Massage and Bodywork Licensing Examination MBLEx Test Client Assessment and Treatment 1 — Questions and Answers
Question 1: During palpation of the upper trapezius, a therapist identifies a taut band with a hypersensitive nodule that reproduces the client's familiar headache pain when compressed. This finding is most consistent with which of the following?
- Delayed onset muscle soreness
- A myofascial trigger point (Correct answer)
- Ligamentous laxity
- Acute muscle strain
Correct answer: A myofascial trigger point
A taut band with a hypersensitive nodule that refers pain in a recognizable pattern is the hallmark of a myofascial trigger point. DOMS presents diffusely after exercise, ligamentous laxity involves joint stability, and acute strain lacks the referral pattern.
Question 2: A client experiences pain during active knee flexion but reports no pain when the therapist passively moves the knee through the same range of motion. This difference most likely implicates which type of tissue?
- Articular cartilage
- Joint capsule
- Contractile (muscle-tendon) tissue (Correct answer)
- Collateral ligaments
Correct answer: Contractile (muscle-tendon) tissue
Pain that occurs during active but not passive motion indicates that the contractile elements (muscles and tendons) are involved, since passive movement does not require muscular contraction. Cartilage, capsule, and ligament issues typically produce pain during both active and passive movement.
Question 3: During a health intake, a client discloses a recent diagnosis of deep vein thrombosis (DVT) in the left calf. What is the most appropriate action for the massage therapist?
- Perform only light effleurage distal to the affected area
- Avoid the left leg entirely and massage the rest of the body normally
- Refer the client back to their physician before beginning any treatment (Correct answer)
- Apply moist heat to the calf to promote circulation
Correct answer: Refer the client back to their physician before beginning any treatment
DVT is a systemic contraindication because massage could dislodge the clot, creating a life-threatening embolism. The therapist must obtain physician clearance before any massage is performed, even to unaffected areas.
Question 4: While observing a client's gait and static posture, a therapist notices pronounced anterior pelvic tilt and excessive lumbar lordosis. Which muscle groups should be prioritized in the assessment and treatment plan?
- Hamstrings and abdominals
- Hip flexors and lumbar erector spinae (Correct answer)
- Gluteus medius and tibialis anterior
- Gastrocnemius and soleus
Correct answer: Hip flexors and lumbar erector spinae
Anterior pelvic tilt with increased lordosis is typically driven by shortened/overactive hip flexors (iliopsoas, rectus femoris) and lumbar erectors pulling the pelvis into anterior rotation. Addressing these facilitates correction of the postural deviation.
Question 5: When passively moving a client's shoulder into full external rotation, the therapist perceives a firm, leathery resistance before the anatomical end range is reached. Which term best describes this finding?
- Soft tissue approximation end-feel
- Bony end-feel
- Capsular end-feel (Correct answer)
- Empty end-feel
Correct answer: Capsular end-feel
A firm, leathery quality that stops motion before the true end range is characteristic of a capsular end-feel, indicating tightness or fibrosis of the joint capsule — commonly seen in conditions such as adhesive capsulitis.
Question 6: A client describes their neck pain as a 4/10 stiffness that is worst in the morning, eases after 20–30 minutes of movement, and worsens again after prolonged desk work. In a properly structured SOAP note, where is this information documented?
- Objective (O) section
- Assessment (A) section
- Subjective (S) section (Correct answer)
- Plan (P) section
Correct answer: Subjective (S) section
Information reported by the client — including pain intensity, quality, onset, aggravating and relieving factors, and behavior over time — is subjective data and belongs in the S section of a SOAP note. The therapist's measurable findings go in O, clinical impressions in A, and the treatment strategy in P.
