PTA014 YMCA Sports Massage Manual

Sports massage therapy
(Level 3)
Manual
Sports massage therapy (Level 3) manual
© YMCA Awards 2016 | 2

Sports massage therapy

(Level 3)
Manual

Contents
Let’s get started ...................................................................................................................................... 5
Chapter 1: Principles of health and fitness ............................................................................................. 7
Effects of exercise on the body ........................................................................................................... 8
The components of fitness ................................................................................................................. 9
The principles of training .................................................................................................................. 10
The importance of healthy eating..................................................................................................... 11
Chapter 1: Points to discuss .............................................................................................................. 14
Chapter 2: Professional practice in sports massage ............................................................................. 17
Legislation in sports massage ........................................................................................................... 17
Scope of practice within sports massage .......................................................................................... 19
Professional standards ...................................................................................................................... 22
Chapter 3: The principles of soft tissue dysfunction ............................................................................ 29
Chapter 4: Sports massage treatments ................................................................................................ 36
Development of sports massage ...................................................................................................... 37
Complementary sports massage....................................................................................................... 37
The fundamentals of sports massage treatments ............................................................................ 37
Meeting the needs of your client...................................................................................................... 47
Glossary ................................................................................................................................................. 53
Create your own… ................................................................................................................................. 55

Let’s get started
This manual will explore:

 Health and fitness: the effects of diet and exercise on the body
 Professional practice in sports massage: following the law, good
communication and keeping records
 The principles of soft tissue dysfunction
 The fundamentals of sports massage: the environment and
equipment
 Meeting the needs of the client through evaluation
 The techniques of sports massage and some possible routines.

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Summary

Chapter 1: Principles of health and fitness

In this chapter you will learn…
 The value of leading an active, healthy lifestyle
 The effects of exercise on the body
 Advice and guidance on healthy eating.
Introduction:
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Effects of exercise on the body
The short and long-term effects of exercise on the body systems:

Short term Long term
Activity of the nervous system increases to Lungs become more efficient
control the various changes that take place
Heart rate, blood flow, oxygen uptake, The left ventricle of the heart increases in
cardiac output and stroke volume all volume and its muscular wall becomes
increase stronger
Blood vessels dilate Lower resting heart rate
Concentration of CO2 in the blood Arteries and veins become more efficient at
increases, which increases breathing rate delivering oxygen and removing waste
Muscle temperature and overall core body Increase in the number of blood capillaries
temperature increase
Levels of lactic acid in the blood rise, causing Increase in both the blood volume and the
a burning or aching sensation in the muscles number of red blood cells in which oxygen is
carried
Blood pressure increases; systolic pressure Fat metabolism is promoted
rises, and diastolic pressure stays the same
Joints become more mobile due to Lowering of ‘bad’ cholesterol (low density
increased flow and viscosity of the synovial lipoproteins, or LDLs)
fluid
Reduction in overall blood pressure
Increase in bone density (due to weight-

bearing activities)
Increase in muscle strength − joints become

more stable
Increase in the number and size of

mitochondria in muscles (the muscles
capable of utilising more oxygen and fat at
any given time) means less lactic acid is
produced, delaying onset of fatigue

The blood pooling effect following exercise
Delayed onset of muscle soreness (DOMS)
Delayed onset of muscle soreness describes the muscle pain, soreness or stiffness that is felt
12 - 72 hours after exercise.
Likely causes include:

 Beginning a new exercise programme
 A change in sports activities
 An increase in the duration or intensity of exercise or activity
 Activities which include an eccentric training component.
The components of fitness

Factors that affect fitness:
The factors that affect health and skill-related fitness include:
 Genetic factors, such as body type

 Lifestyle factors
 Previous experience
 Kinaesthetic awareness.
The principles of training

Signs of overtraining
The signs and symptoms of overtraining include:
 Lack of results
 Lethargy/decreased motivation
 Depression
 Irritability
 Difficulty in concentrating
 Susceptibility to colds, falling ill more often
 Raised morning pulse.
The importance of healthy eating

The dietary role of key macronutrients:
The dietary role of micronutrients

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Common dietary sources for macro and micro nutrients

Grains Bread, pasta, potatoes, cereal Provide carbohydrates for
and rice energy and fibre
Fruit and vegetables Provide fibre, vitamins and
minerals
Dairy Milk, cheese and yoghurt Source of calcium for strong
teeth and bones
Meat and protein Fish, nuts, dry beans and eggs Provide protein, iron and zinc
Saturated fats/trans Cakes, biscuits, pastries Provide little nutrition
fats and sweets
Importance of adequate hydration
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It’s vital to drink enough water when following
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a training programme
Healthy eating guidelines
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Revision tip
For more information about healthy eating, see advice from NHS choices:
Eight tips for healthy eating
www.nhs.uk/Livewell/Goodfood/Pages/eight-tips-healthy-eating.aspx.
The importance of healthy eating in relation to growth, repair and injury

Chapter 1: Points to discuss
Check your understanding! Please tick:

You understand…
The benefits of an active, healthy lifestyle
The long term and short term effects of exercise on the
body
The components of fitness and the principles of training
The importance of a healthy diet and adequate hydration
for fitness
The role of key macro- and micro-nutrients
Healthy eating government guidelines.
TEST YOURSELF
Describe delayed onset of muscle soreness (DOMS) and list its likely
causes.
Write your answer here:
What are the effects of long and short term exercise? Give three or
four examples for each.
Short term effects
Long term effects

Describe the roles of each of the following in the body:

Protein
Fats
Carbs
Vitamins and minerals

Revision notes on Chapter 1:

Write up any notes about the chapter you want to make here:

Chapter 2: Professional practice in sports

massage
 The legislation that a sports massage therapist must follow
 The scope of your practice and when you should refer clients to
another professional
 How to communicate to others in a professional way
 The professional standards you must follow
 How to keep and store your records.
Introduction
Legislation in sports massage
Duty of care
Collins Dictionary of Law (2006)
The Data Protection Act 1998

The Health and Safety at Work Act 1974
Working with children and vulnerable adults
Informed consent
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Legal consequences
The consequences of noncompliance with legislation and professional standards can be

serious. They may include:
Legal proceedings against you and prosecution or liability claims

Invalid insurance
Loss of professional membership
Loss of right to practice
Personal injury to clients.
Scope of practice within sports massage

Cautions and contraindications to sports massage
Condition Action Possible Consequences

Contagious skin conditions Local - avoid area Exacerbate condition
Open wound Local - avoid area Introduce infection
Injury in acute stage Local - avoid area Promote blood flow to area,
increase in resultant scar
tissue
Any condition ending in ‘itis’ Local/systemic - avoid ‘itis’ is indicative of an
e.g. lymphangitis area/refer to GP inflammatory condition, and
so massage is
contraindicated
Varicose veins Local - avoid area Damage, weaken vein walls/
valves
Colds/fever Systemic - avoid treatment Any stimulation to the
lymphatic system will
encourage the infection

Deep vein thrombosis (DVT) Systemic - refer to GP Any massage may dislodge
thrombosis (cause
embolism)
Diabetes Systemic - refer to GP Massage may be possible,
but medical advice should
be sought before treatment
Any condition of which the Refer to GP The massage therapist has a
therapist is unaware of how duty of care to the client,
massage will affect it and so if in doubt, they
should refer
Referral procedures when working with other professionals

How to communicate in a professional manner
The Joint Commission (2007) National Patient Safety Goals.
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Professional standards
Professional standards: key principles
The key principles of professional standards as set out by sports massage membership
organisations include:
The Association of Soft Tissue Therapists (SMA) code of ethics and conduct
(www.thesma.org/Resources/Documents)
The Institute of Sport and Remedial Massage (ISRM) code of ethics, conduct and practice
(www.theisrm.com/terms.php)
The role of professional organisations
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The purpose of regulation

Continuing professional development (CPD)
Continuing professional development is key to personal development and maintaining your

skills and experience in your professional life.
You can do this through further training and education, and it may also be a professional
requirement depending on your role. CPD allows you to keep up to date with developments,
follow the latest research, and gain awareness of different or divergent views.
Emergency situations
Principles of professional practice in sports massage

The importance of valuing equality and diversity in professional practice

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The importance of insurance
Insurance requirements
To practice sports massage, you should have professional liability/professional indemnity

insurance.
In the event of a client suing for compensation as a result of a treatment, this helps pay for:
 Your legal defence
 Any damages awarded.
 CPD may also be a requirement of insurance coverage.
The importance of professionalism
The importance of appearance and standards

The importance of good communication skills
Means of Advantages Disadvantages

communication
Verbal Messages are communicated Lack of evidence unless

(eg, face-to-face, immediately recorded
telephone)
You can also exercise your Requires direct contact
personal influence to your client
You can judge the reaction of Although reasonable for the

your client client, third parties may have
time constraints.
Any doubts or misunderstandings
can be identified and resolved
immediately
Non-verbal, written No need for personal contact Subject to delays in response

(eg, letters, progress
reports) Provides proof for future Confidentiality concerns
reference since it is possible for written
evidence to be read by
Clear and self-explanatory anyone
How to produce, maintain and store client records

Information which should be recorded
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The principles to apply when recording treatments
Keeping your records: legal requirements
All client data must be stored in accordance with the Data Protection Act. Hard copy data
must be stored in a safe place, in a lockable cabinet. Electronic data needs to be password
protected, with regular back-ups made and firewall protected. Hard copy and electronic
data should not be accessible by third parties. Written permission must be given to gain
access to client records, and clients have the right to access their own records.
Records should be kept for up to eight years, but not longer than necessary. Client records
must be destroyed as legally required which may include the use of a professional data
shredding agency or professionally wiping the drive when disposing of a computer.


You understand…
The legislation you must follow as a sports massage
therapist
The legal consequences if you don’t
Your scope of practice and when and how to refer
clients to other professionals
How to communicate with clients and other
professionals in an appropriate way
The professional standards you must follow
How to keep and store your records.
TEST YOURSELF
Describe how you should store and maintain your client records
according to law.



Chapter 3: The principles of soft tissue

dysfunction
 How soft tissue injury and soft tissue dysfunction present
 Types, factors and common causes
 Signs and symptoms
 Treatment.
Introduction
Differentiating between soft tissue injury and soft tissue dysfunction

Onset Soft tissue injury Soft tissue dysfunction
When? Onset of symptoms readily Exact onset of symptoms

established often vague and not readily
established
How? Mechanism of injury (MOA) Cause can be hard to

normally identified as one or determine. Normally
more of the following types established as being due to
of extrinsic trauma: intrinsic factors such as:
• Human • Muscle imbalance(s)
• Implemental • Muscle weakness(s)
• Vehicular • Muscle tightness(s)
• Environmental • Muscle(s)
overuse/underuse
• Compensatory movement
patterns

Typical presentation Often an acute pain (which General aching/stiffness

commenced immediately
after MOA) Source tends to be more
generalised and harder to
Exact site easily identified identify (client rubs area)
(client points to area)
Dysfunctional soft tissue

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Types of soft tissue dysfunction
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Common causes of soft tissue dysfunction

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Injured soft tissue
Types of soft tissue injuries

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Common causes of soft tissue injury
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Severity of soft tissue injury
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Soft tissue repair

Stages of soft tissue repair

Factors
Treatment
Inflammation
Inflammation is a protective tissue response to injury or destruction of tissues, which serves

to destroy, dilute, or wall off both the injurious agent and the injured tissues.


You understand…
Typical presentations of soft tissue injuries and soft
tissue dysfunction
Types of soft tissue injury and common causes
Signs and symptoms
Treatment.
TEST YOURSELF
Why is inflammation important for the repair of soft tissue?



Chapter 4: Sports massage treatments

 The history and development of sports massage
 The fundamentals of sports massage
 Sports massage techniques
 How to evaluate a sports massage treatment.
Introduction
Massage
Massage is based upon a universal intuitive instinct to rub areas that hurt. The word
‘massage’ comes from the Arabic root ‘massa’ which means to touch, knead or squeeze.
History
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Development of sports massage
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Complementary sports massage
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The fundamentals of sports massage treatments

Contexts

Environment

Types of equipment
Basic wooden couch with four adjustable legs

Towels provide warmth and ensure modesty and

privacy
Contra-actions
Signs and symptoms Response
Redness/itching, indicative of an allergic Remove medium using cologne or similar

reaction to chosen medium alcohol-based cleanser
Cease treatment/use alternative medium
(according to client’s choice)
Heightened emotional state, exaggerated Maintain a professional approach and

parasympathetic responses assure client that reactions are not unusual
(and are ‘involuntary’)
Treatment planning

Massage techniques
Type Purpose Methods Effects
Effleurage Introduce the sports Longitudinal/ Increase circulation at

massage therapist’s transverse the level of application
touch to the client
Superficial/deep Improve skin condition
Relax the client
Increase relaxation of
Apply the massage soft tissues
medium (eg, oil)
General relaxation of soft
Encourage blood and tissues
lymphatic circulation
Warm up the soft

tissues
Monitor the tissues

as part of palpation
Link other sports

massage techniques
Provide a rest
between specific,
deep-tissue
techniques
Conclude the
treatment

Transverse effleurage, fingers follow direction of

stroke across the muscle fibres (upper trapezius)
Petrissage Mobilise muscles or Wringing Increase muscle and

groups of muscles fascial mobility
Reduce Rolling Increase circulation

intramuscular
congestion Reduce fibrous
Kneading adhesions in muscle
Reduce tension in fibres and fascia
muscle fascia
‘Picking up’ Improve skin condition,
Assist in free especially elasticity
movement of Compressions/
muscles or muscle pressures
groups

Petrissage (squat stance), showing effective contact

of tissues whilst minimising use of individual fingers
Tapotement To stimulate the Hacking Mental stimulation

client (sympathetic
response) Cupping Increased muscle tone
To help tone muscles Beating

that have atrophied
because of Pounding
disuse/poor neural
recruitment
Passive Therapist taking affected joint though an extended range of motion;

stretching however:
Before undertaking any passive stretching, the therapist must make sure
that:
 On presentation, the client has no pain or inflammation
 The area to be stretched has been warmed
 There are indications for undertaking passive stretching
The client:
 undertakes active stretching before passive stretching
 has a pain free movement pattern
 has no radicular, or radiating pain or paraesthesia
 has no co-existing pathology
 has no contraindications.

Application variables
Application variable Effect upon treatment
Speed Faster application elicits sympathetic

responses
Slower application elicits parasympathetic

responses
Pressure Superficial pressure has little

physical/physiological responses and may
irritate client
Firmer pressure will produce greater

physical/physiological responses and help
reassure and relax client
Excessive pressure may cause client to tense

up
Depth Determines which soft tissue structure may

be accessed:
 Shallow: skin, blood/lymph
capillaries
 Moderate: fascia, blood/lymph
vessels, ligaments
 Deep: muscles.
Application considerations (including safety)
Method of application Considerations
Hand positions Reinforced digits
Fingers aligned to direction of force
Avoid excessive use of fingers
Effective contact Maintain contact throughout treatment
Begin superficial progress to as deep as required

Rhythmical application of techniques
Use pressure that is sufficient to reach target structures while

ensuring minimal client discomfort
Effleurage: pressure applied in direction of venous return

reduced on return strokes
Appropriate direction Longitudinal effleurage strokes applied towards the major

lymph nodes/direction of venous return
Shorter strokes applied in whichever direction is considered to

have the greatest effect
Work away from bony structure to avoid pinching/discomfort
Regions treated Work on proximal areas before distal
Avoid working directly on bony structures or endangerment

sites
Positioning and posture
Lunge stance

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Use of props
Effects and benefits of commonly used mediums in sports massage
A selection of oils which can be used in sports

massage

Meeting the needs of your client
Evaluation of treatment
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Aftercare
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Hitting the spot
Your client has been training hard for a marathon, and they’ve asked you for a leg massage.
Create a basic massage sequence which you feel will meet the needs of your client.
Use the space below to write up your notes.

The bare necessities
You’ve been asked to provide sports massage for a mountain bike team. The course is
around 400 metres from the car park, across a muddy field. As you will need to carry
everything yourself, make a list of all the essentials you think you will need.
Use the space below to write up your list.


You understand…
How sports massage came to be developed and its
complementary uses
The fundamentals of sports massage – the equipment
and environment
How to evaluate your sports massage treatments and
meet the ongoing needs of your clients.
TEST YOURSELF
Describe the main sports massage techniques.



Glossary
Compressions
Continuing professional development (CPD)
Delayed onset of muscle soreness (DOMS)
Effleurage
Inflammation
Massage
Passive stretching
Petrissage
Subjective information
Objective information
Tapotement

Vibrations

Create your own…
Glossary
Term Definition

Revision notes


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Sports massage therapy

© YMCA Awards 2016 | 2

Sports massage therapy

© YMCA Awards 2016 | 3

© YMCA Awards 2016 | 4

Let’s get started

This manual will explore:

© YMCA Awards 2016 | 5

© YMCA Awards 2016 | 6

Chapter 1: Principles of health and fitness

© YMCA Awards 2016 | 7

Effects of exercise on the body

The short and long-term effects of exercise on the body systems:

Blood vessels dilate Lower resting heart rate

Reduction in overall blood pressure

Increase in bone density (due to weight-

Increase in muscle strength − joints become

Increase in the number and size of

© YMCA Awards 2016 | 8

The blood pooling effect following exercise

Delayed onset of muscle soreness (DOMS)

Likely causes include:

The components of fitness

© YMCA Awards 2016 | 9

Factors that affect fitness:

The factors that affect health and skill-related fitness include:

 Genetic factors, such as body type

The principles of training

© YMCA Awards 2016 | 10

The signs and symptoms of overtraining include:

The importance of healthy eating

The dietary role of micronutrients

© YMCA Awards 2016 | 11

Common dietary sources for macro and micro nutrients

Importance of adequate hydration

Healthy eating guidelines

The importance of healthy eating in relation to growth, repair and injury

© YMCA Awards 2016 | 13

Chapter 1: Points to discuss

Check your understanding! Please tick:

Long term effects

© YMCA Awards 2016 | 14

Describe the roles of each of the following in the body:

Vitamins and minerals

© YMCA Awards 2016 | 15

Revision notes on Chapter 1:

© YMCA Awards 2016 | 16

Chapter 2: Professional practice in sports

Legislation in sports massage

Collins Dictionary of Law (2006)

The Data Protection Act 1998

© YMCA Awards 2016 | 17

The Health and Safety at Work Act 1974

Working with children and vulnerable adults

© YMCA Awards 2016 | 18

The consequences of noncompliance with legislation and professional standards can be

Legal proceedings against you and prosecution or liability claims

Scope of practice within sports massage

Condition Action Possible Consequences

© YMCA Awards 2016 | 19

Referral procedures when working with other professionals

© YMCA Awards 2016 | 20

How to communicate in a professional manner

The Joint Commission (2007) National Patient Safety Goals.