Research, intake & reflexology
This guide mirrors the content distribution of the 50-question Theory Exam #2 without copying the exam questions. Study the concepts, then practice applying them to client scenarios.
Exactly what's on Theory Exam #2
Research literacy and reported physiologic, musculoskeletal, nervous-system, psychological and whole-body effects of massage.
Scope, standard of care, communication, health literacy, intake, pain scales, interviewing, treatment planning, PICO, consent, client rights, documentation and SOAP.
Reflexology history, zones, landmarks, techniques, treatment guidelines, pressure, foot mapping and contraindications.
Lymphatic drainage, later pathology units, ethics chapters, business, advanced techniques and other material that hasn't been taught yet.
Chapter 6 · Massage Therapy & Research
Research is an ongoing process. Findings can conflict or change. Separate evidence from myth and avoid turning a reported effect into a guaranteed outcome.
Know reported changes involving skin blood flow, capillary flow, surface temperature, heart rate and blood pressure.
Know reported findings involving lymphatic drainage, edema and immune-related measures without claiming massage prevents or cures infection.
Review range of motion, pain, muscle relaxation, EMG activity, fatigue, connective tissue, scar and tendon findings.
Review relaxation, parasympathetic response, stress, anxiety, depression and well-being.
Sleep, pain and fatigue are common outcomes studied across multiple populations.
Why is “massage cures anxiety” weaker language than “research has reported reductions in anxiety in some populations”?
The second statement accurately reflects uncertainty and population differences instead of promising a universal medical outcome.
What should you do when research findings conflict?
Acknowledge that evidence is mixed, evaluate study quality and avoid overstating certainty.
How should you handle a client claim about “flushing toxins”?
Don't reinforce an unsupported mechanism. Clarify the client's real goal and explain realistic massage effects in evidence-based language.
Chapter 10 · Professional Standards
Know what massage therapists can legally and competently do. Assessment for massage planning is different from diagnosing disease.
The level/type of care expected from a reasonably competent professional with similar training under similar circumstances.
Communicate factually. Document what was seen, heard, reported and done rather than inventing conclusions.
Clients need understandable information to make decisions. Communication should account for language, culture and comprehension.
Intake & assessment
Assessment happens before, during and after treatment. It helps determine health status, massage goals, contraindications, preferences, functional concerns and response to treatment.
Personal/contact information, relevant health/medical information, massage history and preferences.
VAS uses a line; NRS commonly uses 0–10; VDS uses descriptive phrases; Wong-Baker uses faces.
Allow explanation and reflection.
Request a specific answer such as yes/no or a location.
Seek deeper understanding.
Confirm that the client's meaning was received and understood.
Treatment planning & PICO
A treatment plan can include goals, techniques, areas treated/avoided, positioning, pressure, session duration/frequency, reassessment, adjunctive approaches within scope, home care and referrals.
Patient, population or problem
Intervention
Comparison or control, when applicable
Outcome of interest
Why is PICO useful?
It turns a clinical uncertainty into a focused question and helps identify useful search terms for evidence.
Informed consent & client rights
Consent requires adequate information, voluntariness and competence. Discuss relevant procedures, products/tools, draping, benefits, risks, costs/policies, privacy and therapist qualifications. Clients can refuse or withdraw consent at any time.
A client signed a consent form last month but asks you not to perform a technique today. Which instruction controls?
Today's refusal. Consent is ongoing and can be withdrawn.
Can a therapist refuse or postpone a session?
Yes, including when contraindications exist, boundaries are violated or the therapist feels unsafe.
Documentation & SOAP
What the client reports: feelings, symptoms, preferences and experiences.
Observable or measurable massage-relevant findings.
Massage-relevant summary of the session/findings and client response without diagnosing outside scope.
Future treatment focus, frequency, reassessment, home care or referral recommendations.
How should a handwritten documentation error generally be corrected?
Use the approved documentation procedure, commonly a single line through the error with initials rather than obscuring the original entry.
Chapter 13 · Foot Reflexology
Pressure to specific points on feet/hands; historically called zone therapy. Eunice Ingham mapped and popularized modern foot reflexology.
Traditional theory uses 10 vertical zones, five associated with each foot.
Know the neck/shoulder, diaphragm, waist and pelvic lines and the treatment regions they help organize.
Finger/thumb walking progressively works across a zone or treatment area.
Direct pressure and hook-in/backup isolate specific traditional reflex points.
“Desserts” include foot/ankle flop, dorsiflexion, plantar flexion, inversion and eversion.
Does a tender reflex point medically diagnose a problem in the corresponding organ?
No. Reflexology mapping is a traditional framework, not a medical diagnostic test.
How deep should reflexology pressure be?
Within the client's pain threshold, not beyond it.
Name several local contraindications for direct foot reflexology.
Examples include active fungal/bacterial/viral skin infection, skin lesions, gout, recent foot/ankle injury, painful corns/bunions or pitting edema.
Integrated practice
A client says, “I want you to diagnose why this shoulder hurts before we start.”
Explain that massage assessment can guide treatment, but medical diagnosis is outside massage therapy scope.
A client reports pain 7/10 before massage and 4/10 after. Where could those numbers be documented?
As client-reported pain data, with the measurement method identified. They can support reassessment of the treatment goal.
A client withdraws consent after you begin chest work.
Stop that work immediately, re-drape appropriately and discuss whether the client wants to continue with another area or end the session.
A client with athlete's foot requests reflexology directly over the affected skin.
Avoid direct work over the contagious fungal infection and follow infection-control procedures.
Ready?
If you can explain these concepts without looking them up and apply them to new scenarios, you're ready for the aligned 50-question exam.
Take Theory Exam #2 →