions, genetic conditions), medication.

Obtain consent: Prior to and during assessment, verbal, written, practitioner explains nature, purpose, risks and alternatives of test/s, opportunity to refuse, boundaries of consent.

Carry out objective assessment: Informed consent, subjective information informs tests to be carried out, range of movement (active, passive), resisted

(isometric), postural analysis, special tests (ligamentous, neural, labral, cartilage).

Analyse findings: Analyse response to questions, interpret and explain responses, analyse findings from objective tests, combine results to form working hypothesis, inform treatment planning.

Complete clinical reasoning forms: Carry out clinic reasoning to form working hypothesis, review conclusion, consult with others as required.

Record information: As required by professional organisations, insurers, legislation, record consent, record chaperone details (if appropriate), subjective information, objective testing results, treatment plan and changes to plan, treatment findings, aftercare.

Learning outcome 3: Be able to devise sports massage treatment plans from information gathered

Devise treatment plan: Select appropriate techniques, meet clinical aims and objectives, meet patient aims and objectives, to be agreed with patient, work towards short, medium and long term goals, may involve other healthcare professionals.

Rationale: Indications for use of techniques, meet clinical aims and objectives, meet patient aims and objectives, meet short, medium and long term goals, agreement with patient.

Present strategy and rationale: Information given to patient to obtain informed consent, justification of treatment plan, remove misconceptions, ensure treatment meets patient’s expectations, ensure understanding and preparation of patient for treatment, introduce equipment, massage medium, positioning, patient instructions.

Obtain consent: Prior to and during treatment, verbal, written, practitioner explains nature, purpose, risks and alternatives of treatment, opportunity for patient to refuse or modify treatment, boundaries of consent, consent of chaperone if appropriate.

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Learning outcome 4: Understand neurological presentations

Pathways of peripheral nerves: Brachial plexus, median nerve, radial nerve, ulnar nerve, lumbosacral plexus, sciatic nerve, common peroneal nerve, superficial and deep peroneal nerve, femoral nerve, saphenous nerve, tibial nerve, sural nerve.

Characteristics of dermatomes: Dermatome map, sensory nerves cells, dorsal root, glove and stocking.

Characteristics of myotomes: Myotome map, motor nerves, ventral root.

Organisation of dermatomes: Dermatome map, pathway from peripheral limb to nerve root to spinal cord.

Common causes of neurological damage: Autoimmune diseases i.e. multiple sclerosis, lupus, Guillain Barré syndrome, cancer, compression, trauma, diabetes, motor neurone disease, nutritional deficiencies, toxic substances, stroke, infection i.e. Hepatitis C, Lymes disease, HIV, ischemia.

Common peripheral neuropathy patterns: Mononeuropathy, carpal tunnel, axillary nerve palsy, sciatica, polyneuropathy, diabetic neuropathy, multiple mononeuropathy, neuritis.

Presentations warranting neurological testing: Motor nerves – unexplained weakness, muscle atrophy, fasciculation, paralysis, partial paralysis, decreased reflexes, foot drop.

Sensory nerves – decreased sensation of peripheral limbs, paresthesia, numbness, tingling, prickling, pins and needles, dysesthesia, hypersensitivity, burning.

Common neurological injuries/soft tissue dysfunction: Pathophysiology of ankle/foot – Morton’s neuroma, metatarsal stress fracture, posterior tibial nerve pathology, syndesmosis sprain, retinaculum inflammation, deltoid ligament sprain/rupture, lateral ankle sprain/rupture.

Pathophysiology of knee – sprain/rupture medial collateral ligament, lateral collateral ligament, anterior cruciate ligament, posterior cruciate ligament, patellofemoral syndrome (chondromalacia patellae), anterior meniscal horns, medial meniscus, lateral meniscus, posterior horns of menisci, osteoarthritis, Bakers cyst, fat pad inflammation.

Pathophysiology of hip – osteoarthritis/joint lesion, stress fracture neck of femur, anterior/posterior sacroiliac ligaments, labrum tear.

Pathophysiology of shoulder – acromioclavicular joint injury, inferior instability, labral tear, anterior/posterior dislocation, glenohumeral laxity/subluxation, adhesive capsulitis.

Pathophysiology of elbow – osteophytes, ulnar (medial) collateral ligament, radial (lateral) collateral ligament, elbow avulsion medial apophysis.

Pathophysiology of wrist and hand – collateral ligament sprains, proximal interphalangeal and distal interphalangeal ligament strains, Volkmann’s contracture, Dupuytren’s contracture.

Pathophysiology of back and neck – whiplash, torticollis, ankylosing spondylitis.

Learning outcome 4: Understand neurological presentations (continued)

Importance of referral for neurological testing: Radiating pain and/or paresthesia upon objective assessment, aggravated by objective testing, does not fit a specific peripheral nerve pattern, always refer

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Learning outcome 5: Understand sports specific posture and gait

Phases of gait cycle: Stance phase, swing phase, heel strike, foot flat, mid-stance, heel-off, toe-off, mid-swing.

Methods to analyse gait: Visual (observation), recording, (motion capture, electromyography, electrogoniometry, apps), pressure mats (in shoe sensors, force plates).

Foot deformities: Pes cavus/planus, hammer toes, claw toes, club foot, rear foot varus/valgus, equinus, plantar-flexed first ray.

Effect on gait: Altered gait patterns, altered biomechanics, altered weight distribution, altered stride length, reduced speed, instability.

Gait abnormalities: Hemiplegic, spastic diplegic, neuropathic, myopathic, Parkinsonian, choreiform, ataxic (cerebellar) and sensory, antalgic shuffling, high stepping, ataxia, scissor.

Postural deviations: Pigeon chest, barrel chest, myofascial body reading e.g. anatomy trains, Schleips slings, Zink patterns.

Effect on sporting performance: Reduced speed, reduced performance, increased risk of injury, biomechanical

inefficiency, increased fatigue, increased muscular tension, reduced stability.

Principles of sports specific posture: Unilateral dominance, movement efficiency, result of sports technique or repetitive performance, correction may impact performance.

if positive straight leg raise, slump or Valsalva test.

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Learning outcome 6: Understand the principles and practice of complex assessment methods for sports massage

Complex assessment methods: Subjective – recognising radiating pain and parathesia patterns (for dermatomes, common peripheral neuropathies), palpation.

Range of movement – active, passive, resisted, spine (gross movements only, not segmental).

Postural analysis – barrel chest, pigeon chest, myofascial body reading e.g. anatomy trains, Schleips slings, Zink patterns.

Special Tests – ligament testing, labral testing, cartilage testing, impingement (trapped peripheral nerve), dislocations.

Dermatome assessment of sensation – sharp/soft, hot/cold, light touch, C3-T1, L1-S2, myotome assessment of weakness (positioning, application of resistance, C3-T1, L1-S2).

Special tests per joint area (list is not exhaustive): Ankle – draw test (anterior and posterior ligaments), Morton’s test, Syndesmosis sprain (squeeze test), Talar tilt (inversion, eversion).

Knee – valgus stress, varus stress, anterior drawer test, posterior drawer, patellofemoral grind test, Clarke’s test, forced hyperextension, McMurrays test, Apley’s grind test, Apley’s distraction test.

Hip – passive circumduction, Faber’s test, fulcrum test, anterior distraction test, posterior distraction test (Hibbs test), slump test, straight leg raise, spine section, valsalva.

Shoulder – compression (Scarf) test,

Sulcus sign, O’Brien’s labral test, apprehension test (anterior and posterior dislocation), acromial clavicular (AC) spring test.

Elbow – passive repeated extension, valgus stress test, varus stress test, posterolateral rotatory draw test, ulnar nerve test, median nerve test, radian nerve test.

Wrist and hand – Allen test, Tinel’s sign, metacarpophalangeal and interphalangeal ligament stress tests (passive rotation, distraction, compression), valgus and varus stress tests.

Critical evaluation: Validity, reliability, sensitivity, specificity, accuracy, strengths and weaknesses, value of using tests in tandem.

Yellow flags: Psychosocial indicator of potential long term disability/pain, severe or increased pain at presentation, previous pain episodes, multiple pain sites, belief that pain and activity are harmful, catastrophic thinking, passive coping strategies, high levels of distress, low or negative moods, social withdrawal/dysfunction, problems at work, poor job satisfaction, overprotective family or lack of support, assessment methods for yellow flags.

Potential impact on prognosis: Care to avoid unnecessary or inappropriate referrals, care to avoid increasing patient anxiety, balance between ruling out serious conditions and over assessment.

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Red flags: Potentially serious conditions requiring urgent medical assessment (cauda equina syndrome, saddle anaesthesia, thoracic pain, severe worsening pain, unexplained weight loss, history of cancer, age over 55 or under 16, unremitting night pain, bilateral symptoms, neurological deficit, reduced anal tone, bladder retention, deformation of the spine).

Importance of urgent medical referral: Possibility of disability, damage, death.

Clinical reasoning process: Process by which clinical decisions are made, amalgamation of assessment outcomes, mechanism of symptoms, contributing factors, precautions and contra-indications, research of condition, creation of working hypothesis, treatment plan.

Stages of problem solving: Problem recognition, problem definition, analysis, generation of solution, alternatives, selection of best option, evaluation of results, reflective practice.

Learning outcome 6: Understand the principles and practice of complex assessment methods for sports massage (continued)

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.

USP50_v1

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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Range

*You must practically demonstrate that you have:

Applied all techniques Portfolio referenceMyofascial

Positional release

PNF

Active Isolated Stretching

Used all aftercare methods Portfolio referenceMobility relevant to condition

Proprioception

Isometric strengthening

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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


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


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


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


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)

VTCT Level 5 Certificate in Sports Massage Therapy

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