SPS Sports Performance Services

CNH22 Plan, evaluate and apply complex massage/soft tissue methods


This standard is about preparing for and applying the following massage/soft tissue methods:
· friction
· connective tissue massage
· proprioceptive neuromuscular facilitation
· positional release/strain counter strain techniques
· effleurage
· petrissage
· muscle energy techniques
· myofascial techniques
· neuromuscular techniques/trigger point therapy
· soft tissue release
· tapôtement
· vibration
· compressions
· passive stretching
Massage may be applied in the following contexts:
· injury management – post acute phase
· injury prevention
· problem solving (non-injury presentations)
· pre-existing conditions/disease processes (therapeutic and remedial)
Users of this standard will need to ensure that practice reflects up to date information and policies.
Version No 1


You will need to know and understand:
1. the different types of data and information:
2. anatomy, physiology and pathology appropriate to the massage methods and contexts covered by the unit
3. the importance of applying the underpinning knowledge of anatomy, physiology and pathology to the practice of massage
4. the accepted standards of practice and recognition of client’s presenting with pre-existing conditions and problems
5. the importance of accurate client assessment and record keeping
6. the physiological and neurological effects of the massage/soft tissue methods covered by this unit
7. the content of massage mediums in relation to allergic reaction and contraindication
8. the psychology of injury as it applies to massage/soft tissue methods
9. the relevance of nutrition – hydration, food fuels, chemical fuels
10. the importance of physiology in understanding the client’s needs
11. how to conform to protocols for all forms of communication
12. the importance of cleanliness and hygiene and the standards that should be applied when applying massage in a variety of situations and environments
13. the importance of maintaining the dignity and comfort of the client throughout the massage process
14. the importance of ensuring the client is correctly positioned
15. the importance of having a suitable chaperone present when working with clients and the principles to observe in relation to protection of children and vulnerable adults and child protection legislation
16. the importance of obtaining informed consent prior to any assessment and application or course of massage – practitioners are required to tell the client anything that would substantially affect the client’s decision; such information typically includes the nature and purpose of the massage, its risks and consequences and any alternative courses of treatment
17. the importance of working within the limits of informed consent
18. the importance of obtaining information on the possible cautions and contraindications to massage before commencing any treatment and how to obtain this information
19. the indications for massage
20. what the cautions and contraindications to massage are, for example: acutetrauma, tumour, open wounds, frostbite, acute soft tissue injury, circulatory disorders, fractures, thrombosis, bursitis, periostitis, myositis ossificans, infections,
skin disorders, allergic conditions, risk of haemorrhage, areas of altered skin sensation, mental incapacity
21. the agreed standards of personal hygiene, dress and appearance and why they are important
22. current safety legislation for the types of equipment used in massage
23. the importance of making sure the equipment and the area provide for the comfort and dignity of the client
24. the correct materials to use for the range of massage methods covered by the unit
25. the importance of explaining the aims and objectives of massage to the client
26. how to obtain relevant information
27. how to observe, palpate, assess and move the area to be massaged in advance and why
28. the importance of referral to relevant professionals when necessary and of working within your scope of practice
29. how to prepare the body area for the range of methods listed and why
30. why the client should understand the nature and purpose of the massage and the equipment being used
31. how to apply the range of methods listed in the unit with particular reference to: contour of hands, position (stance/posture), depth of pressure, direction of movement, the medium used, speed and rhythm of movement
32. the application of the range of methods to the range of conditions/situations listed
33. situations in which you should and should not remove the massage medium
34. the importance of evaluating the effectiveness of massage
35. how to obtain feedback from the client on the effects of massage
36. the possible adverse reactions to massage and how to identify these
37. why it is important to provide reassurance and opportunities for further feedback and how to do so
38. how and when to report/refer to relevant health care professionals, why it is
important to follow their directions and recognising working within scope of practice
39. the details of the massage and its effects that should be recorded
40. the importance of accurate and confidential record keeping and safely storing records
41. legal requirements for the storage of information on clients and the methods you have applied


You must be able to do the following:
1. ensure there is adequate public liability and professional indemnity insurance
2. apply agreed standards of personal hygiene, dress and appearance
3. make sure equipment meets current health and safety requirements
4. make sure equipment and area provide for the comfort and dignity of the client
5. identify, assess and manage risks in the area
6. make sure equipment and area are clean and hygienic
7. select materials that are appropriate for the planned massage/soft tissue method
8. where necessary, follow approved guidelines for the presence of a chaperone
9. prepare and store records according to legal requirements
10. obtain information on the client and context
11. obtain information relevant to the cautions and contraindications to massage/soft tissue methods
12. observe, palpate, assess and move the area in a way that is consistent with the context and the client’s condition
13. agree the aims and objectives of the massage/soft tissue method
14. devise a combined massage and soft tissue strategy appropriate to the client and the context within your scope of practice
15. refer when necessary to a relevant professional
16. identify objective and subjective markers to measure the effect of massage/soft tissue method
17. follow the correct procedures to obtain informed consent
18. make sure the client understands the nature and purpose of the massage/soft tissue method and the equipment to be used
19. adapt your working practices to the area in which you are working
20. where necessary, follow approved guidelines for the presence of a chaperone
21. prepare the relevant body area with due respect to the client’s dignity and their informed consent
22. make sure the client is correctly positioned, safe and comfortable throughout the massage/soft tissue method
23. select and apply massage methods that are within your scope of practice and the client’s informed consent
24. apply the massage/soft tissue method correctly and consistently to meet the client’s presentation and needs in the context
25. observe and take account of the cautions and contraindications to massage/soft tissue methods
26. record and respond appropriately to visual and oral feedback during the delivery of massage/soft tissue methods
27. provide the client with appropriate materials and assistance to remove the massage medium when appropriate
28. respond appropriately to pre-existing conditions and disease processes
29. obtain and record feedback on the effects of massage/soft tissue methods from the client
30. measure client feedback against the aims and objectives of your massage strategy
31. identify any adverse reactions
32. make reassessments if necessary
33. provide the client with appropriate advice and additional opportunities for feedback
34. make clear records in an acceptable format
35. refer and/or report to the relevant health care professional and follow their directions
36. store records safely and securely according to legal requirements
37. evaluate the massage strategy
38. destroy records as legally required


This National Occupational Standard was developed by Skills Active and were transferred to Skills for Health.
This standard links with the following dimension within the NHS Knowledge and Skills Framework (October 2004):
Dimension: HWB7 Interventions and treatments