Jing Certificate in Advanced Clinical Massage

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JING INSTITUTE OF ADVANCED MASSAGE TRAINING PO BOX 5291, BRIGHTON BN50 8AG l VAT NO: 866374290

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1 2 Table of Contents

Section 1: Syllabus and summary of modules

Section 2: Guidance notes for students and contract

Section 3: Reading list

Section 4: Notes on assessment

Section 5: Structuring your study; guidelines and sample quizzes

3 4 Certificate in Advanced Clinical Massage – Student syllabus

Learning Assessment Criteria Underpinning knowledge Outcome UnitIntroduction to Advanced Massage Techniques – 120 learning hours 1 1.1 Utilise 1.1.1 Evaluate Client assessment – record taking based on appropriate assessment HOPRS; basic visual assessment; range of assessment techniques based movement; pain levels techniques for on HOPRS Client communication – explanation of presenting 1.1.2 Utilise correct treatment; importance of communication & client assessment conditions techniques for feedback; basic listening & questioning based on presenting client skills; non verbal communication in HOPRS conditions assessment 1.2 Demonstrate 1.2.1 Perform all specific Techniques – effleurage; petrissage; the ability to techniques tapotement; trigger point therapy; perform all correctly on neuromuscular techniques; muscle energy specific superficial muscles technique; myofascial release including techniques 1.2.2 Perform all specific indirect and direct fascial approaches, correctly and techniques appropriately appropriately using structural integration, basics of craniosacral correct pressure therapy and visceral manipulation; amma and client fusion; stretching – passive, PNF, AIS; soft communication tissue release 1.3 Consolidate 1.3.1 Correctly identify Musculo-skeletal – bones and basic bony knowledge of major bones, basic landmarks; basic skeletal muscle musculo- bony landmarks, attachments and functions; major joints; skeletal basic attachment directions & planes of movement anatomy and points and apply specific functions for techniques superficial skeletal based on this muscles knowledge 1.3.2 Perform specific techniques appropriately for individual muscles and muscle groups 1.3.3 Utilise correct terminology with reference to directions & planes of movement 1.4 Utilise specific 1.4.1 With reference to Client assessment – record taking based on techniques specific HOPRS; basic visual assessment; range of appropriately pathologies, movement; pain levels during the evaluate and utilise Client communication – explanation of course of a specific techniques treatment appropriate to treatment; importance of communication & treatment of those feedback; basic listening & questioning pathologies skills; non verbal communication in assessment

5 treatment treatment; importance of communication & feedback; basic listening & questioning skills; non verbal communication in 1.4.2 Assess and develop assessment individual treatment protocols which use appropriate techniques in a correct and logical sequence 1.5 Use significant 1.5.1 Review presenting Pathologies – musculo-skeletal including judgement to client information injury, acute & chronic pain conditions; basic apply the 1.5.2 Apply knowledge of knowledge of other systemic pathologies correct specific techniques including skin, cardiovascular, lymphatic, treatment to create 2 autoimmune, digestive, respiratory, urinary, protocol to appropriate 50 each minute treatment reproductive, neurological, endocrine individual protocols – one for Analyse client needs – review client records; client an upper body identify primary and secondary pain areas; treatment pathology and one manage client expectations based on for a lower body Research – use of textbooks, online knowledge of pathology resources; medical terminology the presenting pathologies Referral – appropriate situations for referral to other therapists; knowledge of other relevant alternative therapies 1.6 Evaluate client 1.6.1 Analyse findings Client aftercare – cryo & thermotherapy needs with from a treatment including use of heat lamps, heat pads, hot reference to for a specific & cold packs, ice, gels and stones; aftercare pathology stretching; basic nutritional requirements advice 1.6.2 Evaluate client and appropriate referral; basic exercise feedback from advice and appropriate referral; basic advice treatment in stress reduction techniques 1.6.3 Create 2 Analyse client feedback – use of appropriate appropriate questioning; verbal and non-verbal feedback aftercare plans during treatment; assessment; changes to including at least 2 pain levels; changes to pathologies; manage distinct client client expectations actions for each – one for an upper body pathology and one for a lower body pathology

Unit 2 – Further Advanced Massage Techniques – 120 learning hours 2.1 Consolidate all 2.1.1 Perform all specific Techniques – effleurage; petrissage; practical techniques tapotement; trigger point therapy; experience of correctly on all neuromuscular techniques; muscle energy specific skeletal muscles in technique; myofascial release including techniques the body as appropriate indirect and direct fascial approaches, 2.1.2 Perform all specific structural integration, basics of craniosacral techniques therapy and visceral manipulation; amma appropriately using fusion; stretching – passive, PNF, AIS; soft correct pressure, tissue release quality & touch and client communication 2.1.3 Transfer and apply skills to a range of presenting client pathologies 6 2.2 Analyse client 2.2.1 Review client case Client record taking – documentation case history history including SOAP and HOPRS; questioning and 2.2.2 Review presenting techniques; client consent; data protection; presenting pathologies referral; communication with medical pathologies to 2.2.3 Critically assess specialists create an client range of appropriate movement and Contraindications & red flags – systemic treatment experience of pain diseases; acute injuries; chronic injuries & plan pain conditions; medication Pathologies – systemic; skin; cardiovascular; lymphatic; autoimmune; digestive; respiratory; urinary; reproductive; neurological; endocrine; musculo-skeletal 2.3 Critically 2.3.1 Critically review Musculo-skeletal anatomy – bones; bony review client information landmarks; skeletal muscle attachments; knowledge of as collected at skeletal muscle actions; actions of muscle specific client intake groups at major joints; range of movement techniques, 2.3.2 Analyse knowledge Research – use of manuals, textbooks, presenting of specific pathologies techniques, online resources; medical terminology and musculo- pathologies and Client feedback – listening & communication skeletal musculo-skeletal skills; client assessment; range of anatomy to anatomy movement assessment create individual treatment protocols 2.4 Evaluate 2.4.1 Critically review Cryo & thermal therapy – use of wheat bags, ongoing client range of aftercare hot water bottles, ice, hot & cold packs; needs to options in relation timings & frequencies for each create an to presenting client Stretching – passive stretching; active appropriate pathologies stretching; timing and frequency of programme of stretches; client instruction & review aftercare Basic principles of nutrition – functions of advice based proteins, carbohydrates & fats; importance on existing of correct hydration; supplements, vitamins knowledge of & minerals; diet adaptation pathologies Exercise – basic exercise types; and musculo- cardiovascular; strength; rehabilitation; skeletal special situations eg pregnancy anatomy Referral – physiotherapy; personal trainer; Alexander technique; pilates; yoga; osteopath; chiropractor; counsellor etc 2.5 Exercise 2.5.1 Analyse and Analyse client feedback – use of appropriate significant evaluate client questioning; assessment; changes to pain judgement in feedback, levels; changes to pathologies; manage the review of assessment and client expectations ongoing client treatment results Assessment – visual assessment; range of care based on movement; specialist orthopaedic tests client feedback, continuing assessment and treatment results Unit 5 – Anatomy & Physiology for Clinical & Sports Massage – 180 learning hours

7 5.1 Utilise 5.1.1 Accurately identify Bones – cranial & facial bones; shoulder specialist bones and major girdle; bones of the arm & forearm; bones of knowledge of bony landmarks on the wrist & hand; thorax; spine; bones of musculo- models the pelvic girdle; bones of the leg & lower skeletal 5.1.2 Transfer and apply leg; bones of the ankle & foot anatomy to specialist correctly and knowledge to accurately accurately identify identify the bones and major main bones bony landmarks and bony through palpation landmarks in of the body the body 5.2 Utilise 5.2.1 Accurately identify Muscles – erector spinae, splenius capitis & specialist main muscles and cervicis, sub-occipitals, trapezius, levator knowledge of muscle groups, scapula, rhomboid major & minor, serratus musculo- their main anterior, hyoids, pectoralis major & minor, skeletal attachment points anatomy to and main actions scalenes, sternocleidomsatoid, the rotator correctly and on diagrams cuff muscles – supraspinatus, infraspinatus, accurately 5.2.2 Transfer and apply teres minor, subscapularis – rhomboids, locate and specialist deltoid, triceps brachii, latissimus dorsi & identify the knowledge to teres major, subclavius, intercostals, main muscles accurately identify coracobrachialis, biceps brachii, and muscle main muscles and brachioradialis, serratus posterior superior, groups in the muscle groups, body, their their main brachialis, supinator, extensor muscles, main attachment points flexor muscles, pronator teres, erector attachment and main actions spinae group, multifidi & rotators, quadratus points and through palpation lumborum, gluteus maximus, medius & their main and movement of minimus, lateral rotator muscles – piriformis, actions the body quadratus femoris, obturator internus & externus, gemellus inferior & superior, tensor fascia latae & iliotibial band, psoas & iliacus, internal & external obliques, adductor group – adductor magnus, brevis & longus, gracilis & pectineus, rectus abdominis, hamstrings – biceps femoris, semimembranosus & semitendinosus, popliteus, plantaris, gastrocnemius, soleus, tibialis posterior, flexor digitorum longus, flexor hallucis longus, musculature of foot, peroneus longus & brevis, tibiallis anterior, quadriceps group – rectus femoris, vastus lateralis, vastus intermedius & vastus medialis 5.3 Apply 5.3.1 Accurately identify Major joints – atlanto-occipital, atlanto-axial, knowledge of main muscles and gleno-humeral, humero-ulnar, joints of the musculo- muscle groups at hand & wrist, acromio-clavicular, sterno- skeletal major joints and clavicular, joints of the thorax including facet anatomy to their directions and correctly planes of joints & costal joints, sacro-iliac, coxal, tibio- identify the movement on femoral, talo-crural, joints of the foot muscles and diagrams Planes & directions of movement – sagittal, muscle groups frontal or coronal, transverse, superior, involved in inferior, posterior, anterior, proximal, distal, movement of medial, lateral, deep, superficial, extension, the major flexion, adduction, abduction, medial/ 8 joints of the internal rotation, lateral/external rotation, correctly joints & costal joints, sacro-iliac, coxal, tibio- identify the femoral, talo-crural, joints of the foot muscles and Planes & directions of movement – sagittal, muscle groups 5.3.2 Transfer and apply frontal or coronal, transverse, superior, involved in specialist inferior, posterior, anterior, proximal, distal, movement of knowledge to medial, lateral, deep, superficial, extension, the major accurately identify flexion, adduction, abduction, medial/ joints of the main muscles and body including muscle groups, internal rotation, lateral/external rotation, planes and their attachment circumduction, rotation, lateral flexion, directions of points and main horizontal adduction, horizontal abduction, movement actions in relation supination, pronation, opposition, inversion, to major joints eversion, plantar flexion, dorsi flexion, through palpation protraction, retraction, elevation, and movement of depression, deviation the body 6.1 Develop 6.1.1 Accurately describe Postural & structural deviations – elevated specialist and demonstrate shoulder; retracted ‘military’ shoulders; knowledge of understanding of forward ‘slumped’ shoulders; forward head common common posture; retracted head posture/military pathologies, pathologies, diseases and diseases and neck; lordosis; kyphosis; scoliosis; genu disorders disorders valgum; genu varum; genu recurvatum; excessive Q angle Common pathologies – muscle strain; neuromuscular pain; shoulder separation; rotator cuff tear; shoulder impingement syndrome; bicipital tendinitis; pectoralis minor syndrome; sub-acromial bursitis; glenohumeral dislocation/subluxation; adhesive capsulitis/frozen shoulder; thoracic outlet syndrome; whiplash; torticollis; cervical disk pathology; olecranon bursitis; lateral humeral epicondylitis/tennis elbow; medial humeral epicondylitis/golfers elbow; carpal tunnel syndrome; DeQuervians tenosynovitis; repetitive strain injury; piriformis syndrome; lumbar disk pathologies; facet joint irritation; adductor strains; iliolumbar ligament strain; trochanteric bursitis; Sartorius tear; sacroiliac joint dysfunction; anterior cruciate ligament strain; posterior cruciate ligament strain; medial collateral ligament strain; lateral collateral ligament strain; meniscal injury; patellofemoral pain syndrome; chondromalacia patella; patellar tendinitis; Osgood-Schlatter’s disease; prepatellar bursitis; iliotibial band friction syndrome; shin splints; runners knee; plantar fasciitis; calcaneal bursitis; compartment syndrome Diseases & disorders – osteoarthritis; rheumatoid arthritis; osteoporosis; spondylolysis; spondylolisthesis; ankylosing spondylitis; periostitis; myositis; fibrositis; fibrosis; myalgia; myotonia; atony; atrophy; multiple sclerosis; fibromyalgia; chronic fatigue syndrome; bone fractures – simple, compound, comminuted, greenstick, 9 impacted, complicated, spiral; stress pathologies, diseases and neck; lordosis; kyphosis; scoliosis; genu disorders valgum; genu varum; genu recurvatum; 6.1.2 Critically evaluate excessive Q angle common Common pathologies – muscle strain; pathologies, neuromuscular pain; shoulder separation; diseases and rotator cuff tear; shoulder impingement disorders in syndrome; bicipital tendinitis; pectoralis relation to treatment minor syndrome; sub-acromial bursitis; glenohumeral dislocation/subluxation; adhesive capsulitis/frozen shoulder; thoracic outlet syndrome; whiplash; torticollis; cervical disk pathology; olecranon bursitis; lateral humeral epicondylitis/tennis elbow; medial humeral epicondylitis/golfers elbow; carpal tunnel syndrome; DeQuervians tenosynovitis; repetitive strain injury; piriformis syndrome; lumbar disk pathologies; facet joint irritation; adductor strains; iliolumbar ligament strain; trochanteric bursitis; Sartorius tear; sacroiliac joint dysfunction; anterior cruciate ligament strain; posterior cruciate ligament strain; medial collateral ligament strain; lateral collateral ligament strain; meniscal injury; patellofemoral pain syndrome; chondromalacia patella; patellar tendinitis; Osgood-Schlatter’s disease; prepatellar bursitis; iliotibial band friction syndrome; shin splints; runners knee; plantar fasciitis; calcaneal bursitis; compartment syndrome Diseases & disorders – osteoarthritis; rheumatoid arthritis; osteoporosis; spondylolysis; spondylolisthesis; ankylosing spondylitis; periostitis; myositis; fibrositis; fibrosis; myalgia; myotonia; atony; atrophy; multiple sclerosis; fibromyalgia; chronic fatigue syndrome; bone fractures – simple, compound, comminuted, greenstick, impacted, complicated, spiral; stress fracture; scar tissue; respiratory diseases; cancers and general pathologies of the major body systems

10 Summary of Certificate Modules Overview The Certificate course combines the nine core modules from the Advanced Clinical Massage series with special mastery days for integration of the skills learned. You will gain confidence treating most common pain conditions such as sciatica, chronic neck pain, frozen shoulder, sprains, strains, sporting injuries, RSIs, migraines and arthritis.

This course will give you an extraordinary edge in building a professional practice that is profitable and rewarding.

Foundation in Advanced Clinical Massage Techniques – 3 days This module will give you a theoretical and practical foundation in advanced clinical massage techniques including trigger point therapy, myofascial release (MFR), forearm massage, sports stretching, body mechanics based on Tai Chi principles to protect your back, wrists and thumbs, palpation skills and the power of listening touch and table shiatsu.

Living Anatomy – 1 day A hands-on module designed to get the knowledge out of the text book and into your hands. By palpating and exploring the movement of living body you will gain a thorough understanding of all the major bones and muscles.

Low Back Pain – 2 days Low back pain is the leading cause of disability and pain in the UK. Treating it can be the key to expanding your business. This module covers: • A powerful protocol incorporating trigger point therapy, soft tissue release (STR), stretching, range of movement (ROM) and other advanced techniques to identify and relieve the sources of pain in 1-6 treatments; • Find, palpate and treat the relevant musculo-skeletal anatomy including the erector spinae group, quadratus lumborum, the gluteal group, piriformis and iliopsoas; • Body mechanics to protect your own body while giving the best treatment possible to your clients; • The causes and contraindications of common low back pathologies such as sciatica, acute locked back and piriformis syndrome.

Neck & Upper Shoulder Pain – 2 days Neck & shoulder restrictions are common causes of pain conditions which are aggravated by increasing use of computers and mobile technology. Treating these effectively can expand your client base. This module covers: • A powerful protocol incorporating trigger point therapy, soft tissue release (STR), stretching, range of movement (ROM) and other advanced techniques to identify and relieve the sources of pain in 1-6 treatments; • Find, palpate and treat the relevant musculo-skeletal anatomy including upper trapezius, levator scapula, scalenes, sternocleidomastoid, rhomboids and posterior cervicals; • Body mechanics to protect your own body while giving the best treatment possible to your clients; • The causes and contraindications of common neck & shoulder pathologies such as chronic neck pain, whiplash, torticollis, migraine, cervical disc pathologies and brachial neuralgia.

Shoulder Girdle & Rotator Cuff Pain – 2 days Learn skills to significantly increase client range of motion and decrease recovery time for this complex injury site – a great module for treating athletes. This module covers: • A powerful protocol incorporating trigger point therapy, soft tissue release (STR), stretching, range of movement (ROM) and other advanced techniques to identify and relieve the sources of pain in 1-6 treatments; • Find, palpate and treat the relevant musculo-skeletal anatomy including the rotator cuff muscles, pectoralis major and minor, trapezius, scalenes and deltoid;

11 • Body mechanics to protect your own body while giving the best treatment possible to your clients; • The causes and contraindications of common shoulder girdle pathologies such as frozen shoulder, dislocation and bursitis.

Wrist & Arm Pain – 1 day Using these simple techniques you can prevent painful surgery and decrease recovery time for post-operative patients. This module covers: • A powerful protocol incorporating trigger point therapy, soft tissue release (STR), stretching, range of movement (ROM) and other advanced techniques to identify and relieve the sources of pain in 1-6 treatments; • Find, palpate and treat the relevant musculo-skeletal anatomy including scalenes, brachioradialis, supinators, pronators, wrist flexors and extensors and the flexor retinaculum; • Body mechanics to protect your own body while giving the best treatment possible to your clients; • The causes and contraindications of wrist and elbow repetitive strain injuries (RSIs), carpal tunnel syndrome, golfers and tennis elbow.

Upper Body Theory & Practical Application Mastery – 2 days The exact content of the clinical mastery days will be adapted to each group depending on their specific learning needs. Included in the days will be: • Theory review quizzes – upper body anatomy, physiology, pathologies diseases & disorders, treatment; • Practical review – client assessment, treatment & aftercare advice for upper body pathology, including written case history & assessment, written client feedback.

Advanced Sports Stretching – 3 days Effective stretching is an essential part of massage therapy and can provide exceptional results in the rehabilitation of chronic pain conditions. Stretching increases flexibility for athletes and creates a general feeling of wellness in everyone. This module covers: • How to stretch every major joint and muscle in the body; • The three most advanced forms of stretching used by massage therapists, sports therapists and physiotherapists for recovery and prevention of injury – • Passive stretching, PNF (proprioceptive neuromuscular facilitated) stretching and AIs (active isolated stretching); • Applied anatomy – increase your knowledge of the location and action of the major muscles of the body; • How to easily incorporate stretching into your existing massage; • Self-help stretches for client aftercare advice; • Efficient and safe body mechanics.

Leg Knee & Foot Pain – 2 days The perfect course to learn skills to treat athletes, runners, skiers or football players. This module covers: • A powerful protocol incorporating trigger point therapy, soft tissue release (STR), stretching, range of movement (ROM) and other advanced techniques to identify and relieve the sources of pain in 1-6 treatments; • Find, palpate and treat the relevant musculo-skeletal anatomy including hamstrings, quadriceps, dductors, Sartorius, tibilais anterior, gastrocnemius, soleus, achilles tendon and deep flexor compartment; • Body mechanics to protect your own body while giving the best treatment possible to your clients; • The causes and contraindications of common leg knee & foot pathologies such as hamstring, quadriceps or groin strain, shin splints achilles strain and plantar fasciitis.

12 Hip & Pelvis Pain – 2 days Treating and rebalancing the pelvis is essential as imbalances here can lead to distortions and restrictions which can affect structures throughout the entire body. This module covers: • A powerful protocol incorporating trigger point therapy, soft tissue release (STR), stretching, range of movement (ROM) and other advanced techniques to identify and relieve the sources of pain in 1-6 treatments; • Find, palpate and treat the relevant musculo-skeletal anatomy including the six deep lateral rotators, the abductor and adductor groups and iliopsoas; • Body mechanics to protect your own body while giving the best treatment possible to your clients; • The causes and contraindications of common hip & pelvis pathologies such as osteo- arthritis, sacro-iliac joint dysfunction, groin strain and sports injuries.

Lower Body Practical Application Master Class & Clinical Assessment – 2 days The exact content of the clinical mastery days will be adapted to each group depending on their specific learning needs. Included in the days will be: • Theory review quizzes – including lower body anatomy, physiology, pathologies diseases & disorders, treatment; • Practical review – client assessment, treatment & aftercare advice for lower body pathology, including written case history & assessment, written client feedback. • These days will include a mock practical exam where you will get detailed feedback from Jing tutors and your peers

Practical & Theoretical Final Exams – 2 days During the final two days of the Certificate course you will be assessed on your knowledge of the theoretical and practical knowledge and skills you have learned including:

• Written assessment – including multiple choice musculo-skeletal anatomy & physiology, techniques, pathologies diseases & disorders, treatment, muscle actions & ROM; • Practical assessment – presenting client assessment, treatment & aftercare advice, including written case history & assessment, written client feedback

13 14 Jing BTEC Level 6 and Jing Certificate in Advanced Clinical Massage- guidance notes for students

The Jing Level 6 BTEC Diploma in Advanced Clinical & Sports Massage is not only the highest level massage qualification in the UK and equivalent to a degree, it is also an exciting learning adventure. It is a vocational qualification, which means that the emphasis is on practical hands-on skills rather than academic theory.

The theory subjects included in the course are relevant to your practice and taught in an interactive style which complements the practical modules.

Jing students come from all walks of life with differing experiences of learning. Our Diploma is therefore designed to include all and to provide support at an appropriate level for each individual.

Structure of the course

The Diploma is a 2½ year course which is divided into Part 1 and Part 2.

Part 1 - Jing Certificate in Advanced Clinical Massage. Part 1 is called the Certificate year and lasts for 12 months with a total of 24 taught days including review days and final practical and written exams. During your Certificate year the emphasis is on learning practical massage skills, supported with relevant theory in musculo-skeletal anatomy and pathologies. On successful completion, you will be awarded the Jing Certificate in Advanced Clinical Massage. You will be able to put the letters ACMT (Advanced Clinical Massage Therapist) after your name. Part 2 of the Diploma can be taken over 18 months – 3 years with a total of 33 taught days including review days. The emphasis is now on studying advanced theory subjects such as anatomy of injury and rehabilitation, as well as marketing & business development. We also continue to refine and enhance your practical skills on the clinical mastery days. During this part of your course you will also complete written assignments and a final project on a topic of your choice.

The Jing Diploma is quite a commitment in terms of time and effort, yet the payoff is amazing. We developed the Diploma as we are passionate about providing the best level of massage training in the UK and have therefore created a qualification which reflects this. The Diploma is based on the American & Australian models, where all massage therapists must complete a 2 year full time course before they are allowed to practice. This is currently not the case in the UK, but we hope that others will follow our lead to develop massage into a recognised and respected profession. By enrolling on the Diploma, you are committing to becoming one of the best qualified and most professional massage therapists in the UK.

How much time should I allow for study and practice?

As the Diploma is modular, it means that students have plenty of time between modules for study and practice. The course has been structured so that the first part focuses mainly on practical skills, with some theory, whereas the second part focuses more on theory subjects, combined with refining your practical skills.

Part 1 - Jing Certificate in Advanced Clinical Massage. Practical skills: For year one (the Jing certificate) we recommend you get as much hands on time as possible. The certificate year is mainly devoted to you gaining confidence in practical and clinical massage skills. You should be building up your clinics and using the techniques on both paying clients plus family and friends. This can be a great way to spread word of mouth about 15 what you can do and the problems you can help. We recommend you set aside a number of evenings or days per week as your clinic time. Make sure you fill those slots even if is not all with paying customers. Aim for at least 3-6 hours a week practical hands on time. Included in this pack is a log where you can record the hours you have completed. For the full Diploma you need to complete 200 practice hours so it is good to start this as soon as possible!

Theory: The amount of time you devote to study will differ between individuals; we recommend little and often rather than devoting large chunks of time before your assessment days! We recommend that students allow at least 2-3 days per month following each module to consolidate the theoretical elements (half a day or evening per week or half an hour per day is a good benchmark to aim for)

We recognise that our students are juggling adult lives including busy practices and families. The reality is that if you want to make a living out of massage you need to gain the theoretical and practical skills that are taught on the Certificate. So make time to make time to consolidate this important information that will gain you clients and help you make a good living! You are important and remember if you love what you do you will never work another day in your life!

What happens on the review days?

The review days are one of the most important parts of the Certificate process as this is the time you can review all the material you are unsure about. The review days are NOT assessment days. They are times to get all your questions answered so this is actually a time to get it wrong and allow yourself to be vulnerable! Review days cover both practical and theoretical elements such as pathologies, trigger point patterns, anatomy etc.

The lower body review days also include a mock practical on day 2 so you can experience what it is like to take the practical exam and gain valuable feedback. Most students take this feedback on and can improve tremendously between then and their exam date.

How is the Jing Certificate assessed and is it graded?

During the Jing certificate year, you are formally assessed once at the end of the year with a written and practical exam, although you will be informally assessed throughout all modules. We will give you feedback as you are going along about your skills and any areas to work on. The assessment at the end of year one accounts for 20% of the total Diploma marks if you choose to go onto years 2-3 and complete the Diploma in Advanced Clinical and Sports Massage For the Jing certificate you are given written feedback on different elements of your performance on both the written and practical exam. You are not given a percentage. During Part 2 of the Diploma there are no exams. Instead you are required to complete 5 written assignments, a final project and 2 practical assessments which take place in class. You are also required to complete some case studies, a contact hours log and a reflective practice journal.

What happens on the ACMT certificate exam days? There are 2 assessment days for the ACMT Certificate: Written exam: comprising multiple choice and short answer. You will also be asked to label a diagram of common muscles you have learned. You will be given example quizzes on the review days so you will be prepared for the type of questions asked. The exam should take between 2-3 hours. Practical assessment: You will perform a treatment on one of your classmates - pairs will be assigned on the day. You will be observed and assessed by a Jing tutor; you will also complete a self assessment form and your client will complete a peer assessment. The form in this file shows what on what skills you will be assessed. We are looking for your ability to carry out a good assessment and outcome based treatment that incorporates all the skills learned ie: HFMAST! We DO NOT need to see all the protocols in the exact sequence as the manuals - we are more looking for your ability to use a combination of skills learned to achieve a good outcome. 16 Who assesses our work?

Your practical and written assessments are carried out Jing tutors. If you choose to go onto years 2-3 of the BTEC these will form part of your portfolio and will also be externally verified by the EdExcel external examiner.

What happens if I miss a module?

You must make every effort to attend the days you have committed to. If you miss a module due to severe extenuating circumstances such as a death in the family or severe illness it is your responsibility to make up the module at the next available opportunity. In most cases you will need to complete all modules before taking the exam. However in some cases we have allowed students to take the exam if they have only missed one module. However you will not be granted your certificate until all modules have been completed.

I don’t feel prepared! Can I change my exam date?

The short answer is no! We strongly advise against students delaying exam dates. There is an extra charge of £150 plus VAT each for both the practical and written exam if you wish to change your date. There are no exceptions to this rule unless there are extreme extenuating circumstances such as death of a close family member.

What happens if I fail the exams?

It is important to see both practical and written assessments as just another way of getting detailed feedback on your work not a life or death process! The absolute worst that can happen is that we ask you to come back to do a re-take - It is rare for a student to fail to reach the required standard for all elements of the written exam; however on occasions you may be asked to re-sit a section before we feel we can issue your certificate. The certificate process is not a “rubber stamp” and we are proud of the standard we ask students to reach to be considered a Jing Advanced Clinical Massage therapist. Re-sitting a section of the written exam costs£75 + VAT. Re-sitting the whole written exam costs £150 + VAT. Re-sitting the practical exam costs £150 + VAT. Resits will take place at the next available exam days.

Techie Bits!

Here are a few hints and tips to help the technology side of your ACMT course run as smoothly as possible.

Social Media

ACMT Facebook Group: We would like you all the join the ACMT Facebook Group for your track. The Group is completely private which means that it is only you, the Members, who have access to it.

Its purpose is to help you with your learning and for you to ask/share with your fellow students any questions/queries/info that you may have. This could be something that you have learnt on one of the modules, help with a tricky client, finding out who is staying in Brighton/London when you are there, sharing information that may have helped you to learn/revise something etc, etc.

How to join your ACMT Facebook Group: We will advise you of the link to the Facebook Group at the beginning of your journey with Jing - this will be sent to you via email. If you already have a Facebook page, then click on the link and request to join the Group. The Administrator will accept your request and then you will be a Member of the Group.

17 If you have not got a Facebook page, then go to http://www.facebook.com/ and follow the joining instructions. This will only take you a couple of minutes to do! Then follow item 2. above.

Yahoo Chat Group: This is a great place to share ideas, ask questions, and become part of a world wide community.

Instructions for joining the online chat group 1. Go to http://groups.yahoo.com/ (or google “yahoo groups”)

2. In the top left corner search for “advanced massage” – this should take you to a number of advanced massage groups. Choose the one entitled “advanced_massage” with a description “For graduates of any of the Jing Advanced Massage”

3. If you do not have a yahoo email address you will need to create one. Please note info@ addresses do not work

4. Your request will then be sent to the moderators of the group who will approve your membership request within 1-2 weeks.

5. You will then be sent an email approving your request. YOU NEED TO FOLLOW THE INSTRUCTIONS and click on the link for your membership to be activated.

6. Once you join the group you can choose to receive the emails singly (not recommended as you will have a lot of emails cluttering your inbox every day, as a daily digest (all emails for day in grouped together in one email) or just for you to check on the web when you need to.

7. By going to the yahoo home page for the group you can also join the free database of therapists and see resources that other therapists have uploaded such as photos or intake forms.

Twitter: Twitter is a real-time information network that connects you to the latest stories, ideas, opinions and news about what you find interesting. Simply find the accounts you find most compelling and follow the conversations. At the heart of Twitter are small bursts of information called Tweets. Each Tweet is 140 characters long, but don’t let the small size fool you—you can discover a lot in a little space. You can see photos, videos and conversations directly in Tweets to get the whole story at a glance, and all in one place To Join please follow the below link to create an account: https://twitter.com/

We are @JingInstitute, please ‘follow’ us to keep up to date with everything that is happening at JING!

Skype: Skype is an internet based telephone system, that allows you to talk to other skype users for free. This is great and free way to get in contact with study buddies!

To set up a skype account please visit: www.skype.com

Technical Support!

You are not alone! If you have any problems setting up/using any of the above, please always feel free to give Nina a call in the office on 01273 628 942

18 www.jingmassage.com 01273 628 942

Jing Student Contract for the ACMT - Certificate in Advanced Clinical Massage Therapy

This contract is to make clear what you can expect of us and what we expect from you. If you have any concerns please talk to us.

1. Aims of the Jing Institute

To provide the highest level of advanced massage and bodywork training in the UK. We endeavour to do so in safe and supportive environment. It is our every wish to share all our experience and knowledge with you so that you can achieve all of your greatest professional goals.

2. Session format

Classes will be interactive and involve lectures, demonstration and students working in pairs under close supervision. We expect your participation in the process through asking questions and preparing for class, by means of reviewing material such as the appropriate muscles and theory before hand.

All courses run from 9:30am-5:30am. We ask you arrive between 15-20 minutes early for registration. Please arrive promptly.

You will not receive individual confirmation letters for each module, so please ensure you are aware of your attached schedule. As an extra courtesy we also aim to call students before the course however please do not rely on this as a prompt!

3. What you need to bring

Uniform – students should wear comfortable clothing for practical work.- jeans and skirts are not appropriate. All jewellery to be removed during massage sessions, long nails should be cut short. Please do not wear any perfume or cologne.

Linens are required for EVERY SESSION - a single fitted sheet or a couch cover and a large bath sheet or single sheet plus a pillowcase, are required. Extra towels/ blankets are always helpful. Please do not rely on other students bringing linens - any student not bringing linens to practical assessments will be failed.

Oil/ Wax- please bring a non scented massage medium.

Pen and notebook

19 Course text books

Please see attached reading list in section 4

Also bring a good attitude. Be prepared to learn from us and each other, this is really the best part. We expect that you respect yourselves, each other and the property of the school. Students found to be disrespectful to anyone will be asked to leave. In this circumstance, no refund will be available.

Students found causing damage to property or equipment, through negligence or intent, will be liable to costs.

4.Course Attendance

Students must attend all modules outlined in the Certificate. Your individual schedule is attached. You must make every effort to adhere to this schedule once set.

If you require changes to this schedule, for example changing the dates of your modules, each change will be an admin fee of £75. Changes of exam dates are £150 + VAT for each exam. Subject to availability.

You must give as much notice as possible in writing for changes and in the case of illness or emergency we expect you make every effort to inform us.

Missed modules

If you are unable to attend, you are still liable for the full course fees and your monthly standing order. You will be required to make up the module at the next available date. All modules must be completed before taking the practical and written exams.

5. Course fees

The current cost of the Certificate year is £2375 + VAT; this normally comprises a deposit of £550 and a monthly payment plan. The deposit is non-refundable. Payments of fees should be made in full on the dates agreed by yourself and the Institute.

Payment will be made by standing order to the Jing Institute’s account.

All fees must be paid in full before sitting your final exam.

If payment cannot be made you must inform the Institute immediately.

Late payments will incur an admin fee of £50.

Non payment of any monthly instalment without notice will result in the student being removed from the course with no refund of previous payments. If two payments are late or unpaid, a fee of £100, and the missed payments must be made in order to start the certificate program again.

Fees for Re-sits

Re-sitting a section of the written exam costs£75 + VAT. Re-sitting the whole written exam costs £150 + VAT.

Re-sitting the practical exam costs £150 + VAT.

20 Resits will take place at the next available exam days.

6.Insurance and First Aid

All students are required to have professional liability insurance. You must bring a copy of your certificate as soon as possible and it will be added to your file. It is also a requirement you have a current first aid certificate, which must also be brought.

7. Cancellation Policy

I understand by undertaking the outlined diploma, I am making a commitment to myself and the Jing Institute to complete all modules of the ACMT certificate as have been outlined to me.

I understand to make any changes to my allocated schedule, I must put it in writing and email to [email protected].

I also understand that I must pay all associated admin charges associated, fees which may change with out notice.

If at any time I choose to cancel the course, I am liable for the following:

Cancellation within the first three months:

• £550 deposit fee (if you have not yet given a deposit you are still liable for this cost) • Cost of individual modules taken

Cancellation after three months:

• I am liable for the entire course cost £2375+VAT

If due to circumstances beyond the control of the Jing Institute the entire diploma course is unable to be delivered, I will not hold the Jing Institute responsible or accountable.

I understand and agree to the above terms.

Name (BLOCK CAPITALS)…………………………...... ……...... …

Signature…………………...... ……...... ………………………

Date………………………………...... ………………….

21 22 JING BTEC 6 PROFESSIONAL DIPLOMA IN ADVANCED CLINICAL AND SPORTS MASSAGE: SUGGESTED READING LIST FOR BOTH CERTIFICATE AND DIPLOMA COURSES

There are a wide range of resources available to learners – some are suggested as follows although this is by no means an exhaustive list. Many of the compulsory books are available from the Jing office. You can also visit the Jing website http:// www.jingmassage.com/shop/ for quick links through to Amazon of the major books recommended.

Compulsory Text Books for Jing Certificate Year

Biel, A, Trail Guide to the Body, 3rd edition, Books of Discovery (2005), 978-0-9658534-5-3

Finando, D & Finando, S, Trigger Point Therapy for Myofascial Pain, 2nd edition, Healing Arts Press (2005), 978-1-594-770548

OR

Davies, C & Davies, A, The Trigger Point Therapy Workbook, 2nd edition, New Harbinger Publications (2004), 978-1-5722437-5-0

A Massage Therapists Guide to Pathology: Fourth Edition- Ruth Werner Lipincott Williams and Wilkins ISBN-10: 0781769191 | ISBN-13: 978-0781769198

OR

Rattray, F & Ludwig, L, Clinical Massage Therapy, Talus Incorporated (2000), 978-0-969-817710

Highly recommended

Trail Guide to the Body - Student workbook 4th edition Andrew Biel ISBN-13: 978-0982663417

Jing DVD in Advanced Clinical Massage techniques - available as DVD or download from Jing website -http://www.jingmassage.com/category/videos/

Other recommended text books

Beinfield, H, Between Heaven and Earth, Ballantine Books Inc (1992), 978-0-3453797-4-0 First Aid Manual, 9th edition, Dorling Kindersley (2008), 978-1-4053-3537-9 Greene, L & Groggins, RW, Save Your Hands!, 2nd edition, Body of Work Books (2008), 978-0-9679549-1-2 Jarmey, C, The Concise Book of Muscles, 2nd edition, Lotus Publishing (2008), 978-1-905367-11-5 Jarmey, C, The Concise Book of the Moving Body, Lotus Publishing (2006), 978-1-905367-01-6 Kapit, W & Elson, L, The Anatomy Coloring Book, 3rd edition, Benjamin Cummings (2002), 0-76092-01369 Kapit, W & Macey, R & Meisami, E, The Physiology Coloring Book, 2nd edition, Benjamin Cummings (2000), 0-321-03663-8 Lundberg, P & Dorelli, F, The Book of Shiatsu, Prentice Hall & IBD (1992), 978-0-6717448-8-5 Mochizuki, S, Amma: The Art of Japanese Massage, Kotobuki Publishing (1999), 978-1-5761500-0-9 23 Oxford Concise Colour Medical Dictionary, 3rd edition, Oxford University Press (2003), 9-780-198-607540 Premkumar, K, Pathology A-Z: A Handbook for Massage Therapists, 2nd edition, Lippincott Williams & Wilkins (2002), 978-0-7817410-0-2 Riggs, A, Deep Tissue Massage, North Atlantic Books (2007), 978-1-5564365-0-5 Simons, DG & Travell, JG, Travell & Simons’ Myofascial Pain and Dysfunction – Upper Half of Body, 2nd edition, Lippincott, Williams & Wilkins (1998), 978-0-6830836-3-7 Simons, DG & Travell, JG, Travell & Simons’ Myofascial Pain and Dysfunction – Lower Extremities, Lippincott, Williams & Wilkins (1992), 978-0-6830836-7-5 Sohn, T, Amma Therapy, 2nd edition, Inner Traditions Bear and Company (1995), 978-0-8928148-8-6 Stone, RJ, Atlas of Skeletal Muscles, 6th edition, McGraw-Hill (2008), 978-0-0712835-9-5 Apps, Netters Anatomy Flashcards

Course Specific Text Books

Advanced Clinical Massage Series:

Clay, JH & Pounds, DM, Basic Clinical Massage Therapy, 2nd edition, Lippincott Williams & Wilkins (2007), 978-0-7817567-7-8 Paine, T, The Complete Guide to Sports Massage, 2nd edition, A&C Black (2007), 978-0-7136-8579-4 Ward, K, Hands-On Sports Therapy, Thomson Learning (2004), 1-86152-920-1

Advanced Sports Stretching:

Anderson, B & Anderson, J, Stretching, 30th anniversary edition, Shelter Publications Inc (2010), 978-0-9360704-6-9 McAtee, RE & Charland, J, Facilitated Stretching, 3rd edition, Human Kinetics Europe Ltd (2007), 978-0-7360624-8-0 Mattes, AL, Mattes’s Method of Active Isolated Stretching, Aaron Mattes Therapy (2000), 978-0-9656396-1-3 Wharton, J & Wharton, P, The Whartons’ Stretch Book, Times Books (1996), 978-0-8129262-3-1

Soft Tissue Release:

MR - Sanderson, M, Soft Tissue Release, 2nd edition, Corpus Publishing (2002), 978-1-9033331-3-6

Anatomy of Injury:

MR - Rattray, F & Ludwig, L, Clinical Massage Therapy, Talus Incorporated (2000), 978-0-969-817710 Peterson, L & Renstrom, P, Sports Injuries Their Prevention and Treatment, 3rd edition, Taylor & Francis (2005), 1-85317-119-0

Practical Pathology for the Massage Therapist:

MR - Rattray, F & Ludwig, L, Clinical Massage Therapy, Talus Incorporated (2000), 978-0-969-817710

Orthopaedic Assessment:

MR - Lowe, Whitney, Orthopedic Assessment in Massage Therapy, Daviau Scott Publishers, 978-0-966119633 24 Kendall, F, McCreary, E, Provance, P, Rodgers, M, & Romani, W, Muscle Testing and Function with Posture and Pain, 5th edition, Lippincott Williams & Wilkins (2005), 978-0-781747806

Myofascial Release:

General Manheim, CJ, The Myofascial Release Manual, 4th edition, Slack Incorporated (2008), 978-1-5564283-5-7

Indirect approaches - MFR

Barnes, JF, Healing Ancient Wounds, MFR Treatment Centers & Seminars (2000), 978-1-9298940-5-5

Structural Integration and Rolfing Approaches

Anatomy Trains - Tom Myers Churchill Livingstone; Re-issue edition (20 Sep 2001), 978-0443063510 Fascial release for structural balance - James Earls and Tom Myers, North Atlantic Books; 1 edition (November 9, 2010) 978-1556439377 Feitis, R & Schultz, RL, Remembering Ida Rolf, North Atlantic Books (1998), 978-1-5564323-8-5 Schultz, RL & Feitis, R, The Endless Web, North Atlantic Books (1996), 978-1-5564322-8-6

Visceral Manipulation and craniosacral therapy

Barral, JP & Mercier, PJ, Visceral Manipulation, Eastland Press (2008), 978-0-396165-2-7 Upledger, JE, Your Inner Physician and You, North Atlantic Books (1997), 978-1-5564324-6-0

Working with Trauma Levine, P, Waking the Tiger, North Atlantic Books (1997), 978-1-5564323-3-0

Marketing for the Massage Therapist:

Bolton, GEJ, Reflective Practice: Writing and Professional Development, 3rd edition, Sage Publications (2010), 978-1-8486021-2-0 Fritz, S, Business and Professional Skills for Massage Therapists, Mosby (2010), 978-0-3230571-8-9 Hardy, P & Sumner, T, Succeeding in Business, Holistic Therapy Books (2003), 1-903348-05-6 Jenkins, N, Business Practice for Therapists, Hodder Education (2003), 978-0-3408-7679-4 Johns, C, Becoming a Reflective Practitioner, 3rd edition, Wiley-Blackwell (2009), 978-1-4051856-7-7 Mann, J, An Introductory Guide to Business, EMS Publishing (2009), 978-1-90334-8-2 Sohnen-Moe, CM & Benjamin, BE, The Ethics of Touch: The Hands-On Practitioner’s Guide to Creating a Professional, Safe & Enduring Practice, Sohnen-Moe Associates (2004), 978-1-8829084-0-0

Research Methodologies for the Massage Therapist:

Griffiths, F, Research Methods for Health Care Practice, London, Sage Publications (2009) Walliman, N & Appleton, J, Your Undergraduate Dissertation in Health and Social Care: The Essential Guide for Success, London, Sage Publications (2009)

General: Barbour, R, Introducing Qualitative Research, London, Sage Publications (2008) Flick, U, An Introduction to Qualitative Research, London, Sage Publications (2009) 25 Gilbert, N (ed), Researching Social Life, London, Sage Publications (2008) Kumar, R, Research Methodology: A Step-by-step Guide for Beginners, 2nd edition, Sage Publications (2005), 978-1-4129119-4-8 Neale, J (ed), Research Methods for Health and Social Care, Basingstoke, Palgrave, Macmillan (2009) Roberts, P & Priest, H (eds), Healthcare Research: A Textbook for Students and Practitioners, Sussex, Wiley-Blackwell Robson, C, Real World Research: A Resource for Social Scientists and Practitioner Researchers, 2nd edition, Oxford, Blackwell (2002) Swetnam, D & R, Writing Your Dissertation: The Bestselling Guide to Planning, Preparing and Presenting First-Class Work, 3rd edition, How to Books (2000), 978-1-8570366-2-6

Interviews:

Barbour, R, Introducing Qualitative Research, London, Sage Publications (2008) Bryman, A, Social Research Methods, Oxford, Oxford University Press (2008) – Chapters 15 & 19 Gilbert, N (ed), Researching Social Life, London, Sage Publications (2008) – Fielding, N – Qualitative Interviewing Robson, C, Real World Research: A Resource for Social Scientists and Practitioner Researchers, 2nd edition, Oxford, Blackwell (2002) – Chapter 9

Surveys:

Gilbert, N (ed), Researching Social Life, London, Sage Publications (2008) – Chapter 10 Griffiths, F, Research Methods for Health Care Practice, London, Sage Publications (2009) – Chapter 8 Neale, J (ed), Research Methods for Health and Social Care, Basingstoke, Palgrave, Macmillan (2009) Sue, V & Ritter, L, Conducting Online Surveys, London, Sage Publications (2007)

Participant Observation:

Bryman, A, Social Research Methods, Oxford, Oxford University Press (2008) – Chapters 12 & 18 Denscombe, M, The Good Research Guide for Small-Scale Social Research Projects, Buckingham, Open University Press – Chapter 8 Flick, U, An Introduction to Qualitative Research, London, Sage Publications (2009) – Chapter 12 Mason, J, Qualitative Researching, London, Sage Publications (2002) – Chapter 4

Literature Reviews:

Fink, A, Conducting Research Literature Reviews: From the Internet to Paper, London, Sage Publications (2005) Gash, S, Effective Literature Searching for Students, 2nd edition, Gower (2000) Gilbert, N (ed), Researching Social Life, London, Sage Publications (2008) – Chapter 4 Hart, C, Doing a Literature Search, London, Sage Publications (2001)

Doing Small-Scale Research Projects:

Seale, C, Researching Society and Culture, London, Sage Publications (2004) – Bhatt, C, Doing a Dissertation Blaxter, L et al, How to Research, Buckingham, Oxford University Press (2006) Clough, P & Nutbrown, C, A Student’s Guide to Methodology, London, Sage Publications (2007) 26 Denscombe, M, The Good Research Guide for Small-Scale Social Research Projects, Buckingham, Open University Press Rudstam, KE & Newton, RR, Surviving Your Dissertation: A Comprehensive Guide to Content and Process, London, Sage Publications (2001) Robson, C, Real World Research: A Resource for Social Scientists and Practitioner Researchers, 2nd edition, Oxford, Blackwell (2002) – Chapter 3 & pp 526-32 ‘writing a project proposal’ Walliman, N, Your Research Project: A Step-by-Step Guide for the First-Time Researcher, London, Sage Publications ((2005)

Journals

Massage World – the only independent UK magazine focusing exclusively on massage therapists and bodywork – www.massageworld.co.uk Massage Magazine – leading US magazine for touch therapists, available as print publication or digital edition – www.massagemag.com Choice Health & Wellbeing – UK magazine for complementary health, education and wellbeing – www.choicehealthmag.com sportEX – UK publications producing 3 titles – www.sportex.net: sportEX medicine - aimed at professionals working in the treatment, diagnosis and rehabilitation of sports and exercise-related injuries. sportEX dynamics - aimed at professionals helping individuals achieve optimal musculoskeletal health both in everyday life but also in sports-related situations. sportEX health - aimed at professionals promoting health through physical activity to inactive populations. Journal of Bodywork and Movement Therapies – the latest therapeutic techniques and current professional debate covering a wide range of subjects - techniques featured include: physical therapy; osteopathy; chiropractic; massage therapy; structural integration; feldenkrais; yoga therapy; dance; physiotherapy; pilates; alexander technique; shiatsu and tuina; occupational therapy; tai chi / qi gong; cranial therapy; neuromuscular therapy; lymph drainage and myofascial therapy – www.bodyworkmovementtherapies.com

Websites

Professional Membership Bodies:

These websites offer up to date information and articles about issues affecting complementary therapists in the UK. Their job is to accurately represent the concerns of therapists and promote our profession to the public and government bodies. www.cnhc.org.uk - Complementary and Natural Healthcare Council – the UK regulator for complementary healthcare practitioners. Its key function is to enhance public protection by setting standards for registration with CNHC. The CNHC ‘quality mark’ is being recognised as the hallmark of quality for the sector. This means that the general public, and those who commission the services of complementary healthcare practitioners, will be able to choose with confidence by looking for the CNHC quality mark. Joining the CNHC register is inexpensive and is recommended for all professional therapists. www.ctha.com - Complementary Therapists Association – one of the leading professional membership bodies representing complementary therapists in the UK and Ireland. 27 www.fht.org.uk - Federation of Holistic Therapists – one of the leading professional membership bodies representing complementary therapists in the UK and Ireland. Membership of either the CThA or the FHT is recommended for all professional therapists and also confers guaranteed acceptance of application to join the CNHC register. Of the two organisations, the FHT is more pro-active when it comes to lobbying on behalf of it’s membership. www.thesma.org - Sports Massage Association - the leading independent professional body for Sports Massage in the UK – membership requires at least a UK Level 3 qualification in Sports Massage. www.thesrtc.org.uk - The Sports & Remedial Therapies Council - an independent, not for profit, professional forum comprising professional associations that represent professional sports and remedial therapists who are qualified, experienced, insured and regulated. For example, the CThA and FHT are both members of this organisation.

Research:

US National Library of Medicine: Comprises of Medline and Pubmed: www.nlm.nih.gov/databases/databases_medline.html - Medline is the National Library of Medicine's premier bibliographic database covering the fields of medicine, nursing, dentistry, veterinary medicine, the health care system, and the preclinical sciences. Medline is the largest component of PubMed. www.pubmed.gov - An amazing resource, PubMed comprises more than 20 million citations for biomedical literature from MEDLINE, life science journals, and online books. This is a library of all significant published medical and complementary research and review worldwide. www.nhsdirect.nhs.uk – a useful website for the provision of information about symptoms, pathologies and general medical advice. www.group.bmj.com/products/journals BMJ (British Medical Journal) Open is an open access, online general medical journal, dedicated to publishing all types of medical research. www.statistics.gov.uk – the Publication Hub, gateway to UK national statistics. It is the first port of call for all those seeking the latest statistics from government departments in the UK. It is the central website for hosting all first releases of National Statistics. www.hse.gov.uk/statistics - HSE is the national independent watchdog for work-related health, safety and illness. They provide statistics on work-related ill health, fatalities and injuries and enforcement in the UK. A good source of information about reported incidences of low back pain, RSI etc. http://journals.sfu.ca/ijtmb/index.php/ijtmb/index - the International Journal of Therapeutic Massage & Bodywork (IJTMB) is an open access, peer-reviewed publication intended to accommodate the diverse needs of the rapidly-expanding therapeutic massage and bodywork community. Principal sections of the journal span the areas of research, education, and clinical practice. http://www.biomedcentral.com/browse/journals - the research articles in all journals published by BioMed Central are open access – recommended sections are Musculoskeletal Disorder, Clinical Pathology, Chiropractic, Osteopathy, Skeletal Muscle and Sports Medicine. www.businesslink.gov.uk - Business Link – the government's online resource for business, this provides essential information for all small business owners, from taxation to marketing your business. Business Link also provides free workshops and advice for business start-ups. www.fsb.org.uk - Federation of Small Businesses – the FSB a membership organisation and is the UK's largest campaigning pressure group promoting and protecting the interests of the self-employed and owners of small firms. Membership benefits include discounted business services (eg free business banking), business support and legal cover.

28 Clinical Assessment for Massage Therapists

What is Clinical Assessment?

“ An assessment is an educated evaluation of a clients condition and physical basis for his/her symptoms in order to determine a course of treatment”(Clinical Massage Therapy: Rattray and Ludwig)

“ A judgement about something based on an understanding of the situation” (Encarta world English dictionary”)

Assessment, Diagnosis and working within your scope of practice

It is firstly important to understand the difference between assessment and diagnosis with respect to your role and scope of practice as a massage therapist. Massage therapists use the word assessment when evaluating the nature of a condition. This is not a diagnosis which is a term used by the medical profession. It is the difference between investigating the nature of a condition (assessment) and naming that a certain condition is present (diagnosis)

Why do an assessment

Quite simply, a good assessment enables us to plan effective treatments that achieve the goals or outcomes that the client desires. From a business point of view, achieving good outcomes leads to satisfied customers, which leads to a thriving and interesting practice. Doing an assessment enables you to be the equivalent of a massage Sherlock Holmes, picking up clues from your client in various different ways to help you figure out what is going on and how you can best help. A good assessment enables you to see whether your treatment is working and gives you measurable benchmarks so both you and your client are able to assess progress.

Assessment is usually divided into 4 components, which you can remember, by the acronym “HOPS”:

• H -Health history questions (usually known as your case history or medical intake) • O- Observations (i.e.: of posture) • P- Palpation (of soft tissues including muscles and fascia) • S- Special Orthopaedic Tests (specific tests that help us to identify problems more precisely)

Depending on your skill, knowledge and scope of practice you may focus more on some areas of the above than others. However whether you are doing relaxation massage, sports massage, energy work or pregnancy massage, some form of assessment is vital. You always need to know why your client has come to you, what they are expecting from the treatment and a baseline for any changes you make.

29 Health History

“A good listener is not only popular everywhere, but after a while he knows something” (Wilson Mizner)

Taking a case history is often the first real contact you have with your client. This is the point where you can really start to hear your client’s story, make a connection with them as a human being, and start your detective journey gathering clues as to their physical, emotional and spiritual make up. It is also the point where your client will start to make judgements about you; your level of skills and professionalism, and ultimately whether they will come back to you. Taking time to do a thorough case history is an investment not only in your client’s welfare but your business.

Your job at this point is to draw out the information that you need to make an assessment of your clients needs and, most importantly, what outcome they would like to see from this treatment or series of treatments. It is your job as a professional to figure out how you can achieve this outcome and realistically how many sessions this may take.

A great simple question to ask is “How would you like to feel after the treatment”. This focuses the client onto their expectations- if they don’t know what they want from the treatment, it will be very difficult for you to meet their needs. Once you get an answer, try and narrow this down even further.

For example, your client may say they just wish to “relax”. This may seem like a simple goal but the more precise you can be, the better you will be able to achieve your outcome. Through careful questioning and listening, try to ascertain what relaxation feels like for the client- a useful question to ask is “How will that feel in your body that is different from now”. This more precise questioning will often get to the nub of what is needed – for example your client may then say, “ my shoulders will feel looser”. Great! Now you have something concrete you can do – any wonderful techniques you know to release shoulders (trigger point work, general Swedish techniques, hot stone work, stretching, range of motion). You also have a measurable outcome that you can refer back to at the end of the session; afterwards you can ask your client “how do your shoulders feel now”. If the answer is “looser” you both know you have done a good job!

If your client is presenting with some kind of pain problem you will need to focus in further with your questioning to give you the information you need to treat effectively. Use the mnemonic OPQRS to help:

O Origin of the pain. When did the pain begin? Was there a precipitating factor – accident, fall, emotional trauma?

P Provocation: Does anything make the pain worse? i.e.: cold, movement, getting stressed. Conversely does anything make the pain better? Ie: warm bath, moving around etc.

Q Quality of the pain. This can help you identify the source of the problem. Nerve pain tends to be tingling or electric. Chronic soft tissue pain can be dull and achy whereas more recent acute muscle pain can be sharp and stabbing. Pain of a muscular origin is often aggravated or relieved by movement. Beware of pain that is deep and unrelenting, even in sleep, and make sure that other causes have been ruled out. This type of pain can often be a sign of a more organic problem such as a tumour.

30 R Radiate: Does the pain stay in one place or does it radiate to different parts of the body?

S Site: Where is the pain exactly? Get your client to point to it. It can also be helpful to have a picture of a body on your case history form where the client can draw in the areas of pain.

Observation

This part of the assessment process begins the minute you see your client. How do they walk, take their coat off, are they easy in their body or are there areas of apparent restriction? How do they seem emotionally – do they have a good vital energy or do they seem tired and low? The more you use your powers of observation, the more you are able to develop this sense to your advantage. Ida Rolf, the founder of Rolfing, famously was able to assess the exact location of a lumbar herniation of an unknown client walking through the door in a heavy overcoat.

It is also useful to carry out a more structured process of body reading- the exact way you do this often depends on your training or particular bodywork discipline. Physios, osteopaths and other bodyworkers will often observe the body in a systematic fashion – noting for example, relative heights of the shoulders, tilts to the pelvis, rotations of the legs etc. This gives us clues as to what areas of soft tissue may be tight or restricted. For example a laterally rotated leg could indicate a tight piriformis muscle that may be the cause of a client’s sciatica by entrapping the sciatic nerve.

A quick way of assessing visually is simply to look at your client while they are standing and notice any gross, observable differences between the 2 sides of the body (left to right and front to back) Which areas seem tight or drawn together? These may well be areas you need to work to free up muscular or fascial adhesions.

Palpation

“Palpation cannot be learned by reading or listening; it can only be learned by palpation” (Frymann 1962)

“There are no limits to sensitivity” Jean Pierre Barral

Palpation is truly one of the most wonderful tools in our repertoire and is a skill that we develop constantly in our work. There are no limits to palpation as an assessment tool - as we develop our sensitivity as bodyworkers, we find that we are able to feel more and more subtle differences in tissues and energy fields. Developing palpation skills relies on you touching the body with intent and focus; Neuman (1989) states “ The three most common errors made while palpating to assess tissue are:

• Lack of concentration on what is being touched • Too much movement of the palpating fingers • Using excessive pressure”

If you are focussing on soft tissue, the information gathered from palpation can be organised into 4 categories – the 4 “T’s” of palpation:

Temperature: Tissue may be hot, indicating inflammation, or cool, indicating ischemia.

31 Texture: Healthy tissue has an even texture throughout. Adhesions feel as if the muscle is stuck together. Trigger points can feel like a small pea or as big as an olive. Tenderness: Pain can be indicated if the client winces with compression Tone: Tissues can be hypertonic (increase in tone relative to nearby muscles) or hypotonic (decrease in tone)

Of course our palpation skills need not be limited to muscle and fascia- a skilled therapist will learn to appreciate subtle movements such as the cranial or visceral rhythm or subtle energies such as the chakras and the meridians. This is what makes massage so magical!

Special Orthopaedic Testing

These can be subdivided into:

• Active range of motion test: These focus on the contractile tissues i.e.: the muscle tendon unit. • Passive Range of Motion test: These focus on the inert tissues i.e.: ligaments or the joint capsule • Manual Resistive Tests: These assess contractile tissue for pain and weakness with muscle, tendon or peripheral nerve injury. • Special Regional Orthopaedic Tests: These are used to isolate a specific condition.

Bringing it all together

When you have gathered all your information from the various aspects of your assessment process you are in a position to make an informed judgement about a treatment plan. Make sure you have really listened to your client, not just with your ears but your informed touch and your assessment is not based on snap judgements. Be prepared to modify your treatment plan as you go along depending on what you find with further exploration of the tissues and how your client responds.

Bringing assessment skills into your work will enhance your practice tremendously; try some ideas out bearing in mind the words of Socrates:

“Four things belong to a judge, to hear courteously, to answer wisely, to consider soberly and to decide impartially.”

Copyright Jing Advanced Massage February 2007. Text Rachel Fairweather. Photos Meghan Mari Article first appeared in Todays Therapist 2007

32 TAKING A GOOD CASE HISTORY

Remember your assessment starts as soon as your client makes contact with you; from the initial phone call or conversation with a colleague about their pain problem. Never lose any opportunity to gain information about your client’s physical, spiritual and emotional make up.

Phone call, initial enquiry

• Listen; use open questions; jot down notes if needed. Find out what they want. • Explain about your approach, relevant training and background; what they can expect in terms of your approach to working with pain conditions • Explain about your scope of practice and why this may be different from surgeon/ physio/osteo/chiro; this is important if the client has had previous treatment that was ineffective. If client is having current treatment explain how massage can work well in conjunction with this. • Give some idea of treatment duration (ie: 1-6 treatments weekly initially to see a decrease in pain) • Explain practicalities: how to get to venue; do they have special needs (ie: unable to negotiate stairs etc); how long will the treatment take (then stick to it-this is the essence of good boundaries!)

Observation on entrance

You can start to observe your clients the minute they walk through your door. Getting a sense of how they move and present themselves can help you build up an overall picture of how to make a connection and give them the best treatment. Think of both structural and emotional considerations:

• Structural: Are they able to walk, sit etc easily • Emotionally: are they held in, holding themselves together, confident, nervous, frightened, are they taking ownership of their mind-bodies or are they looking for someone to fix them • Make observations while keeping an “open mind set”.

Taking a case history

Most people in pain need to feel heard. This is your big opportunity to make a lasting connection with your client; meaningful connection is the real reason why someone comes back to you. Remember to keep an open mind and look for “the face behind the face”- what is it in this person that helps you to understand them. A good assessment process has a dual purpose - it is both holistic and reductionist. You are trying to build a broad picture of your client and their life while looking for specific clues that will help you address the problem they are presenting.

Schedule at least half an hour extra on your first appointment with someone to allow adequate time for this.

Listening: Medical intake form

•Develop the ability of forming a connection with your client while jotting down relevant notes; you may wish to use key words which you can flesh out after the session. Your client’s perception of you will be greatly influenced by your body

33 language during the intake; you are likely to gain more information if you are not glued to your note taking during this process.

•Do not use tick-box forms for them to fill in themselves (unless you are going to explore this in detail later). People do not fit into tick-box forms. They want to know that you have heard them. Ask them the questions and use boxes if you like with plenty of room for comments.

•Talk to them, using the form as a guide. Draw them out if necessary – use open questions. If your client has a tendency to talk a lot about irrelevant matters try and gently draw them back to the relevant topics without being abrupt. Closed questions can help to narrow things down with clients who tend to ramble!

•Distinguish urgent issues from underlying important issues; treat the urgent issue, and inform, educate about the underlying issues

• If your client is presenting with some kind of pain problem you will need to focus in further with your questioning to give you the information you need to treat effectively. Use the mnemonic OPQRS to help:

• O Origin of the pain. When did the pain begin? Was there a precipitating factor – accident, fall, emotional trauma?

• P Provocation: Does anything make the pain worse? i.e.: cold, movement, getting stressed. Conversely does anything make the pain better? Ie: warm bath, moving around etc.

• Q Quality of the pain. This can help you identify the source of the problem.

o Nerve pain tends to be tingling or electric. o Chronic soft tissue pain can be dull and achy o Recent acute muscle pain can be sharp and stabbing. o Pain of a muscular origin is often aggravated or relieved by movement. Beware of pain that is deep and unrelenting, even in sleep, and make sure that other causes have been ruled out. This type of pain can often be a sign of a more organic problem such as a tumour.

• R Radiate: Does the pain stay in one place or does it radiate to different parts of the body?

• S Site: Where is the pain exactly? Get your client to point to it. It can also be helpful to have a picture of a body on your case history form where the client can draw in the areas of pain.

•Outcome focus; make sure you have a clear outcome for the session even in relaxation massage. Your outcome should be SMART:

oSpecific oMeasurable oAchievable oRealistic

34 oTime line: how long before they can expect to see a difference; this may be different depending on the condition, severity, length of time experienced, plus your experience in treating similar conditions.

• The question “how would you like to feel after the session that is different from now” can be very helpful especially if your client is having trouble formulating their needs. Great question to ask in relaxation massage to get a clearer outcome.

•Remember what the client has come to you for: in a sense they are making a contract with you about what they expect. “Contracts” can be:

oStructural: ie: I want to be out of pain oEmotional/nurturing: I want to relax/take time out/ be looked after/ feel safe in my body oPersonal growth: I want to understand my body better; access emotional hurts that may be locked away. oExploratory: I want to know what a hot stone massage feels like.

You will need to be aware of this when designing your treatment plan. If your client has come to you to start to receive safe touch because of abuse issues it may well be a breach of your unwritten “contract” to do heavy trigger point work even if needed. Often you need to become aware of the clients needs that are unspoken; the “urgent” issue (ie: shoulder problem) is often a mask for the more important “underlying” issue (ie: woman who never takes any time out for herself). Recognising the “contract” in the underlying issue often helps you keep that client for a long time: people need a reason to come back; your job is to find out what that reason is!

•Use subjective pain scale 1 – 10. Clients forget what it felt like to be in pain, and therefore forget to give you the credit for getting them out of it! You can remind them on a subsequent visit if you have a pain scale note.

•Tell them about yourself and your approach (ie: I use a variety of techniques etc). Explain what you are going to do in that session, address the urgent issue and explain how the ‘urgent’ issue fits in with the ‘underlying important issues’

o Explain exactly what is going to happen in that session; how to position themselves; how they will be draped. Ensure a “safe space” emotionally and physically by letting the client know that this is a confidential space and whatever they need to do during the session is OK. Let them know they are in control and if anything doesn’t feel OK in any way you will back off and change what you are doing. Remind them that pain does not lead to gain during therapeutic massage and to let you know if you are doing anything that is making them grit their teeth or clench their fists.

o Explain what will happen at the end of the session (ie: I will leave the room and let you get dressed in your own time. When you are ready, just wait in the chair and I’ll come back after a few minutes. It is really great for me to get feedback on how you found the session as that will help us in future sessions to design a treatment plan that is most appropriate for you)

Note taking

• SOAP: Use the SOAP format to take notes on your intake, the session and your treatment plan: 35 o Subjective (what client told you) o Objective (what you observed, palpated etc) o Assessment: What you assess to be the presenting issues o Plan: How you are going to treat the presenting issues

36 Jing Diploma Student Practice Hours Log

Students are required to complete 200 hours of logged hands-on practice. This can include: practice on friends & family; private clinic hours; hours worked as a therapist within another clinic; voluntary work and event & onsite massage. The only caveat is that all practice logged must be with the consent of the client, clinic owner, event organiser etc.

To log your practice hours, simply complete the form below for each client/event with:

Date – of practice or event Name – of client, clinic or event Hours – number of practice hours – for hours worked for someone else (eg at an event), this should be the total number of hours (as opposed to listing each individual client)

Signed – by either the client or the clinic owner, event organiser etc. All entries must be fully completed to qualify.

Please use duplicates of this form as required to record hours.

Date Name Hours Signed

37 Date Name Hours Signed

38 STRUCTURING YOUR STUDY

Written exam

The exam covers several different areas:

- Anatomy - Pathologies -Trigger point referral patterns -Written treatment plans -General knowledge ie: about trigger points, nature of fascia, types of stretching, use of hot and cold

Anatomy

• Terms of movement

• Review your understanding of all the terms of movement as outlined in Living anatomy manual

• Be able to get a client to demonstrate all the relevant ranges of motion at each joint covered so far

• Know which muscles at each joint produce the movement (at front of each Trail Guide chapter)

Muscle actions and attachments:

• Know the attachment points and at least one major action for all the muscles covered in each ACMT module. As a guide to the amount of information we are looking for - for the scalenes we would need you to be able to:

• Identify and palpate the location of this muscle group between the SCM and trapezius on the anterior neck. • Know the major actions: ie: rotation to the opposite side and lateral flexion. Be able to direct a client to carry out this movement. • For attachment points we would expect you to know that the scalene group runs from the cervical spine to the first and second rib; however we would not expect you to know that it attaches to anterior/posterior tubercles or specific attachment points for anterior/middle and posterior scalene (we will wait until you are on the anatomy certificate for that!)

Recommended text book: Trail Guide. Note you DO NOT need to know the attachment points in as much detail as the Trail Guide. You should know the attachment points well enough to be able to work out the muscle actions. Know at least one action for each muscle.

Pathologies:

• Recommended text books: Jing manuals; Ruth Werner pathology book ( see reading list) • For this section you need to know the major points about each pathology covered (3-5 sentences minimum) • Structure your learning by preparing a sheet for each of the following pathologies as follows:

What it is? (2-3 sentences)

39 Symptoms:

How to treat using HFMAST:

Summary of pathologies studied

General:

The following pathologies pertain to all areas of the body

• Strain • Sprain • Tendinopathies: know the difference between tendinosis and tendonitis

Low Back

o Piriformis Syndrome o Lordosis o Kyphosis o Scoliosis o Lumbar Disc pathology (herniated disc) o Spondylolysis o Spondylolisthesis o Facet joint Irritation

Neck and shoulder

o Whiplash o Torticollis o Cervical Disk pathology o Thoracic Outlet Syndrome

Shoulder Girdle

o Frozen shoulder o rotator cuff injury o pectoralis minor syndrome o subacromial bursitis o subluxation o shoulder separation o shoulder impingement syndrome o bicipital tendinitis

Hand and Wrist • Tendinitis • Tendonosis • Tennis Elbow: • Golfers Elbow: • DeQuervains Thumb • Carpal Tunnel Syndrome • Rheumatoid arthritis

Leg, Knee, Foot

o Genu valgum; o genu varum; o genu recurvatum;

40 o anterior cruciate ligament sprain; o posterior cruciate ligament sprain; o medial collateral ligament sprain; o lateral collateral ligament sprain; o meniscal injury; o patellofemoral pain syndrome; o chondromalacia patella; o patellar tendonitis; o Osgood schlatters disease; o prepatellar bursitis; o IT band friction syndrome o Plantar fascitis o Ankle sprain o Shin splints

Hip and Pelvis:

o Groin strains; o sartorius tear; o piriformis syndrome; o iliolumbar ligament sprain; o trochanteric bursitis; o sacroiliac joint dysfunction; o osteoarthritis of the hip.

Trigger point referral patterns

• Recommended text books - Jing manuals and Finando or Clair Davis trigger point books (see reading list) • Know the major trigger point referral patterns ie: psoas - groin and low back area

Treatment Plans

• As you study each pathology also think about how you would treat it according to the HFMAST protocol

Practical Assessment

• Read the handouts on assessment • Review your own case history forms so that you are able to take the info you need to carry out a clinical outcome based treatment • Practice practice practice! Loads of hands on time! No excuses! You love it!

41 Tried & Tested Top Tips!

My top study tip is "studying in the gaps of life" - have your notes or materials always to hand and read through on train journeys or take yourself out for a coffee and read them in the cafe. I find I study best of train journeys; in cafes or elsewhere out of my normal environment rather than at home which feels boring and serious. When I was at massage school I had one morning a week when I re-wrote my notes into small notebooks and carried them round with me to read on the tube. - Rachel, JING Director

My hottest top tip is to get a study buddy (or group!). I am not good at sitting down and doing it on my own (always find something else to do like clean the toilet!) and sitting and looking at the book it just doesn't go in, but putting a date in the diary to meet up a) makes it happen, b) it works and c) it is so much more fun. Also tend to learn things from each other that maybe you didn't pick up first time round. Doing/talking/showing together is much more powerful than trying to do it on your own. (Can always have a big glass of vino rouge afterwards!). Sue Ingram, JING teacher

My top tip for study is to practice on your clients in clinic. When working on clients I try to imagine the actual muscles below by hands and a) think of the layers and feel my way down through them and/or b) imagine the shape, size, location and direction of fibres of the individual muscles and feel them. This is great for revision, especially if you also feel for the attachment points, and also helps to improve both your palpation and your treatments! Amanda Oswald, The pain clinic, Brighton

Know what type of learner you are and tailor your studying to suit that. For hands on learning I found drawing the muscles onto a doll with washable felt pens really helped.Wee flashcards with all my course notes and they too were great for carrying around and even getting people to quiz you with. Fiona Serle, JING teacher Edinburgh

Tip - talk to people about what you're learning - tell your clients - bore the pants off them. The more you use the info in different ways, the more you learn it. Tell clients about referred pain patterns - they like it! Look them up together. Tip - involve your kids - draw pictures for them, explain things simply to them. Tip - Put up a muscle of the week on the fridge and speak its name, attachments, actions, and referral points ( and synergists if you want brownie points) out loud every time you open the fridge. Tip - do short bursts of learning every day - half an hour - it gets easier. Don't spend hours at a book!! Tip - meet up with fellow nerds and talk nerdy. Tip - palpate, palpate and palpate. Choose a muscle for the week - could be the one on the fridge, and palpate every client's that week. make notes, compare differences! See if you can find the broadest or largest point, and follow it up to the attachments - feel the difference between muscle fibre and tendon- se if you can feel which way the fibres run - and while you're there, you might as well treat any trigger points!! Then work out how to move it to stretch it.

Ros Cope, MTI tutor, Edinburgh

Rome wasn't built in a day so don't expect to know it all in a day either. 'Layering' is my advice! Its like making a good Italian Lasagne – one layer of pasta is no good & won't last long! You start with a good layer of filling (first layer of knowledge) then you put a layer of lasagne pasta to absorb those flavours (time to absorb & put that knowledge into practice), another layer of filling (next section of your study), more pasta to absorb & fill the gaps, next layer etc etc until you feel satisfied (or the dish is filled & so is your head!), then as you put it in the oven (exams get closer), the heat may start rising BUT the result is well worth waiting for!!! You will feel very satisfied when you have passed & know that all that effort was worthwhile!! Get making that Lasagne!!Yvonne Cervetti, JING teacher, Cumbria

Top study tip from Nina... Coffee and lots of it!

42 Sample exam questions – Jing certificate

1. What are the primary actions of the teres major? a. Extension, adduction, medial rotation b. Flexion, abduction, medial rotation c. Flexion, adduction, medial rotation d. Lateral rotation, extension, adduction

2. Which of the following actions is performed by the biceps brachii? a. Extension of the arm at the shoulder joint b. External rotation of the arm at the shoulder joing c. Supination of the forearm at the radioulnar joints and flexion of the forearm d. Ulnar deviation of the hand at the radioulnar

3. If a client experiences pain radiating distally while a therapist is palpating the piriforrmis the practitioner may be putting pressure on which of the following nerves? a. Femoral b. Obturator c. Peroneal d. Sciatic

4. If your client reports they have dequervains syndrome where would they be experiencing pain? a. Knee b. Elbow c. Around the wrist and base of the thumb area d, SI joint

5. Which term can also be used to describe protraction of the scapula? a.Abduction b.Adduction c. Downward rotation d.Upward rotation

6. What is the term for fluid that lubricates joints? a. Synovial b. Plasma c. Serous d. Lymph

7. Which of the following muscles is palpable directly inferior to the spine of the scapula a. Supraspinatus b. Infraspinatus c. Supbscapularis d. Upper trapezius

8. Applying a “lock” to a muscle with pressure then taking the muscle into a short stretch and rhythmically repeating is known as:

43 a. STR b. MFR c. Trigger point release d. Active isolated stretching

9. The short term application of cold has which of the following affects: a. Increased local production of lymph b. Increased pain c. Reduced local production of white blood cells d. Reduced pain and vasoconstriction of blood vessels in the area

10. Which of the following is indicated for inflammation within the first 24 hours? a. Analgesic balm b. Contrast bath c. Ice pack d. Paraffin dip

11. The function of ligaments is to: a. Connect muscle to bone b. Connect muscle to muscle c. Move joints d. Stabilise joints

12. Which of the following is most accessible when a client is lying prone with a shoulder abducted to 90 degrees and the forearm hanging freely off the table? a. Biceps brachii b. Coracobrahialis c. Pec major d. Triceps brachii

13. The primary action of the erector spinae group is to: a. Flex the spine b. Extend the spine c. Rotate the spine d. Flex the hip

14. The piriformis muscle attaches to: a. Sacrum and greater trochanter of the femur b. Sacrum and greater tubercle of the femur c. Femur and L1- L5 d. Femur and thoraco lumbar fascia

15. The attachment of the serratus anterior muscle is: a. First 3 thoracic vertebrae b. 4th & 5th thoracic vertebrae c. Upper 8 or 9 ribs d. Sternum

16. In carpal tunnel syndrome which nerve is impinged: a. Ulnar nerve

44 b. Median nerve c. Radial nerve d. Axillary nerve

17. A contraindication for heat therapy is: a. An injury that is older than 72 hours b. A chronic pain condition c. injury that is still inflamed d. A dull aching pain

18. The primary action of the brachioradialis muscle is: a. Flex the shoulder b. Flex the elbow c. Extend the shoulder d. Extend the elbow

19 .The origin of the pectoralis major muscle is: a. Process of scapula b. Axillary process of scapula c. Lateral epicondyle of humerus d. Clavicle and sternum

20. The aftercare advice you would give for tenderness over the left lateral epicondyle would be: a. Rest that arm as much as possible and apply ice to the painful area daily b. Stop all sport for one week c. Prescribe anti-inflammatory medication d. Stop the sport which caused the pain

21. Tingling and weakness in the hands and wrist could be caused by: a. Carpal tunnel syndrome b. A tight pectoralis minor muscle c. Tight scalenes d. All of the above

22. For how long should you hold pressure on a trigger point: a. 2-7 seconds b. 8-12 seconds c. 10-20 seconds d. Up to 2 minutes

23. The attachment of the levator scapulae muscle is: a. Upper 4 cervical vertebrae b. Last cervical vertebra and first thoracic vertebra c. Upper 9 ribs d. Superior angle of the scapula

24. The primary action of the levator scapula is: a. Turn head and neck to opposite side b. Flex head and neck c. Depress scapula

45 d. Elevate scapula

25. If a client presents with ‘question mark’ headaches in which muscle could you expect to find trigger points: a. Levator scapula b. Upper trapezius c. Scalenes d. Sternocleidomastoid

26. A client presents with pain on the medial side of the elbow. What might this indicate: a. Tennis elbow b. Student’s elbow c. Golfer’s elbow d. Dislocation

27. Which is the following is not a benefit of cold therapy: a. Decreases inflammation b. Increases ease of movement c. Decreases pain d. Increases localised blood supply

28. Headache pain over the forehead can be caused by trigger points in which muscle: a. Sternocleido- mastoid b. Levator scapulae c. Trapezius d. Rhomboids

29. Pain over the chest in finger like projections and pain down the arm can be caused by trigger points in which muscle? a. Sternocleido mastoid b. Scalenes c. Pec minor d. Sub occiptials

30. Which is the main muscle implicated in torticollis: a. Sternocleidomastoid b. Deltoid c. Scalenes d. Levator scapula

31. Which of the following muscles is an antagonist to itself: a. Biceps brachii b. Deltoid c. Triceps brachii d. Coracobrachialis

32. Numbness and tingling down one leg could be caused by: a. A tight piriformis muscle b. Keeping a wallet in your back pocket c. Herniated lumbar disc d. All of the above

46 33. What is the difference between a strain and a sprain?

34. What does HFMAST stand for? Why is useful in our practice?

35.What is fascia and where do we find it in the body?

36. Name the muscles you would treat for headaches?

37. Name the muscles you would treat for tingling down the hands and arms.

38. Name the muscles you would treat for stiff lower back after gardening.

39. What muscles would you treat for frozen shoulder?

40. What would be your treatment plan for osteoarthritis of the hip?

Sample exam questions – Jing certificate

47 1.What are the primary actions of the teres major? a. Extension, adduction, medial rotation - CORRECT b. Flexion, abduction, medial rotation c. Flexion, adduction, medial rotation d. Lateral rotation, extension, adduction

2.Which of the following actions is performed by the biceps brachii? a. Extension of the arm at the shoulder joint b. External rotation of the arm at the shoulder joing c. Supination of the forearm at the radioulnar joints and flexion of the forearm CORRECT d. Ulnar deviation of the hand at the radioulnar

3. If a client experiences pain radiating distally while a therapist is palpating the piriforrmis the practitioner may be putting pressure on which of the following nerves? a. Femoral b. Obturator c. Peroneal d. Sciatic CORRECT

4. If your client reports they have dequervains syndrome where would they be experiencing pain? a. Knee b. Elbow c. Around the wrist and base of the thumb area CORRECT d. SI joint

5. Which term can also be used to describe protraction of the scapula? a. Abduction CORRECT b. Adduction c. Downward rotation d. Upward rotation

6. What is the term for fluid that lubricates joints? a. Synovial CORRECT b. Plasma c. Serous d. Lymph

7. Which of the following muscles is palpable directly inferior to the spine of the scapula? a. Supraspinatus b. Infraspinatus CORRECT c. Supbscapularis d. Upper trapezius

8. Applying a “lock” to a muscle with pressure then taking the muscle into a short stretch and rhythmically repeating is known as: a. STR CORRECT b. MFR c. Trigger point release d. Active isolated stretching

9. The short term application of cold has which of the following affects:

48 a. Increased local production of lymph b. Increased pain c. Reduced local production of white blood cells d. Reduced pain and vasoconstriction of blood vessels in the area CORRECT

10.Which of the following is indicated for inflammation within the first 24 hours? a. Analgesic balm b. Contrast bath c. Ice pack CORRECT d. Paraffin dip

11. The function of ligaments is to: a. Connect muscle to bone b. Connect muscle to muscle c. Move joints d. Stabilise joints CORRECT

12. Which of the following is most accessible when a client is lying prone with a shoulder abducted to 90 degrees and the forearm hanging freely off the table? a. Biceps brachii b. Coracobrahialis c. Pec major d. Triceps brachii CORRECT

13. The primary action of the erector spinae group is to: a. Flex the spine b. Extend the spine CORRECT c. Rotate the spine d. Flex the hip

14. The piriformis muscle attaches to: a. Sacrum and greater trochanter of the femur CORRECT b. Sacrum and greater tubercle of the femur c. Femur and L1- L5 d. Femur and thoraco lumbar fascia

15. The attachment of the serratus anterior muscle is: a. First 3 thoracic vertebrae b. 4th & 5th thoracic vertebrae c. Upper 8 or 9 ribs CORRECT d. Sternum

16. In carpal tunnel syndrome which nerve is impinged: a. Ulnar nerve b. Median nerve CORRECT c. Radial nerve d. Axillary nerve

17. A contraindication for heat therapy is: a. An injury that is older than 72 hours

49 b. A chronic pain condition c. Injury that is still inflamed CORRECT d. A dull aching pain

18. The primary action of the brachioradialis muscle is: a. Flex the shoulder b. Flex the elbow CORRECT c. Extend the shoulder d. Extend the elbow

19. The attachment of the pectoralis major muscle is: a. process of scapula b. Axillary process of scapula c. Lateral epicondyle of humerus d. Clavicle and sternum CORRECT

20. The aftercare advice you would give for tenderness over the left lateral epicondyle would be: a .Rest that arm as much as possible and apply ice to the painful area daily CORRECT b. Stop all sport for one week c. Prescribe anti-inflammatory medication d. Stop the sport which caused the pain

21.Tingling and weakness in the hands and wrist could be caused by: a. Carpal tunnel syndrome b. A tight pectoralis minor muscle c. Tight scalenes d. All of the above CORRECT

22. For how long should you hold pressure on a trigger point: a. 2-7 seconds b. 8-12 seconds CORRECT c. 10-20 seconds d. Up to 2 minutes

23. The inferior attachment of the levator scapulae muscle is: a. First cervical vertebrae b. Last cervical vertebra and first thoracic vertebra c. Upper 9 ribs d. Superior angle of the scapula CORRECT

24. The primary action of the levator scapula is: a. Turn head and neck to opposite side b. Flex head and neck c. Depress scapula d. Elevate scapula CORRECT

50 25. If a client presents with ‘question mark’ headaches in which muscle could you expect to find trigger points: a. Levator scapula b. Upper trapezius CORRECT c. Scalenes d. Sternocleidomastoid

26. A client presents with pain on the medial side of the elbow. What might this indicate: a. Tennis elbow b. Student’s elbow c. Golfer’s elbow CORRECT d. Dislocation

27. Which is the following is not a benefit of cold therapy: a. Decreases inflammation b. Increases ease of movement c. Decreases pain d. Increases localised blood supply CORRECT

28. Headache pain over the forehead can be caused by trigger points in which muscle: a. Sternocleido- mastoid CORRECT b. Levator scapulae c. Trapezius d. Rhomboids

29. Pain over the chest in finger like projections and pain down the arm can be caused by trigger points in which muscle? a. Sternocleido mastoid b. Scalenes CORRECT c. Pec minor d. Sub occiptials

30.Which is the main muscle implicated in torticollis: a. Sternocleidomastoid CORRECT b. Deltoid c.Scalenes d. Levator scapula

31.Which of the following muscles is an antagonist to itself: a. Biceps brachii b. Deltoid CORRECT c. Triceps brachii d. Coracobrachialis

32. Numbness and tingling down one leg could be caused by:

51 a. A tight piriformis muscle b. Keeping a wallet in your back pocket c. Herniated lumbar disc d. All of the above CORRECT

33. What is the difference between a strain and a sprain?

Sprain- tearing of ligament fibres Strain- tearing of muscle fibres

34. What does HFMAST stand for? Why is useful in our practice?

Explain what each initial stands for and why we treat the body in this order

35. What is fascia and where do we find it in the body?

Connective tissue; made up of collagen and elastin fibres. Found everywhere (give examples).

36. Name the muscles you would treat for headaches?

Upper trapezius, SCM, suboccipitals, levator scapulae, Scalenes.

37. Name the muscles you would treat for tingling down the hands and arms.

Main ones: pectoralis minor and scalenes both impinge brachial plexus. A more full answer would give muscles from neck and shoulder, shoulder girdle and carpal tunnel protocols

38. Name the muscles you would treat for stiff lower back after gardening.

Erector spinae, Q.L. Gluteal group; piriformis.

39. What muscles would you treat for frozen shoulder?

Supraspinatus, infraspinatus, teres major and minor, pec major and minor, deltoid, triceps, biceps

40. What would be your treatment plan for osteoarthritis of the hip?

1.Use HFMAST as the basis for your answer 2. Name which muscles around the joint you would treat (ie: hip and pelvis protocol)

52 Practical Exam Excellent Good Needs Comments feedback Improvement

OBSERVATION OF CONSULTATION Quality of consultation form Eye contact/ non verbal communication Used assessment questioning: OPQRS Checked ROM of 2 joints ON QUESTIONING Had Clear outcome Proposed treatment plan- was clear, and reasonable in time Was able to correctly name ROMs at a given joint Was able to name muscles; location; action; stretch

OBSERVATION OF TREATMENT Draping and client care Body mechanics Quality of touch

Variety of Techniques used: HFMAST? Debriefing and aftercare advice Achieving outcome

General comments:

53 Pathology:

Description:

Symptoms:

Treatment Plan: Hot/Cold:

Fascia:

Muscles:

Acupressure (if known):

Stretches:

54