5/a

It is essential to comply with the law when offering services as this is a legal requirement. Failure to do so could result in fines or the closure of the premises. It is also important for the protection of the general public yourself and colleges.

Some things are covered by guidelines - such as the Code of Practice, which is not legally binding, but is a suggested code which all beauty professionals should follow to ensure high standards in the industry.

Others arc covered by Government Acts and are legally binding. If you do not operate within the guidelines of this legislation, you could face prosecution. The laws are there to protect businesses, employees and clients.

Code of Practice for Hygiene in Beauty Salons:

First printed in 1987, this is published by VTCT in association with the professional bodies in beauty therapy. The Code of Practice provides a set of guidelines to prevent cross infection during treatments.

The following hygiene/safety precautions should be followed. They are important not only to avoid cross infection, but to ensure client confidence. It will also minimise the chance of the treatment being ineffective, or causing damage or injury to the client. Damage to the clients clothing and property is also avoided.

Premises, furnishings and fittings should be kept hygienically clean and neat at all times. There should be adequate heating. A comfortable working temperature is 18 - 20 degrees C. There should be adequate ventilation in the clinic to keep the air fresh and to prevent the build up of fumes. Extractor fans and open windows help to remove pungent smells.

There should be a constant supply of clean, hot and cold water and adequate sanitary facilities. All equipment should be disinfected regularly.

Implements to be sterilised or use of disposable items where possible. Freshly laundered towels should be used for each client.

Disposable couch roll should be used to cover the towels on the couch and props. A piece of couch roll should be placed on the floor for the client to stand on.

Use a cut-out method for removing products from pots and keep lids on bottles to prevent transference of germs.

Ensure the client has no infectious diseases that you may catch and pass on to other clients or colleagues.

If you need to cleanse the feet before a treatment use a separate piece of cotton wool for each foot.

Never let rubbish accumulate and always dispose of all rubbish in a lined,

covered bin, which is sealable and leak proof.

Any cuts or abrasions on the therapists hands should be covered with a waterproof dressing. Jewellery should be removed from the client and therapist before treatment.

The therapist should wash her hands with an anti-bacterial handwash before and alter each client.

5/b

All premises offering massage and other special treatments must apply for a licence from the local authority before they commence trading. It is an offence to operate without a licence.

Larger local authorities may have their own legislation under which beauty establishments are licensed. The position is not uniform and advice can be obtained front the local Environmental Health Officer.The Local Government (Miscellaneous Provisions) Act 1982 governs special licenses which are required for premises carrying out massage, electrolysis or piercing treatments as they may produce body fluids.

5/c

We live in a multi-cultural society and our clients and colleagues will be drawn from this community. It is important to deal fairly and equally with everyone we come into contact with. Discrimination of any type, racial, age, or religion is boycotted by the professional bodies and is not acceptable behaviour for the therapist. It is illegal.Once you are qualified you are entitled to join a professional body. Such organisations offer help and support to its members, relevant and suitable insurance. As a member the Code of Practice and the Code of Ethics bind you, you are expected to work within the rules laid and to maintain the standards set by the organisation.

The Equality Act 2010 replaces the existing anti discrimination laws with a single Act. It simplifies the law, removing inconsistencies and making it easier for people to understand and comply with it. It also strengthens the law in important ways to help tackle discrimination and inequality.

The Equality Act 2010 is an Act of Parliament of the United Kingdom, and has the same goals as the four major EU Equal Treatment Directives, whose provisions it mirrors and implements.

The primary purpose of the Act is to codify the complicated and numerous array of Acts and Regulations, which formed the basis of anti-discrimination law in Great Britain. This was, primarily, the Equal Pay Act 1970, the Sex Discrimination Act 1975, the Race Relations Act 1976, the Disability Discrimination Act 1995 and three major statutory instruments protecting discrimination in employment on grounds of religion or belief, sexual

orientation and age. It requires equal treatment in access to employment as well as private and public services, regardless of the protected characteristics of age, disability, gender reassignment, marriage and civil partnership, race, religion or belief, sex, and sexual orientation.

5/d

In law, a minor is a person under a certain age—usually the age of majority—which legally demarcates childhood from adulthood. The age of majority depends upon jurisdiction and application, but is generally 18. Minor may also be used in contexts unconnected to the overall age of majority. For example, the drinking age in the United States is 21, and people below this age are sometimes called minors even if they are older than 18. The term underage often refers to those under the age of majority, but may also refer to persons under a certain age limit, such as the drinking age, smoking age, age of consent, marriageable age, driving age, voting age, etc. These age limits are often different from the age of majority.

In England and Wales and in Northern Ireland a minor is a person under the age of 18; in Scotland, under the age of 16. The Age of Legal Capacity (Scotland) Act 1991 (c.50) is an Act of the Parliament of the United Kingdom applicable only in Scotland which replaced the pre-existing rule of pupillage and minority with a simple rule that a person has full legal capacity at the age of 16.

Children usually referred to in legislation as a minor (a person under the age of 16) unable to give consent, working with opposite gender clients.

When working with vulnerable adults the therapist should consider the presence of a chaperone for their own and their client’s protection.

They will need to sign the record card as consent for the treatment to go ahead. This is a legal requirement and you would be breaking the law if you were to provide the treatment without consent.

5/e

When working with these client groups it is even more important than normal, to fully explain the treatment, check understanding and gain permission for the treatment. Children should not be treated without the presence of a parent or guardian, or the written permission of the parent or guardian, the child must then be chaperoned by another adult. When working with vulnerable adults the therapist should consider the presence of a chaperone for their own and their client’s protection.

Physical Abuse:

As you are working in a way in which you may readily be able to see the results of physical abuse you must be able to recognise the signs and deal with it appropriately. If you suspect that a child or vulnerable adult is at risk,

or they make an allegation of abuse, you have a duty to inform a superior or to contact an organisation who can investigate the matter.

Verbal and Mental Abuse:

Not all abuse is so easily visible. The results of verbal and mental abuse can be difficult to see but watching a client’s body language and their reactions and responses to questions will be the key. Any sign of abuse should be noted and if explanations are given they too should be noted.

5/f

If you are performing a massage treatment on a client who is under 16 years of age you will need a parent or guardian present during the consultation and throughout the treatment. They will need to sign the record card as consent for the treatment to go ahead. This is a legal requirement and you would be breaking the law if you were to provide the treatment without consent.

Protection of Vulnerable Clients

As a therapist you must be aware of legislation that exists to protect children and vulnerable adults from harm and the professional way in which to work with them. The therapist must also take measures to protect themselves.

The working environment must allow clients to feel at ease and the therapist’s behaviour must remain professional throughout. Your aim is to support the client and maintain their dignity.

5/g

The principle that patients should give informed consent to medical treatment is fundamental to medical ethics. The legal significance is that any treatment given without the patient's consent is technically a form of assault. A patient could in theory sue a doctor for giving any treatment they were opposed to and did not consent to, or that they gave consent to without being 'informed', that is, having all the pros and cons thoroughly explained to them.

Any procedure or treatment that could possibly cause you damage or permanent alteration of skin or body (such as massage) should be consented to in writing so that the person undergoing the procedure or treatment does not later sue the provider. In order for the consent to be valid for a minor it must be signed by a parent or guardian. Minors do not legally have the capacity to consent.

As a minor can not legally be held to a contract their signature means nothing and will not protect the business requesting the signature. If you have an adult guardian sign the contract for a minor it is legal and can be enforced.

5/h

Hygiene

The professional organisations set out standards relating to hygiene which

are designed to ensure that treatments take place in an environment that is

free from the risk of contracting and spreading infection. This will have been

covered in your practical sessions, the use of disposable equipment and

covers where possible, thorough cleaning of non disposable equipment,

thorough washing of hands before and after treatment, covering of cuts and

abrasions during treatment, the wearing of gloves where appropriate.

Personal hygiene is also governed by the code of practice. Presenting a

clean, well groomed image is mandatory in your qualification and should be

adhered to once you are out in the workplace. When preparing for

treatments, showering daily, washing uniform daily, paying attention to oral

hygiene, will ensure that you are fresh and free from body odours. You are

working in close proximity to your client and that this really matters.

5/i

All waste must be placed straight into a bin which has a lid and contains a bin liner. At the end of the day/session, this should then be sealed and disposed of immediately into the main bin liner. Any waste that has met body fluids should be placed into a yellow bin liner if a large item, otherwise into a yellow ‘sharps’ container. This will then be collected and incinerated at a suitable site

5/j

Personal Information keeping:

Client’s records contain personal details and as such are required to be stored safely. Secure cabinets should be used for paper based records with access to them being limited. They should be stored in alphabetical order by surname in a locked metal filing cabinet or box. This should be easily accessible to the therapist, when ready to perform a treatment. A client is entitled to view their own record cards but under no circumstances should a client be able to gain access to other’s records.This information could also be updated onto a computerised system. As more salons begin to use computer-based records, other considerations must be made. The Data Protection Act has strict rules about what information can be held, who has access to it, and who is responsible for it.

5/k

A record card should be completed for all treatments and contains confidential personal information about each client that is specific to each treatment. Complete client record card and treatment record, checking if the client is aware of any contra indications they may have. Ask client what they are hoping to achieve from having the massage. ie relaxation. stimulation etc. It is a good idea to complete a treatment plan to ascertain what factors contribute to the clients stress levels. It is important that the client signs the client record card and treatment plan to show that they are happy with the information stored, and you are both in agreement as to how the treatment will proceed.Without this informed consent, you will not legally be covered.

5/l

In order for the client to be satisfied with the treatment you must know what is expected. As a therapist, you must be able to put the client at ease and be good at encouraging clients to give you the required information.

Instruct the client on how to prepare for the treatment:

-Ask them to remove jewellery from the area and glasses if worn.

-Clothing should be removed (explain what underclothes should be kept on).

-Explain to the client how to lie on the couch.

-Provide a towels for covering the client.

-Leave the client in privacy to prepare for the treatment.

5/m

Managing the time in a salon is an important element of the business. As we have mentioned in staffing, the therapist’s time is precious and should not be wasted. Good planning will ensure that the therapist’s time is used fully, with clients booked in at regular intervals without large gaps of idleness. Keeping to the commercially accepted time for treatments is crucial, as running over time will result in subsequent clients being kept waiting. Working in this way will be cost effective i.e. treating the greatest number of clients in the shortest possible time whilst maintaining a high standard of service.

A calculation is made for how long each treatment should take to ensure that the price charged for each treatment is correct and profitable. It is important

that you complete the service within the set time because:

-It prevents time wastage within the salon.

-Clients can calculate the time required for the treatment.

-Clients are not left waiting.

-An effective appointment system is guaranteed.

Full body massage including face and head : 1 hour 15 minutes

Back, neck and shoulder massage : 30 minutes

5/n

It is important to maintain your own standards of personal hygiene and appearance, ie long hair tied back and short clean nails so that you don’t scratch your client, plus long nails can harbour bacteria. Polish could also chip, and can disguise dirt underneath the nail.

5/o

Implements can be sanitised (kills most organisims) with surgical spirit, alcohol based sanitisers or Barbicide, or they can be sterilised (kills all living organisms) in an autoclave or glass bead sterilisei . The salon should always be kept immaculately clean and tidy, with disposable tissue used to line work surfaces and couches, and all products, equipment, work areas, and surfaces regularly disinfected. Bacterial is everywhere, and can even exist in oxygen free areas. Waste must be placed in a lined and covered bin, which is regularly emptied, and bin liners to be tied up securely when removed from bin.

6/a

Working area before a massage treatments:

-Two chairs will be required.

-An adequate supply of freshly laundered towels will be needed.

-Blankets and pillows/bolsters may be needed to keep the client warm and comfortable during the treatment. Alternatively, some salons use a heated electrical blanket underneath the bed cover to keep the client warm.

-A supply of bedroll, cotton wool and tissues should be available.

-Shower and toilet facilities should be clean and in working

order.

-An empty, lined bin should be available for your use.

-Treatment couch should be protected with clean linen. It should also be in full working order and safe.

-Electrical equipment should be checked to ensure that all plugs, wires and switches are safe, all dials are on zero and that the equipment is working correctly

-The trolley should be disinfected with appropriate product or surgical spirit. (Tissues, cotton wool, skin cleaners, massage medium, hair tie)

-All products should be available; containers should be clean and contain an adequate quantity of product.

-Record card and pen should be placed on the bottom shelf of the trolley. Check details of the client’s previous treatments prior to their arrival.

6/b

Appropriate ventilation or heating will be required as the client will be

undressed throughout the treatment - the room temperature should

be slightly warmer than normal. The room temperature should be able

to be adjusted throughout the treatment as required. Adequate

ventilation should also be provided to prevent cross infection of

viruses and diseases, carbon dioxide saturated air, stale smells and

odours.

Subtle lighting is recommended, the lighting should be dim so that it is not bright in the client’s eyes; the client needs to be able to relax.

Ambience, the room should smell pleasant, you may need to use aromatherapy oils or air fresheners. You should also consider the use of appropriate relaxing background music during the treatment (the radio would be inappropriate for a body massage treatment).

6/c

As you touch people, surfaces and objects throughout the day, you accumulate germs on your hands. Cross infection occurs due to certain

contagious micro-organisms (germs such as fungus, virus or bacteria) being transferred through direct or indirect contact. In turn, you can infect yourself with these germs by touching your eyes, nose or mouth. Although it's impossible to keep your hands germ-free, washing your hands frequently can help limit the transfer of bacteria, viruses and other microbes.

Always wash your hands:

-Always wash hands before and after each client. You should thoroughly wash your hands (it takes up to 3 minutes to destroy all germs).

-Preparing food, especially raw meat or poultry

-Using the toilet or changing a diaper

-Touching an animal or animal toys, leashes or waste

-Blowing your nose, coughing or sneezing into your hands

-Treating wounds or caring for a sick or injured person

-Handling garbage, household or garden chemicals, or anything that could be contaminated, such as a cleaning cloth or soiled shoes

-Shaking hands with others

-In addition, wash your hands whenever they look dirty.

How to wash your hands:

-Wet your hands with running warm water

-Apply liquid, bar or powder soap, lather well.

-Rub your hands vigorously for at least 20 seconds. Remember to scrub all surfaces, including the backs of your hands, wrists, between your fingers and under your fingernails.

-Rinse well.

-Dry your hands with a clean or disposable towel or air dryer.

-If possible, use a towel or your elbow to turn off the faucet.

6/d

Massage couch:

The massage couch should be sturdy, of appropriate size to enable a

client with a large frame to relax comfortably and ideally be height

adjustable, to allow perfect positioning for each treatment. The couch

should be lowered to enable easy access for the client and then raised to

the correct height for the therapist. A face hole may also be available to

allow the client to lie face down during a back massage. This is beneficial

as it allows full access to the neck and shoulder area. Other alternatives

are available if a face hole is not present such as towels, bolsters and

horseshoe shaped supports.

Position the client on the couch ensuring maximum support and comfort. A

pillow or towel roll should be supplied for support. The position of the

client should be central to the bed and also allow the therapist access to

the areas which are being treated. The client should be encouraged to lie

straight and not cross their legs. Client positioning is important to enable

the client to relax and prevent discomfort during the treatment, which

could lead to muscular aches and pains.

-In the supine lying position (on the back) offer

support under the neck or head and support may be

required under the knees.

-In the prone lying position (on the front) the head is usually

turned to the side and support can be provided under the ankles.

-Seated position is ideal for a pregnant or elderly client.

The client will sit on a chair and lean onto the protected

couch. Encourage the client to lean forwards, placing their

arms loosely folded and upwards for maximum comfort.

6/e and 6/f

A massage is a very physical treatment and therefore it is important that

you prepare appropriately and have good posture throughout the

treatment. If you have poor posture you will find:

-That you suffer from aches and pains.

-The treatment will be more difficult to perform.

-You will tire more easily.

-You become easily irritated.

-Usually the massage is less effective.

-You may develop Repetitive Strain Injury (RSI).

RSI is caused by injury to the soft tissues resulting from overuse. The

symptoms include pain, tingling and weakness in the wrist and fingers.

To prevent the above from occurring you should use the following

techniques when carrying out a massage treatment:

1. Stride stance – used when working across the body. Keep the back straight and bend your knees.

2. Walk stance – used when working along the body. Place one foot in front of the other and use a rocking motion from one foot to the other whilst moving along the body. Again, you should keep the back straight.

3. Good posture - keep your back straight, shoulders pushed back where possible, do not over stretch, do not hyper extend the knees and keep your weight as evenly balanced as possible.

It is important that you perform mobilising and stretching exercises for

your hands and wrists prior to massage to prevent any repetitive strain

injuries from occurring and to enable a more successful massage to be

performed. Take regular breaks and ensure you are working with the

correct posture. It is also advantageous to stretch the muscles of your

back, shoulders and arms to avoid muscle damage.

6/g

Members must always protect their client’s modesty and sense of dignity.

Guidelines:

-Items of clothing must only be removed where appropriate to treatment.

-Where treatment requires the removal of clothing, these items must be removed by the client.

-No pressure must ever be placed on the client to remove items of clothing if it is against their wishes.

-Clients must be advised during the consultation which items

of clothing, if any, they are required to remove for treatment.

-Should a client not wish to remove certain items of clothing, the member must respect their wishes and make the client aware of the limitations this may place on treatment efficacy and outcomes. A full and thorough consultation should help to identify and resolve any issues in this area.

-If it is necessary to adjust the client’s underwear or other garments for treatment, and it would be impractical for the client to make the necessary adjustment themselves, the member must obtain permission to do this on behalf of the client and ensure that they are comfortable with the adjustment.

-Modesty towels must be used as appropriate to the treatment undertaken.

-When removing items of clothing (or getting dressed after treatment), clients must be given a level of privacy appropriate to the level of disrobing required. Where possible, the member must leave the room if the client is getting undressed, providing them with ample time to remove their clothing and clear guidance as to how to position and cover themselves on the treatment couch with the modesty towels/garments provided.

-During treatment, it is recommended that all areas of the client’s body remain covered, other than the area being treated.

-The client’s hands must be tucked inside a towel or positioned in such a way that personal contact with the therapist is avoided during treatment.

6/h

A therapist must be aware that high standards of hygiene are

essential to prevent cross infection and secondary infection occurring.

Cross infection occurs due to certain contagious micro-organisms (germs

such as fungus, virus or bacteria) being transferred through direct or

indirect contact.

Secondary infection occurs because germs enter a cut or broken skin.

For example, if the client has a small graze and you use unhygienic

practices, the graze could become infected.

Before commencing treatment, you must ensure that the client has no

contagious diseases or disorders. You should then sanitise the area. The

client may shower first or alternatively sanitise the skin with a skin

cleansing substance such as witch hazel or antiseptic. Always remove

clients make-up before massaging the face using a suitable cleanser.

When carrying out a body massage treatment, you must ensure that the

genital area is covered. If the client does not have suitable clothing then

disposable paper pants should be provided. This is to ensure that no body

fluids from the client come into contact with any of the towels.

-Always wash hands before and after each client. You should thoroughly wash your hands (it takes up to 3 minutes to destroy all germs).

-All towels must be boil-washed after each client.

-If wooden spatulas are used for the removal of products, they should be disposed of after each client.

-Only use spatulas to remove products from any containers, never fingers.

6/i

All waste must be placed straight into a bin which has a lid and contains a bin liner. At the end of the day/session, this should then be sealed and disposed of immediately into the main bin liner. Any waste that has met body fluids should be placed into a yellow bin liner if a large item, otherwise into a yellow ‘sharps’ container. This will then be collected and incinerated at a suitable site.

For a business to run cost effectively and make a profit, it is important that all wastage is minimal. To work cost effectively:

-Use the minimal amount of product to produce the desired outcome.

-Split tissues, bedroll and cotton wool.

-Use minimal amount of towels.

-Place tops back on products to work hygienically and prevent spillages.

-Always turn off taps and don’t run the water excessively.

-Store products correctly – usually in the dark, cool, dry and upright.

-Turn out lights when not in use.

-Switch electrical equipment off when not in use

6/j

Therapy is most effective when the client and therapist work together. When using a massage, it is important to check with the client regularly to ensure their comfort is maintained.

7/a

Good communication skills – both verbal and non-verbal; examples of

good body language are good posture, eye contact, smiling and

encouraging head nods. You need to speak clearly, varying your tone

and at the appropriate pace. Use words that your client will

understand and always look at the client when you are talking to them.

Adapting your consultation – you should adapt your consultation for

each individual client taking into consideration their age, gender,

previous knowledge of massage treatments, culture, religion and any

disabilities.

7/b

One of the most important parts of the treatment is the consultation. At this point, you will discuss the client’s needs and decide what is required to meet those needs. Allow the client time to ask questions – this will give the client the opportunity to clarify any concerns or worries and makes them feel valued. In order for the client to be satisfied with the treatment you must know what is expected. As a therapist, you must be able to put the client at ease and be good at encouraging clients to give you the required information.

7/c

Because the body acts as a whole unit, therefore, when receiving massage therapy services or spa treatments, the whole body is being affected. You should obtain any previous record cards and check previous treatment and product details to provide a background about the client’s treatment history. You may also need to check medical conditions and establish if any contra-indications have been given previous medical consent. If you did not obtain important information such as client signature or check for contra-indications

then you could put the client at risk. This could result in the client taking legal action against the salon.

7/d

An initial treatment plan is completed with the client during the consultation. All the details are noted on the record card and agreed to by the client. It is very important that you write down the contents of the treatment plan as important details can easily be forgotten. In addition, another therapist may need to refer to the treatment plan.

7/e

A record card should be completed for all treatments and contains confidential personal information about each client that is specific to each treatment. It is important that the client signs the client record card and treatment plan to show that they are happy with the infiirmation stored, and you are both in agreement as to how the treatment will proceed. Without this informed consent, you will not legally be cowered. The significance is that the answers might be used in a court of law if there is a lawsuit concerning damage caused by the massage. The owners of massage salon must represent the dangers accurately.

7/f

When devising an individual treatment plan you will need to take into account different points; however, primarily the main reason for the client’s visit. The following information should be taken into consideration:

-Skin condition

-Weight

-Height

-Posture

-Muscle tone

-Age

-Health

-Treatment objectives

-Lifestyle:

=Occupation

=Domestic situation

=Dietary and fluid intake

=Hobbies, interests and means of relaxation

=Exercise habits

=Smoking habits

=Sleep patterns

-Contra-indications

-Contra-actions

-Area to be treated

It is important that the treatment plan is realistic, as you will find that the client will follow the treatment plan, and the improved result will be far greater than that of a client who is trying to follow an unrealistic treatment plan. That you must always advise the client that the results will be far greater when combined with the use of exercises, a healthy eating plan and a good homecare routine.

7/g

The therapist needs to be able to recognise postural and skeletal conditions and adapt the routine to suit the individual conditions. This will ensure that:

-The therapist recognises any serious postural faults that cannot be treated. A serious fault should be referred to a doctor.

-The treatment will not cause harm or discomfort.

-The most effective treatment procedure is selected.

-If the client has a minor postural fault, advice can be given to prevent the condition from worsening.

Points that indicate good posture are:

1. The head should not extend beyond the mid line.

2. When relaxed the arms should lie evenly at the sides.

3. The distance between the scapulas and spine is equal on both sides.

4. Scapulas are positioned equally horizontally.

5. The spinal column is straight.

6. The back has a natural curve.

7. The abdomen should appear flat.

8. The curves of the waist are level.

9. The buttocks should not protrude abnormally.

10. The legs should be equal in length, with knees facing forwards.

11. Body weight is evenly distributed.

12. The feet should face forwards and be slightly apart.

7/h

Skin is usually described as being either normal, dry, combination or greasy, with the added complications of being sensitive, dehydrated and mature.

-Normal skin has a good balance of oil and moisture, pores are small, texture fine and colour healthy. It rarely develops spots.

-Dry skin is lacking in either sebum or moisture, or both. It has a matt, dull uneven texture, sometimes flaky. The skin lacks suppleness and often feels tight. It is usually thin and fine with small, tight pores.

-Greasy skin has an excess of sebum. It has a shiny appearance. Skin tone is good due to the protection of sebum. Blackheads may be apparent.

-Combination skin is the most common type, usually dry on the cheeks and neck and oily on the t zone.

-Sensitive skin reacts to new products, the skin is warm to the touch, with high colour or dilated capillaries These are line pinkish lines in the skin. Sensitivity in black skin can be recognised by darker patches.

-Dehydrated skin is lacking in moisture, sometimes from illness, medication, overexposure to sun and central heating and not drinking enough.

-Mature skin is beginning to show signs of ageing, such as dryness, loss of elasticity, fine lines, sagging, thinning, sallow colour and pigmentation marks.

7/i

If the client has a contagious conditions you must recommend that they

seek medical advice and treatment before proceeding with the body

massage. It is important that you do not just send the client home, as

they need to receive treatment from their doctor in order to prevent the

condition from worsening and to alleviate the condition.

If you suspect the client has a contra-indication that prevents

treatment what procedure, should you follow?

1. Inform the client that there is a possibility of a contra-indication and

explain that you cannot carry out the treatment as it may cause harm

to the client.

2. If the client wishes for the treatment to be carried out they must

bring to you a doctors note.

3. Reassure the client.

4. Make a note on the record card.

7/j

It is important that you can recognise a contra-indication so to prevent any further harm to the client, and to prevent cross-infection and secondary infection. If the client has a contagious conditions you must recommend that they seek medical advice and treatment before proceeding with the body massage. It is important that you do not just send the client home, as they need to receive treatment from their doctor in order to prevent the condition from worsening and to alleviate the condition.

I can not diagnose, because Im not a doctor. Is unprofessional and may worry or upset the client unnecessarily.

7/k

Massage terapeuta should be sensitive to a client’s modesty at all times, and provide appropriate draping and treatment in a way that ensures their comfort and privacy. Members should safeguard the confidentiality of all client information. Disclosure to third parties, including other healthcare professionals should be only with the client’s written permission. Where information is disclosed to other parties, advice should be sought relating to the requirement to register under the Data Protection Act.

7/l

An individual's health depends a lot on their lifestyle. Maintaining physical and mental health are crucial to an individual's longevity. The more time spent on hygiene, physical fitness, and diet regulation, the healthier lifestyle they have. Those who chose to participate in any kind of physical activity on a weekly basis are generally healthier than those who don't. Mental illness may occur through various variables. For example, depression may promote mental illness through stress and anxiety. Massage can promote relaxation,

well-being and help relieve tension and stress.

7/m

A healthy lifestyle is an essential companion to any stress-reduction program. Massage can promote relaxation, help relieve tension and stress. People can enhance their general health and stress resistance by getting regular exercise, eating a diet rich in a variety of whole grains, vegetables, and fruits, and avoiding excessive alcohol, caffeine, and tobacco. That you must always advise the client that the results will be far greater when combined with the use of exercises, a healthy eating plan and a good home care routine.

8/a

Ask them to remove any jewellery , glasses or contact lenses (optional). They may also wish to tie up long hair. Ask client to remove upper clothing. and ensure bra straps are pulled down and tucked inside the side band of the bra. Whilst they is doing this make sure the curtains are pulled round.

They should then lay lace up on the couch and pull the large towel up over them, you can then place a smaller one over the chest.

8/b

Is always good practice to give your clients a leaflet explaining the advice, this way you make sure they know and understand what to expect.

The client need to be prepared, by asking them to undress down to pants, removing any jewellery and supplying them with towels. Most clients prefer their therapist to have a confident manner when explaining how to prepare, so do not feel you are being rude or bossy, especially if they have not received a treatment before.

Due to the nature of the treatment, you will find that clients require additional reassurance to that normally provided. You can reassure the client that:

Only the area being treated will be exposed at any one time.

They will feel more relaxed as they become used to their therapist. Generally, on the first visit the client will not be as relaxed as on subsequent visits due to the new surroundings and therapist.

If they are uncomfortable at any time, they must let you know so that you can adapt the treatment.

If the client does not feel comfortable having a certain area massaged, that area can be avoided.

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Massage mediums are products used to allow the smooth flow of movements over the skin during the massage. The medium chosen depends on the client's condition or needs, skin type, the reason for massage and the client's requirements. Dry skin can be recognised by being flaky, tight, peeling and dehydrated so use a medium which will put moisture back into the skin such as vegetable based oil rather than mineral based oil. More mature skin tends to have a loss of elasticity, so again use an oil. If the client has very oily skin, use a cream rather than oil. Other mediums available are talc if you are working on clients who have a lot of body hair. Fine lines around the eyes and mouth on a dry skin could be due to lack of moisture, so again apply a medium that contains oil or a rich nourishing cream. A dehydrated skin will tend to have superficial flaking.

Oil gives the most slip and is usually vegetable, plant or mineral based. Oil can be used on all skin types, however is most suitable for normal skin and hairy areas.

Massage cream will give a moderate amount of slip and is most beneficial on a dry skin type as it is richer in consistency.

Powder can be used if a deeper massage is required as it provides less slip. It is also the best massage medium to use on a greasy skin or on a client with a perspiration problem.

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If the client has make up, you may wish to cleanse the face with a suitable facial cleanser. The client may shower first or alternatively sanitise the skin with a skin cleansing substance such as witch hazel or antiseptic. Always cleanse the clients feet with some surgical spirit before you begin and check for problems such as athlete's foot or verticcas.

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The cell is the smallest unit of matter that can live independently and reproduce itself. Cells are the building blocks of the human body. Cells consist of four elements : carbon, oxygen, hydrogen and nitrogen. Besides the four elements water makes up to 60 to 80 per cent of all cells. Cells constantly divide and reproduce through mitosis. It is when a single cell produces two identical daughter cells. When a cell goes through the process of a programmed death (ie controlled destruction) it is known as apoptosis.

Cells exist in all shapes and sizes :

-elongated

-square

-star

-shaped

-oval

The function of cells is :

-growth

-respiration

-irritability

-movement

-metabolism

-excretion

-reproduction

The tissues

Groups of cells which share function, shape, size or structure are called tissues. There are different type of tissues:

-Epithelial tissue (epidermis) this forms surfaces and linings for protection. stratified epithelial tissue covers the outer surface of body (skin). epithelial tissue which has tall oblong shaped cell with hairlike projections in found in the bronchial and uterine tubes is known as ciliated columnar.

-Connective tissue (bone, cartilage, adipose, blood). This is a structural tissue that supports, surrounds and connects different parts of the body. White fibrous and yellow elastic tissue are types of connective tissue. Adipose connective tissue is also known as fat tissue. Its function is to provide protection to the organs close to it, to reduce heat loss and to act as an emergency energy reserve. It is found around the kidneys and in the subcutaneous (or hypodermis) layer.

-Muscular tissue (muscles) these contract and produce movement.

-Nervous tissue (neurones) these form a communication system between different parts of the body.

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Muscles are responsible for movement of the body and to maintain posture. Each muscle is made up of bundle of elastic fibres wrapped up in a sheath

(the fascia). The ends of this sheath extend to form a tendon, which attaches the muscle to other parts of the body. The outermos layer of the muscle is called the epimysium. Muscles never completely relax. there are always a few contracted fibres in every muscle, even when we are asleep, and this gives normal posture to the body. This is called muscle tone, and will vary from person to person.

A muscle is usually attached by a strong tendon to one bone. The point of attachment is known as the 'origin'. The muscle is also attached to a second bone, which is moved. this is called the 'insertion'.As the muscle contracts, it pulls the two bones towards each other. Not all muscles attach to bones, some insert into an adjacent muscle, or into the skin itself. Muscles never work alone. In general muscles work in pairs - each pair contains an agonist (the contracting muscle) and an antagonist (the Opposing. relaxing muscle.)

There are three different types of muscle tissue:

Cardiac muscle is found only in the heart, and is rcsponsible for keeping the heart beating rhythmically. Cardiac muscle contracts independently of our conscious will, and is characterised by slow, rhythmic movements.

Involuntary muscle (or smooth muscle) carries out automatic functions in the body, such as maintaining blood pressure, and controlling the pupil of the eye, and can commonly be found in the intestines. It contract independently of our conscious will. Involuntary muscles if seen under a microscope have no stripes which is why they are also known as smooth muscles.

Volunttiry muscles (or striated muscles) are the muscles which we consciously control, via our moter nerves. ie moving out legs when we want to walk. (A motor unit is a mator neurone and all of the muscles it stimulates) The muscle fibres look stripy under a microscope.The stripes are made of proteins (actin and mymosin filaments) which run across the muscle fibres in transverse bands. They are alternately light and dark and they give voluntary muscle its other name: striated. When the muscle contracts, the actin filaments slide between the myosin filaments, causing a shortening and thickening of the fibres.

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Abdominal attached to the inner surfaces of the ribs (last 6) and the iliac cres at one end and extends down to the pubis at the other. Action : compresses the abdominal contents and supports the organs of the abdominal cavity.

Biceps: positioned at the anterior of the upper arm. Attached to the scapula at one end and radius and flexor muscles of the forearm at the other. Action : flexes the elbow, supinates the forearm and hand.

Deltoid : thick triangular muscle which caps the shoulder . Attached to the clavicle and scapula at one end and side of humerus at other. Action : abducted at the shoulder (ie draws the arm backwards and forwards).

Erector Spinae: made up of separate bands of muscle, which lie in the groove between the vertebral column and the ribs. Attach to the sacrum and iliac crest at one end of the ribs, transverse and spinous processes of the vertebrae and the occipital bone at the other end of the ribs. Action : extension, lateral flexion and iotation of the vertebral column and maintain.s the correct curvature of the spine.

Gastrocnemius & Soleus:

Gastrocnemius a large, superficial calf muscle with two bellies on the posterior of the lower leg. Action : plantar flexion of the foot and assists in knee flexion.

Soleus situated deep in the gastrocnemius in the calf. Action : plantar flexes the foot.

Gluteus

Maximus a large muscle covering the buttock. Attaches to the back of the ilium, along the sacroiliac joint at one end, and into the top of the demur at the other. Action : extends the hip abducts und laterally rotates the thigh.

Medius partly covcred by the gluteus maximus, attaches to the outer surface of the ilium at one end and the outer surface of the demur at the other. Action : abduct and medially rotates the thigh.

Minimus lies beneath the gluteus medius. Action : abduct and medially rotates the thigh.

Hamstrings (made up of three muscles : the biceps femoris, scmitendinosus and semimembranosus). Semitendinosus and semimembranous are situated on the inside of the thigh and the biceps femoris is situated on the outside of the thigh. Action - extension of hip and flexion of knee.

Latissimus Dorsi & Rhomboids: attached to the posterior of the iliac crest and sacrum, lower six thoracic and five lumbar vertebrae at one end and humerus at the other end. Rhomboids are between the shoulder blades. Action : extends, adducts and rotates the humerus medially.

Obliques:

(external) broad, thin sheet of muscle slanting downwards from lower rubs to the pelvic girdle . Action : flexes, rotates and side bends the trunk, also compresses the contents of abdomen.

(internal) broad thin sheet ot muscle located beneath the external obliques, running up and forwards from the pelvic girdle to the lower ribs. Action : flexes, rotates and side bends the trunk and compresses the contents of the abdomen.

Pectoralis:

major - Thick fan shaped muscle covering anterior surface of upper chest. Attaches to the clavicle and sternum at one end and to the humerus at the other. Action : adducts and medially rotate the arm.

minor - thin muscle which lies beneath the pectoralis major. Attaches laterally and upwards from the ribs at one end to the scapula at the other. Action : draws the shoulder downwards and forwards.

Trapezius: large triangular shaped muscle in upper back. extends from base of skull to the scapula. Action : upper fibres raise shoulder girdle, middle fibres retracts scapula towards vertebrae and lower fibres draw scapula and shoulder downward.

Triceps: a posterior muscle of the upper arm. Attached to the posterior of the humerus and outer edge of the scapula at one end and to the ulna below the elbow at the othei . Action : extends the elbow, straightening the forearm.

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Primary bone or the primary ossification center is the beginning of the bone building process during the first trimester. Calcified cartilage is basophilic and new bone being made is more acidophilic. The primary ossification occurs in the diaphysis. In contrast, secondary ossification centers appear later at the epiphysis of the cartilage and develop similarly to the diaphysis.The human skeleton is the internal framework of the body. It is composed of 270 bones at birth, this total decreases to 206 bones by adulthood after some bones have fused together. The human skeleton can be divided into the axial skeleton and the appendicular skeleton. The axial skeleton is formed by the vertebral column, the rib cage and the skull. The appendicular skeleton, which is attached to the axial skeleton, is formed by the pectoral girdle, the pelvic girdle and the bones of the upper and lower limbs. Anatomical differences between human males and females are highly pronounced in some soft tissue areas, butsubtle differences between sexes in the morphology of the skull, dentition, long bones, and pelvis (sing. pelvis)

are exhibited across human populations.

Axial skeleton

The axial skeleton (80 bones) is formed by the vertebral column (32–34 bones; the number of the vertebrae differs from human to human as the lower 2 parts, sacral and coccygeal bone may vary in length), the rib cage (12 pairs of ribs and the sternum), and the skull (22 bones and 7 associated bones).

Appendicular skeleton

The appendicular skeleton (126 bones) is formed by the pectoral girdles, the upper limbs, the pelvic girdle or pelvis, and the lower limbs. Their functions are to make locomotion possible and to protect the major organs of digestion, excretion and reproduction.

The human skeleton serves six major functions:

support

movement

protection

production of blood cells

storage of ions

endocrine regulation

Each bone is connected to its neighbour by connective tissue or joints. These are the body's hinges. There are three types:

Incompatible joints also known as fibrous such as the cranium and pelvic girdle.

Slightly moveable joints also know as cartilaginous such as those between the vertebrae.The symphysis pubis is also a cartilaginous joint, joining the right and left pubis bone.

Synovitil joints also known as condyloid (or freely moveable joints ) - such as knee, elbow, shoulder and hip.

Hinged Joint

Hinged joints include the elbow, fingers, toes and knee. Movement occurs in only one direction or one plane. Innerbody.com states that the hinged joint in the knee is unusual because it allows the knee to swivel, turning the foot from side to side.

Gliding Joint

Gliding joints allow two or more flat or slightly rounded bones to move easily together without friction or grinding. Enotes.com, an online nursing

encyclopedia, states the function of a gliding joint is to allow motions such as smooth sliding of bone past bone, bending, stretching and circular motion. Examples of gliding joints include the forearm to wrist joint and the lower leg to ankle joint.

Pivot Joint

A pivot joint is a synovial joint designed with one end fitting like a cylinder inside a ring. Pivot joints at the base of the skull allow the head to rotate. Other pivot points allow the rotation of the palm.

Condyloid Joint

Condyloid joints are biaxial joints that permit up, down and side-to-side motions. Medical-look.com lists the radiocarpal joint in the wrist as an example of a condyloid joint.

Saddle Joint

The saddle joint is a biaxial joint that allows movement on two planes--flexion/extension and abduction/adduction. The thumb is the only bone structure in the human body with a saddle joint.

Fibrous Joint

The fibrous (fixed or immovable) joints in the skeletal system include the sutures of the skull. The coronal suture connects the parietal and frontal skull bones. The sagittal suture connects the two parietal bones. The lambdoid suture unites the parietal with the occipital.

Cartilagenous Joint

Cartilagenous joints are partially movable joints consisting of symphyses or synchondroses joints. Examples of cartilagenous types of joints include the rib cage and the spinal column.

Ball-and-Socket Joint

Mercksource.com, an online medical dictionary, describes a ball-and-socket joint as one in which the rounded surface of a bone fits into and moves within a cup-shaped depression. Examples of this type of synovial joint are the hip and shoulder joints. The ball-and-socket joint allows freedom of movement up, down, right, left and in a full 360-degree rotation.

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The three most common ones are:

Kyphosis is used to describe the curving of the back which leads to the top of the back rolling forward and causing a ‘hunchback’. The shoulders appeared curved and the scapulas are positioned further away from the spine. The chin also protrudes forward instead of being tucked neatly under the head.

Lordosis is an increase in curve in the spine. It is caused by certain muscles around the hip and lower back becoming tight such as the erector spinae and the hip flexors, whilst others such as the abdominals and the hip extensors become weaker, this presents a very inward curve in the central lower back.

Scoliosis is described as the spine curving to either side of the body like ) or a (the spine can also curve twice creating an S shape, in this circumstance the person may look straight as the curves counteract each other. The curve can impact on the ribs as it may start to pull the ribcage out of position. It is not always caused by anything in particular and can sometimes go unnoticed.

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The lymphatic system is closely connected to the blood system. Its main function is defence, but it also distributes fluid and traisports fat. It removes bacteria and foreign materials, thereby preventing infection. It also drains away excess fluids for elimination from the body. It also adds extra leucocytes and lymphocytes to the blood. Lymphatic vessels in the small intestines help with the absorption of fats during digestion .these are then transported around the body in the circulatory system and distributed to cells to be used as energy.

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The lymphatic system is a vascular network of tubules and ducts that collect, filter, and return lymph to blood circulation. Lymph is a clear fluid that comes from blood plasma, which exits blood vessels at capillary beds. This fluid becomes the interstitial fluid that surrounds cells . Lymph contains water, proteins , salts, lipids , white blood cells , and other substances that must be returned to the blood. The primary functions of the lymphatic system are to drain and return interstitial fluid to the blood, to absorb and return lipids for the digestive system to the blood, and to filter fluid of pathogens, damaged cells, cellular debris, and cancerous cells . The major components of the lymphatic system include lymph, lymphatic vessels, and lymphatic organs that contain lymphoid tissues.

All lymph passes through two main ducts before re-joining the circulatory system:

The right lymphatic duct : which is positioned at the root of the neck and empties into the right subclavian vein to rejoin the circulatory system. Lymph from right hand side of the head, chest and neck and from the right arm empties into this duct.

The thoracic duct : this extends from the sccond lumbar vertebra to the root of the neck and empties into the left subclavian vein to rejoin the circulatory

system. Lymph from the left hand side of the head, neck, both lowei limbs and the left side of the trunk and left arm empties into this duct.

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The brain and spinal cord are known as the central nervous system. In the brain is cerebrospinal fluid. This is a clear, colourless fluid situated in the lining of the ventricles of the brain and is circulated around the whole brain and spinal cord. Its function is to protect the brain and spinal cord acting as a shock absorber, it also transports nutrients and removes waste and toxiis. It keeps the pressure around the brain and spinal cord constant. The main parts of the brain are the cerebrum, thalamus, cerebellum and brain stem. The cerebrum is the largest portion of the brain and is divided into two hemispheres, and each hemisphere is divided into four lobes: frontal, temporal, parietal and occipital.

The automatic nervous system controls the involuntary activites of smooth muscles cardiac muscles and glands. It regulates the size of pupil, vasodilation and vasoconstriction of the blood vassels, the heart rate, monement of the gut and the secretion of most glands. It is divided into two parts:

The sympathetic division is stimulated by periods of stress or danger, increasing heart rate, dilating the bronchioles of the lungs, dilating the pupil of the eye and increasing sweating. Blood supply to the muscles is increased. and non cssential activities such as digestion. gut movements and ui inc production are slowed.

The parasympathetic division is stimulated in times of relaxation, calming the body. stimulating digestion and absorption of food.

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The enndocrine system is composed of glands which prodilce hormones, the body's chemical messengers. Hormones control and affect many body functions and organs, as well as behaviour. Each gland produces specific hormones. The function of the endocrine system is closely linked to that of the nervous system, and is responsible for maintaining homeostatis.

The respiratory system is the body's breathing equipment. It takes substances from outside the body by inhalation (gases, in particular oxygen), circulates them through the body to cells and tissues , then excretes the excess waste exhalalion of carbon dioxide. Oxygen is the respiratory systems 'food' and carbon dioxide is its 'waste'.

The basic principles of the digestive system are to aid in mastication, digestion, absorption and elimination of food. In the digestive system, food is broken down into component parts before it cnanbe absorbed by the body for nutrititon. Food is taken in through the mouth, broken into smaller particles and absorbed into the bloodstream, where is is utilised by the body. Waste materials not required by the body are their passed through the body to be eliminated. Once food has been absorbed by the body, it is converted into energy to fuel the body’s activities. This is known as metabolism.

The excretory system of the body is made up of the urinary system , ie kidneys, ureters, bladder and urethra and other organs who contribute to the job of waste elimination in the body : as the skin, lungs and intestines. The prime function of the urinaly system is the filtration, re-absorption, production of urine, excretion and regulation of water and salt. It helps maintain homeostatis by controlling the composition, volume and pressure of blood. It does this by removing and restroing selected amounts of water and dissolved substances.

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The skin is the largest organ of the body. It provides a tough, flexible covering with many different functions (mainly defensive), such as:

-Secretion

-Heat Regulation

-Absorption

-Protection

-Elimination of Waste

-Sensation

-Vitamin D Formation

-Melanin formation

The skin is made up three separate structures : the Epidermis, the Dermis, the Subcutaneous layer.

THE EPIDERMIS:

-Basal cell layer (stratum germinativum)

In the germinative zone of the skin , some other important cells are produced

-Prickle cell layer (stratum spinosuin)

-Granular layer (stratum granulosum)

-Clear layer (stratum lucidum)

-Horny layer (stratum corneum)

The epidermis is there to protect the deeper living structures from invasion and harm.

THE DERMIS:

The dermis is situated below the epidermis, and is much thicker, it consists of two layers :

The papillary layer is situated at the interface of the dermis with the epidermis. It is made up of wavy tissue, and the upward projections are called dermal papillae.They contain blood and lymph capillaries and nerve endings. It also supplies the epidermis with its nutrition.

The Reticular layer is situated beneath the papillary layer. It is composed of a network of protein fibres (yellow elastic fibres and white collagen fibres). Elastin gives skin its elasticity and collagen its strength. The reticular layer also contains the skin appendages : nerves, blood vessels, glands, hair follicles.

THE SUBCUTANOUS OR HYPODERMIS:

This layer consists of cells contain ing fatty deposits, called adipose cells. Adipose tissue is a connective tissue made up of fat cell,located in skin below the dermal layer and above the muscle.

It is designed to provide protection to the organs close to it, reduce heat loss and act as an emergency energy reserve. The thickness of the subcutaneous layer varies according to the body area, and is for example, very thin around the eyes. The fatty layer has a protective function and acts as an insulator to conserve body heat, it cushions muscles and bones below from injury, and acts as an energy source as excess fat is stored.

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African-Caribbean skin ages less quickly than Caucasian skin as it has more sebaceous glands and quicker cell turnover. Asian skin can be prone to hyperpigmentation when is scars.

Skin is usually:

-Normal skin has a good balance of oil and moisture, pores are small, texture fine and colour healthy. It rarely develops spots.

-Dry skin is lacking in either sebum or moisture, or both. It has a matt, dull uneven texture, sometimes flaky. The skin lacks suppleness and often feels tight. It is usually thin and fine with

small, tight pores.

-Greasy skin has an excess of sebum. It has a shiny appearance. Skin tone is good due to the protection of sebum. Blackheads may be apparent.

-Combination skin is the most common type, usually dry on the cheeks and neck and oily on the t zone.

-Sensitive skin reacts to new products, the skin is warm to the touch, with high colour or dilated capillaries These are line pinkish lines in the skin. Sensitivity in black skin can be recognised by darker patches.

-Dehydrated skin is lacking in moisture, sometimes from illness, medication, overexposure to sun and central heating and not drinking enough.

-Mature skin is beginning to show signs of ageing, such as dryness, loss of elasticity, fine lines, sagging, thinning, sallow colour and pigmentation marks.

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The subcutanous layer consists of cells contain ing fatty deposits, called adipose cells. Adipose tissue is a connective tissue made up of fat cell, located in skin below the dermal layer and above the muscle.

It is designed to provide protection to the organs close to it, reduce heat loss and act as an emergency energy reserve. The thickness of the subcutaneous layer varies according to the body area, and is for example, very thin around the eyes. The fatty layer has a protective function and acts as an insulator to conserve body heat, it cushions muscles and bones below from injury, and acts as an energy source as excess fat is stored.

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Order to understand the benefits and effects of massage, it is important to consider how the body responds physiologically.

Massage involves two types of responses:

mechanical responses as a result of pressure and movement as the soft tissues are manipulated

reflex responses in which the nerves respond to stimulation.

The Physiological Effects of Massage:

Effects on the Skeletal System: Massage can help increase joint mobility by reducing any thickening of the connective tissue and helping to release restrictions in the fascia. It helps to free adhesions, break down scar tissue and decrease inflammation. As a result it can help to restore range of motion to stiff joints. Massage improves muscle tone and balance, reducing the physical stress placed on bones and joints.

Effects on the Muscular System: Massage relieves muscular tightness, stiffness, spasms and restrictions in the muscle tissue. It increases flexibility in the muscles due to muscular relaxation. It increases blood circulation bringing more oxygen and nutrients into the muscle. This reduces muscle fatigue and soreness. It promotes rapid removal of toxins and waste products from the muscle.

Effects on the Cardiovascular System: Massage can improve circulation by mechanically assisting the venous flow of blood back to the heart dilate blood vessels helping them to work more efficiently produce an enhanced blood flow; delivery of fresh oxygen and nutrients to the tissues is improved and the removal of waste products, toxins and carbon dioxide is hastened via the venous system help temporarily to decrease blood pressure, due to dilation of capillaries decrease the heart rate due to relaxation reduce ischaemia (ischaemia is a reduction in the flow of blood to body parts, often marked by pain and tissue dysfunction).

Effects on the Lymphatic System: Massage helps to reduce oedema (excess fluid in the tissue) by increasing lymphatic drainage and the removal of waste from the system regular massage may help to strengthen the immune system, due to increase in white blood cells.

Effects on the Nervous System: Massage stimulates sensory receptors this can either stimulate or soothe nerves depending on the techniques used. It also stimulates the parasympathetic nervous system, helping promote relaxation and the reduction of stress. Massage helps to reduce pain by the release of endorphins (endorphins are also known to elevate the mood).

Effects on the Skin: Massage can bring about improved circulation to the skin, increased nutrition to the cells and encouraging cell regeneration. increased production of sweat from the sweat glands, helping to excrete urea and waste products through the skin. vaso-dilation of the surface capillaries helping to improve the skin’s colour. improved elasticity of the skin. increased sebum production, helping to improve the skin’s suppleness and resistance to infection.

Effects on the Respiratory System: Massage deepens respiration and improves lung capacity by relaxing any

tightness in the respiratory muscles. It also slows down the rate of respiration due to the reduced stimulation of the sympathetic nervous system.

Effects on the Digestive System: Massage can increase peristalsis in the large intestine, helping to relieve constipation, colic and gas. Promote the activity of the parasympathetic nervous system, which stimulates digestion.

Effects on the Urinary System: Massage increases urinary output due to the increased circulation and lymph drainage from the tissues.

The Physiological Effects of Massage:

Massage can reduce stress and anxiety by relaxing both mind and body. create a feeling of well-being and enhanced self-esteem. promote positive body awareness and an improved body image through relaxation. ease emotional trauma through relaxation.

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The circulation of blood follow 2 main pathways:

Systemic Circultition is when blood is circulated around the body by the heart. The heart is the pump that drives the whole circulatory system. The heartbeat (or cardiac cycle) is the pattern of muscular contraction of the heart wall. Oxygenated blood is send around the body via arteries and de-oxygenated blood is send back to the heart again via veins.

Pulmonary Circulation is when the heart sends de-oxygenated blood via the pulmonary arteries to the lungs to become re-oxygenated, then the re-oxygenated blood is sent back to the heart via the pulmonary veins.

There is also a third system: Portal Circulation which is when the veins from the stomach, spleen, pancreas and intestines join to form the hepatic-portal vein which carries blood into the liver.

When you feel your pulse, you are feeling the corresponding rate of the heart beat. The rate at which your heart pumps blood through your circulatory system. It is a wave of artery wall distension. When blood is pumped from the left ventricle into the aorta, the aorta swells. The elastic wall of the aorta then recoils, thus forcing the blood to more on. This sets up a wave of swelling and contracting which continues along the arteries. Wherever an artery passes close to the surface of the skin and over a bone, we feel this wave. Blood pressure is the forece that is exerted on the walls of the arteries as transmitted from the heart. High blood pressure in the arteries gradually becomes lower in the capillaries and veins. In the large

veins approaching the heart there is negative pressure. The heartbeat also affects blood pressure. When the ventricle is contracting it is high, when the ventricle is dilating it is low.

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Physically:

Muscles receive improved supply of oxygenated blood, muscles are warmed and stretched, improving tone and renge of movement, flexibility increases and pain and fatigue relieved. Lymphatic circulation improves, speeding up the removal of waste toxic debris. Blood circulation is improved, increasing blood flow to the area and helping to flush out metabolic waste. Oxygen and nutrients are delivered to the cells, and the gaseous exchange is improved, promoting healthier cells. Percussion movements have an effect on the lung tissue. Circulation to the bronchioles is increased, helping to feed and nourish the tissues, and this promotes good elasticity and gaseous exchange within the lungs. Sensory nerve endings can be soothed or stimulated, depending on the movements used. The oil and moisture balance of the skin is improved, due to stimulation of the sebaceous and sweat glands. The digestive system becomes more active with an increase in peristalsis.

Psychologically:

Each massage is adapted to the clients psychological needs, a stimulating massage will invigorate the client, whilst a slow, deep message will relax and help relieve tension and stress. The client will also feel energised as the body systems such as blood and lymphatic circulation are stimulated, and generally a feeling of well being is achieved.

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Erythema: a reddening of the skin where blood has rushed to the area being massaged, this is quite normal and quickly recedes.

Hyperaemia: is where an excess of blood has gathered in an area and takes a little longer to recede.

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A contra-indication refers to any condition that either prevents a treatment being carried out or will require the treatment to be adapted. You must thoroughly question the client during the consultation to ascertain if any contra indications are present, so that treatment can be delayed or adapted as necessary.There are always exceptions to the rule aid a therapist must use her common sense and discretion. If ever in doubt politely refuse treatment

and refer client to GP.

As a therapist you are not qualified to diagnose, but if any condition is suspected you must advise the client to seek medical advice. If you miss-informs the client, she could treat the condition with the wrong medication and your insurance would not cover you.

Contra-indications which could prevent a treatment are:

-Skin diseases or infections (viruses, bacteria,fungus,parasites)-Epilepsy (could bring on attack, and client could fall off couch, would need GP approval)-High/low blood pressure (could affect iced ication, & high bp at risk of strokes, low bp risk of fainting) Severe bruising in treatment area (would need to wait until bruising subsided)-History of throbosis or embolism (would need GP appoval, maybe at risk of re-occurance)-Spastic conditions (stiff and rigid muscles, lack of movement would make treatment difficult, would need GP approval)-Dysfunction of nervous system (Could affect medication,loss of sensation, would need GP approval)-Cancer (would depend on type, would need to liaise with coisultant)-Undiagnosed swellings (need to discover cause. would need G P approval)-Skin inflammation or suiburn in area (would need to wait until skin healed)-Severe eczema or psoriasis in area (not contagious, but treatment could irritate, and if weeping and inflamed - unhygienic)-Clieit under the influence of alcohol/drugs (unpi edictable, may collapse, vomit etc. Treatment could exacerbate coidition)

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Contra-indications which could restrict a treatment are :

-Open cuts/abrasions (cover with waterproof dressing and would not work over these) -Recent haemorrhage (usually wait 6 months or would seek GP approvaI)-Recent operations (usually wait 6 months or would seek GP approval) -Recent head/neck injruy (usually wait 6 months or seek GP approval) -Lack of tactile sensation (cai’e would need to be taken with

pressure used) -Recent scar tissue (would not work over this area)-Diabetes (reduced healing, impaired sensitivity, poor skin condition, bruise easily, way affectmedication) proceed with caution and check if any of above relevant and avoid injection site-Pregnancy (would not work over stomach area. Client would not be able to lay on stomach. If unstable pregnancy, then not at all, and some insurance companies stipulate no full body treatments ii first 3 months of pregnancy )-Menstruation (avoid stomach massage during first couple of days)-Arthritis and rhetimatism (be guided by clieit, but would need to be very gentle) -Over varicose veins (do not work over this area)

If you miss-informs the client, she could treat the condition with the wrong medication and your insurance would not cover you.

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Typical contra-actions may include:

-Tiredness due to release of toxins encouraged by the treatment and the initiation of healing energies, which require the body to rest

-Muscular ache and/or headaches the nerve fibres responding to the deep work that has been undertaken during treatment

-Heightened emotional state due to the positive release of deep-held feelings and emotions

-Frequent urination due to stimulation of the lymphatic system

-Changed sleep patterns you can fall asleep during the treatment, a state of relaxation may help you sleep better

-Active bowels body systems, including the digestive one, will work better

-Spots may occur released toxins and hormones may surface through the skin, especially if you previously suppressed your skin condition

Any contra-action symptoms you may experience are absolutely normal and will subside within 24 hours. With regular treatments and as a body starts to heal and re-balance, these after-effects will diminish.

It is important to rest afterwards and have a drink of water or herbal tea, this will help flush out any toxins released by the treatment and will help reduce the risk of any contra actions.

10/d

Contra actions are a mild side effect which can occur during or after treatment. They should subside within 24 hours, leaving you with a sense of wellbeing. This healing crisis (a contra-action) is a normal, positive effect, especially if you have never had a treatment before or if your body is very stressed. Massage helps all body systems to function more efficiently, speeding up waste removal and the elimination of toxins as well as getting rid of negative deep-held emotions. With regular treatments and as a body starts to heal and re-balance, these after-effects will diminish.

11/a

These regulations cover the installation, maintenance and use of electrical equipment and systems in the workplace.

Every piece of electrical equipment should be tested every 12 months by a qualified electrician. Also trained members of staff should regularly check electrical equipment every three months and the results recorded. Although it is the employers responsibility to ensure equipment is safe to use, it is the employees responsibility to always check it is safe before use - every time it is used, and never use if faulty.

Follow safety precautions for electrical equipment and check for any dents in the reflector or bulb as this could cause hot spots. Pre heat he lamp as required. All using part are sanitised and dry. We need enough long cable and proper electric power.

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The advantages of using these items are:

-Reduced stress for the therapist

-A deeper and more effective massage for the client Relaxation of the soft tissue and muscles

-Improved circulation and lymphatic drainage

11/c

Whatever you use to provide lubrication, always apply the medium to your hands first and then to the body. Do not put the oil, lotion, cream, or powder directly on the body because the cool sensation will be jarring to the recipient. Pour, shake, or scoop the lubricant into your hands, gently warming it first, and then apply it. Always check with your receiver to see if she has any known allergy or skin condition.

Using Oils

Oils provide a smooth, friction-free medium that allows you to massage large areas easily. There are many different types of oils: some are natural vegetable- and plant-based oils; others are essential oils; while others are made from nuts or seeds. Choose oils that nourish the skin, rather than oils that contain alcohol or mineral oil, because these rob the skin of nutrients.

Using Creams

Creams and lotions are thicker than oil, with less gliding ability. Lotion absorbs easily into the skin, whereas cream needs more rubbing before the skin soaks it up. Both of these massage mediums are easy to use and are less greasy than many oils. Cream may be easier for you to use when you want to work deep in the muscle. Cream and lotion are both good to use on the face or any area where oil is not preferred. Cream also works well on regions that are hairy, like calves and backs, because the hands are able to glide easily and the cream keeps the areas moist.

Using Powder

Powder reduces the friction when massaging, but it is not as good as cream, lotion, or oil. Powder is good to use on oily skin or when the recipient does not want any oil or cream on his or her body. A receiver with excessive body hair or an eruptive skin condition, like acne, is better served with the use of powder. The best powder to use is a cornstarch- or other natural-base powder made from plants or grains, because these are less likely to clog the pores.

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Infra Red Lamp

This lamp is used to create extra blood flow, which generates heat for the skin and underlying tissue. Muscle fibres will soften and it can be used effectively on any part of the body, but can only treat small areas at a time. due to the limited arc o1 light from the lamp.

Most clients would benefit from pre-heating the areas to be massaged with a device such as an infra red lamp, except perhaps clients with heat sensitivity. It is particularly useful on areas such as the back to loosen up tight muscles around the scapula, to allow deeper penetration during the massage.

The lamp is positioned about 12" away from the client, but adjust nearer or further until the correct amount of heat can be felt which is comfortable too that particular client.

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Using your posture correctly can also help you deliver a much deeper massage, as your body weight can be used, instead of youi hands and arms. This is also much less damaging to your own limbs.

11/f

The range of massage moves used in Body Massage are called effleurage, petrissage, friction, tapotement. and vibrations.

-Effleurage is a light, soothing, stroking movement which prepares the tissues for deeper massage. The pressure may be increased over less bony aieas. Effects are Relaxation, increased desquamation, stimulation of blood supply.

-Petrissage is a selection of compression (pressure) movements using either the whole of the palm or just the pads of the thumbs and fingers. Kneading, knuckling, rolling and pinching are examples. Effects are increased blood and lymph how due to the rhythmical filling and emptying of vessels and ducts, oxygen and nutrients are supplied to the cells and waste products removed. Increased desquamation and relaxed muscles fibres.

-Friction cause the skin and superficial structure to move together ovei the underlying structures. Performed with either the fingers, thumbs, or flats of hands, movement is concentrated in a particular area. Effects are stimulation of the skin and superficial tissues, improved lymphatic and blood circulation. and the breaking down of tension nodules.

-Tapotement is a selection of percussion moves, ie tapping and slapping, which are performed lightly and briskly without compressing the skin. Effects are stimulation of superficial nerve endings, causing toning and tightening of skin, improved blood flow and removal of stagnant lymph from tissues.

-Vibrations these are difficult to perform. A mild shaking or trembling movement is produced through the fingers, and this runs along the nerve pathways. Effects are relaxation, gentle stimulation of the deeper skin layers and relief ft om muscular pain and fatigue.

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It is important to have a good understanding of anatomy and physiology when performing body massage, so that you can understand the effects of the treatment on the body systems and can explain this to your client.The

body needs to be considered on a whole and not as a series of systems.This is important when carrying out holistic treatments, as each system of the body is closely linked to all the others and work in synergy. If you affect one part of the body, you very often affect many more. Massage can be adapted to suit the clients build, preferences and physical characteristics. Ie an children or ari elderly client may need a lighter and shorter massage. The massage can be adapted to the clients physiological and psychological needs. and these are determined during the consultation. The objectives may include - relaxation, stimulation, anti- cellulite etc.

11/h

Massage can be adapted to suit the clients build, preferences and physical characteristics. A muscular client may prefer a deeper massage and possibly the use of a gyratory machine. Care must be taken when using mechanical equipment that it is suited to that particular client, and to each part of the body being treated. For example mechanical massage may not be suitable for children or a very thin, frail, or elderly client. You will need to obtain regular feedback from the client during the use of mechanical massage, to ensure that they are comfortable throughout.

11/i

Male clients should be received in a polite and equal manner as female clients. However, the actual application of the body massage should be varied in the following ways:

-Very specific instructions should be given when asking the client to prepare for the treatment.

-Place one towel widthways across the chest, a towel folded into a double layer across the lower abdomen and finally a towel lengthways over the legs.

-Usually larger and denser strokes will be required.

-When massaging you should avoid the femoral triangle, working only up to a few inches above the knee. The abdomen and buttock area should also be avoided - if a female therapist is massaging a male client.

-Product choice may be affected depending on the amount of hair growth in the area being treated.

-Most men prefer products that feel light on their skin, so where possible select gel or lotion based products throughout the treatment.

-Avoid highly perfumed products.

-Be aware of the client’s personal space, do not lean over

unnecessarily.

-Always be respectful to a client and no suggestive comments or innuendo should be used.

If a male therapist is massaging a female client the chest, abdomen and buttock area should be omitted from the routine to prevent any discomfort or embarrassment.

Abdomen: This is not advisable during the first few days of the clients period. Also check if client would actually like this area massaged, as not all clients do.

11/j

Care must be taken when using mechanical equipment that it is suited to that particular client, and to each part of the body being treated. For example mechanical massage may not be suitable for children or a very thin, frail, or elderly client. You will need to obtain regular feedback from the client during the use of mechanical massage, to ensure that they are comfortable throughout. The abdomen and bones needs gentle treatment.

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The manual massage is relaxing for the clients, and feedback is obtained through the hands, as to areas of tension in the clients body, muscle tone and the effect the massage is having.

The machine works to manipulate the soft tissue of the body to produce the desired effects on the nervous and muscular systems, as well as working to enhance local and general circulation of the blood and lymphatic fluids.

11/l

The application of manual and mechanical massage complement one another, as manual massage is relaxing for the clients, and feedback is obtained through the hands, as to areas of tension in the clients body, muscle tone and the effect the massage is having. Mechanic massage can give a deeper treatment, giving the therapist a chance to work deep into a muscle without causing any injury to their own hands.

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Care must be taken when using mechanical equipment that it is suited to

that particular client, and to each part of the body being treated. For example mechanical massage may not be suitable for children or a very thin, trail, or elderly client. You will need to obtain regulai feedback from the client during the use of mechanical massage, to ensure that they are comfortable throughout.

11/n

Supports can be used under the knees whilst lying on their back if the client has lower back problems, or under the front, can be used under the ankles, when they are led face down to give extra comfort. A pillow or towel roll should be supplied for support.

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Important ask the clients for feedback on the treatment so you can gauge if it has been effective for them. Fill in their record card on your findings and ask when they would like to re-book. This will depend on the client and the reason for treating. Some people like to receive a massage on a weekly basis but, at the least, it is advisable to have a full body massage once a month as a preventative measure. You will design a treatment plan with your client to meet their individual needs.

12/a

A variety of lifestyle or health related habits (behavioural factors), and psychosocial factors (for example, stress and risk taking) can have a major impact on a person’s health. Behavioural and social issues that impact on health include smoking, diet, nutrition and alcohol (which together account for many CHD and cancer deaths), poor diet leading to obesity (reducing life expectancy) or alternatively malnutrition, lack of physical exercise.

The factors listed above reduction, or termination of all cases improves the effectiveness of massage treatment.

12/b

After the treatment it is important to obtain feedback to assist you when making future treatment recommendations. Always ask open questions, ie questions which require a full answer instead of a yes or no answer. Make sure you are listening and not doing all the talking, and giving the client space to discuss the treatment fully, and ask any question This will encourage them to give you truthful feedback so that you can adapt future treatments if necessary. You may wish to give the client some guidance on expected contra actions, how they can make lifestyle changes to improve

stress and tension, and how a healthy diet could benefit them. Clients suffering from particular problems such as extreme muscular tension, regular headaches, stress or anxiety may benefit front regular future treatments.

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DO NOT:

-Have a heavy meal after a treatment - allow 4-6 hours. Your body is in a healing state and is thus resting - massage stimulates the digestive system and therefore might make you feel nauseous.

-Drink a lot of caffeine drinks (tea, coffee, red bull) or stimulants - allow 12-24 hours. Alcohol might cause dehydration.

-Smoke - allow 12-24 hours.

-Rush around - exercise vigorously - allow a few hours. This will limit the effects of the massage.

-Ignore your body's messages. You might feel faint, tired and or thirsty.

DO:

-Relax for a while after a treatment. Have a bath to continue the relaxation process or listen to soft relaxing music.

-Give feedback to the therapist about the treatment.

-Wrap up warmly. You might feel cold after a treatment.

-Take care when driving home as your reflexes might be slower. You may feel faint or tired.

-Drink plenty of water, fruit juice or herbal teas. Your body might have been drained of lymphatic waste and toxins which may result in being thirsty and the water will help flush all the waste and toxins away. Water will help the detoxifying process and to rehydrate your body.

-Pay attention to general posture. Sitting and walking up straight is of importance.

-Have a nap or rest if you can - it will make the muscles relax and make the massage last longer.

12/d

Massage helps the body recover from the stresses of strenuous exercise, and facilitates the rebuilding phase of conditioning. The physiological benefits of massage include improved blood and lymph circulation and muscle and general relaxation. These, in turn, lead to removal of waste products and better cell nutrition, normalization and greater elasticity of tissues, deactivation of trigger points, and faster healing of injuries. It all adds up to relief from soreness and stiffness, better flexibility, and less potential for future injury.