Competency: Adaptation to Individual Client/Patient Needs

The practitioner can demonstrate an ability to adapt to individual client/patient needs and goals.

It is important that the practitioner sees the client/patient as and individual with individual needs and goals. The lack of this ability can results in a practitioner mechanically applying a canned series of techniques. The flexibility to differentiate relies on skills to assess, communicate, and operate from an attitude of respect for client needs and wishes.

Competency: Ancient Use of Massage for Pain Relief

The practitioner will be able to discuss the relevance of massage as an ancient method for relieving pain and discomfort.

Competency: Communication to Assess a Tissue Lesion

Can verbally communicate with client about perceived intensity and spatial distribution of sensation from pressure exerted on a tissue lesion.

While palpation skills and history provide part of an assessment, interactive communication with the client is an essential capability the practitioner can demonstrate.

Competency: Communication to Negotiate Client Comfort

Can negotiate with client to obtain clinical information within client's range of acceptance.

While a technique may create localized discomfort, the practitioner must be able to negotiate with the client and adjust the pace, location, and depth of the work to be effective yet consistent with the client/patient's overall comfort and goals.

Competency: Creation of a Professional Environment

The practitioner can maintain a clean, safe, and professional environment

The practice environment speaks to the practitioner's preparation and over-all persona — cleanliness, warmth, efficiency, flexibility, … How the reception, restroom facilities, office, and treatment room are organized and maintained are business skills that communicate the professionalism and attitudes of the practitioner. The practitioner has the sole responsibility for this in a private office and contributes to this presentation in other settings.

Competency: Eliciting further Information

Can extend from known information to elicit further information.

The practitioner can use verbal and nonverbal clues to infer that the client/patient is ready to communicate further and elicit that communication by their own cueing responses.

Competency: Historical Overview of Massage

The practitioner will be able to relate/discuss the recorded history of massage from ancient time to its current status in the world today.

The practitioner will be able to demonstrate a working knowledge of Massage History; from recorded history from early Greece, Rome, and Egypt, to the Renaissance in France and Sweden, to current history in Europe and America.

Competency: Movement to Assess a Tissue Lesion

The practitioner will be able to demonstrate sufficient motor skills and knowledge of anatomy to reposition joints to shorten or lengthen the specific soft tissues affected by a lesion.

The ability to use movement an client response to localize a tissue lesion is an essential basic assessment skill for tissue specific treatment.

Competency: Response to Symptoms of a Heart Attack

Can recognize symptoms of a heart attack and help the client access immediate medical care.

Early treatment of a heart attack is extremely important. While chest pain is often an indicator, other symptoms such as shortness of breath and unexplained fatigue may be indicators. Particularly in women, heart attack may occur without presence of chest pains. The practitioner must be able to recognize a range of common symptoms and help the client/patient to access emergency care.

Resources

• Heart Attack Warning Signs
• Heart Attack Symptoms

Competency: Response to Symptoms of a Stroke

Can recognize symptoms of a stroke or transient ischemic attack (TIA) and help the client access immediate medical care.

Strokes are often successfully treated when treatment is immediate. Practitioners must be able to recognize common stroke symptoms and help the client/patient access immediate medical care. One of the potential causes of a stroke is a cervical arterial dissection (CAD). CADs have occurred "spontaneously" or with minor traumas, such as activities of daily life. In addition to "walk-in" symptoms, there is thus the low but finite possibility that a neck massage could trigger an existing precondition resulting in a CAD, possibly with delayed onset of symptoms. It is of extreme importance that the practitioner help the client/patient access emergency care if stroke symptoms are observed or reported subsequent to a session.

Resources

• Know Stroke. Know the Signs. Act in Time.
• Unique Symptoms in Women
• "Spontaneous"Cervical Arterial Dissection
• Cervical carotid or vertebral artery dissection

Competency: Response to Symptoms of Deep Vein Thrombosis

Can recognize symptoms of deep vein thrombosis (DVT) and refer for diagnosis and/or modify work according to current best practices.

Deep vein thrombosis presents the potential for dislodging a blood clot. The presentation may be leg pain without history of injury or overuse. Based on client interview and history, direct observation, and presence or absence of an existing medical diagnosis, the practitioner will be to refer or modify work according to existing massage therapy best practices.

Resources

• Deep Vein Thrombosis: What You Should Know
• Deep Venous Thrombosis

Competency: Seeing Connections of Postural Strain

The practitioner can see postural strain connections between different muscle groups

Competency: Social Context of Massage

The practitioner will be able to discuss the current social context (placement) of massage in the United States.

The practice of massage has a complex of social aspects: as an emerging health care profession, as a life-quality enhancing personal facilitation, and often as small-business or micro-enterprise. Because massage has been used as a "front" for prostitution and sexual trafficking, the professional has been the victim of many misperceptions and onerous regulations. Massage is a touch profession and touch is a primal need and interaction. Massage thus interacts with underlying social contexts and inconsistencies toward touch and body image. Because massage steps toward greater body integration, it can affect a larger scope of empathy toward others, social perceptions, and social actions. By understanding the social context of massage, the practitioner is prepared to become a leader in the development of the profession, to understand the foundation of professionalism in altruism, and to position massage therapy to benefit society.

Resources

• Massage Therapists are Planetary Healers by Thomas W. Myers
• Massage Bibliography — Healing, Sociology, & Psychology
• Massage Bibliography — Touch, Embodiment, & Sensory Awareness
• Massage Bibliography — Life as a Practice (particularly, Heckler: 1993)

Competency: Tissue Lesion Palpation

Can palpate/perceive sub-dermal anomalies in tissue tension/texture

Using skills of palpation, the practitioner will be able to distinguish tissue lesions from normal tissue based on differences in texture, density, temperature, and client/patient response.

Competency: Transitioning between Sequences of Techniques

Can tranition smoothly from one sequence of techniques into the next.

Competency: Understanding of Postural Strain Patterns

The practitioner can demonstrate a working knowledge of common patterns of postural strain

Muscular pain and dysfunction often involves connected patterns of dysfunction. Postural muscles tend to shorten in dysfunction while phasic muscles weaken. This gives rise to muscular imbalances such as upper and lower crossed syndromes. Another example is shortening of the vastus lateralis and weaken of the vastus medialis, affecting tracking of the patella.

Resources

• Leon Chaitow, "Muscle Energy Techniques"
• Erik Dalton, "Simplifying The Pain Puzzle"

Competency: Universal Precautions — Bloodborne Pathogens

Can discuss and demonstrate use of universal precautions and basic knowledge of bloodborne pathogens.

The practitioner will understand and be able to use universal precautions and appropriate barriers in dealing with practitioner or client/patient cuts and other skin breaches or in assisting the client with cuts from broken glass (e.g. dropped glass or cup) and other inadvertent hazards in the practice environment. The practitioner will be able to discuss basic knowledge of bloodborne pathogens, their paths of transmission, and use of appropriate preventative protocols and barriers.

Resources

• Bloodborne Pathogens — Work Practices & Engineering Controls
• CDC — Universal Precautions
• CDC — Universal Precautions Update