Although some massage therapists and clients may consider hot stone massage to be simply fashionable, the use of stones and gemstones for healing purposes dates back thousands of years.

A Part Of History
Both verbal and written history confirm the Chinese used heated stones more than 2,000 years ago as a means of improving the function of internal organs. Stones were also used for healing work in North America, South America, Africa, Europe, Egypt and India.

These traditions included laying stones in patterns on the body, carrying or wearing stones for health and protection, using stones for the diagnosis and treatment of disease, and for ceremonial uses, such as sweat lodges and medicine wheels.

A Source Of Healing
The healing practices of curanderas (literal translation: “healers” in Spanish) and other female caregivers often included dealing with disease as well as pregnancy and childbirth. These folk healers used heated stones to diminish the discomfort of menstruation, plus the application of cold stones to slow bleeding after labor.

Some sources also cite instances of cultures in which women believed that simply holding stones during labor added to their strength and endurance.

Ancient Greek and Roman cultures have a long recorded history of many forms of massage and bodywork. The Roman Empire, which dates from 27 B.C. to 476 A.D., is noted for its creation of the Roman baths.

This ancient tradition is still with us today in the form of modern hydrotherapy practices. The Romans also used stones in saunas and combined the effects of hot immersion baths with the cooling effects of marble stone and cold pools.

An Old Technique Is Reborn
The use of heated stones in massage was reborn with the introduction of LaStone Therapy, created by Mary Nelson, in 1993. Stone massage has blossomed since then into a multimillion-dollar industry.

Stone massage, done correctly, is one of the most relaxing forms of massage a person can receive and because of its popularity, has once again traveled quickly around the globe.

The full-body, hot-stone massage has evolved to include deep tissue-specific work, hot-stone facials, hot-stone pedicures and manicures, and hot-stone meridian therapy. Because of their incredible energy, stones are used in reiki, polarity therapy and cranial sacral work.

There are many therapists who use their own variation of stone massage, from just placing stones on the body to a deep-tissue massage. Two important safety factors, however, apply to all uses of hot stones in massage therapy:

Never place a hot stone on bare skin without moving it.
Always use a barrier, such as a specific textile product designed for stone placement, or at least a sheet or towel to protect the skin.
The Evolution Of Stone-Supply Companies
With this massage modality growing in popularity, the need for sources of hot stone massage became a necessity. To this end, stone-supply companies evolved, such as Desert Stone People, TH. Stone, RubRocks and Nature’s Stones Inc.

The next challenge came with the need for heating the stones; incredibly, the initial suggested means of heating stones was in a turkey roaster.

Other options included crock pots, electric skillets and warming trays, all of which carried the possibility of overheating the stones and burning the client.

The problem, of course, was that all these options were actually kitchen appliances as opposed to being professional heating appliances manufactured specifically for spas, chiropractor’s offices and massage-therapy treatment rooms.

After much collaboration and cooperation between Nature’s Stones Inc. and the Metal Ware Corporation (makers of Nesco products), the Spa~Pro Massage Stone Heater, a unit designed specifically for hot-stone massage, was created.

The Value In Hot Stone Massage
As therapists recognized the value of working with massage stones, they also saw the need for high-quality instruction in the use of massage stones. Nelson assembled a team of therapists to teach all around the world. Sonya Alexander from TH. Stone was busy teaching, while Carollanne Crichton, founding director of The Institute of the Healing Arts in Rhode Island, then produced a video showing her method of stone massage.

As one of the first therapists on the East Coast to do stone massage, I was busy designing protocols for different modalities and teaching in Europe, the Caribbean and across the U.S.

Please look for future articles on www.MASSAGEmag.com, as I explore the exciting arena of stone massage. I will write about safety issues, contraindications, the expansion of stone therapy to different modalities, the evolution into cold-stone therapy with marble stones and now the resurgence of stone massage with the innovation of carved basalt stones.

I will also discuss accessory products, such as massage oil, essential oils, heaters, textiles, DVDs and seminars. I look forward to an ongoing conversation with you.

An estimated 10 million Americans suffer from a known hypothyroid condition, and 10 percent of adult American women may have some degree of such conditions, according to endocrineweb.com.
January is National Thyroid Awareness Month, sponsored by the American Association of Clinical Endocrinologists, a time when massage therapists can learn how clients with thyroid disorders might benefit from massage therapy.

Signs of a Challenged Thyroid
Hypothyroidism

The term hypothyroidism encompasses any condition witnessing the thyroid gland’s inability to produce adequate levels of hormones known as T3 and T4. Hashimoto’s thyroiditis, an autoimmune inflammatory condition that destroys the thyroid gland, is the leading cause of hypothyroidism. The other major cause indicates a broad medical treatment term that includes surgical procedures to remove all or a portion of the thyroid. Removal of cancerous tissue in thyroid cancer patients is a prime example of this cause.

Major signs and symptoms of hypothyroidism include fatigue; muscle weakness; fluctuations in weight without an obvious reason; dry, thinning hair; rough skin patching; cold intolerance; depression; abnormal menses; decreased libido; and cognitive challenges.

A patient may be difficult to diagnose by her physician due to not manifesting many of these symptoms initially. Insidious changes occur slowly, leaving a patient wondering why he feels off-balance. Most people will not think to consider their thyroid as the culprit, resulting in symptoms worsening slowly over time. Serious complications can occur, including heart failure, coma and severe depression.

The Enlarged Thyroid
Goiters, or enlarged thyroids, may be witnessed in hypothyroid patients. These result from an

Thyroid Gland

overproduction of thyroid-stimulating hormone (TSH) from the pituitary gland. The constant stimulation from TSH will cause the thyroid tissues to swell. If the thyroid gland still cannot produce adequate T3 and T4 hormones, the patient will be considered to have goitrous hypothyroidism.

It is important to note that the presence of a goiter does not always equate to hypothyroidism. Other conditions featuring the development of a goiter include dietary iodine deficiency, the patient taking lithium carbonate, infectious disease, postpartum complications or a rare fibrosis condition called Riedel’s thyroiditis.

A massage client with hypothyroidism could be on one of several different medications for the treatment for hypothyroidism. The most common drug is a synthetic thyroid hormone usually sold under the brand name Synthroid or Levothroid, according to the website of the Mayo Clinic. The generic name of the drug is Levothyroxine. This drug is a synthetic form of T4 hormone (the most significant of thyroid hormones) and is used to replace one’s T4 hormone levels. Evaluation of dosage can be tricky for some patients. Proper communication with the endocrinologist is key to determining the proper dosage daily. An annual evaluation of the drug’s effectiveness is expected as well.

The half-life of Levothyroxine is six to seven days, meaning it takes this time period for the drug serum levels to drop significantly enough to become insufficient in the patient. Because of such a long half-life, massage therapists must communicate effectively with the client to determine how the drug is affecting the client at the time of massage treatment.

Common side effects of Levothyroxine and other hypothyroid medications include chest pain, changes in menses, headache, fatigue, heat intolerance, hives, facial swelling, breathing challenges, fainting and tremors, according to the Mayo Clinic’s website. Overdosing symptoms include changes in consciousness, skin pallor, vertigo, changes in pulse, confusion and sudden headaches, aphasia and apraxia. It is important for massage therapists to recognize these signs and symptoms with their hypothyroid clients.

Massage for Thyroid Patient Health
Massage therapy and related bodywork can benefit the hypothyroid patient in many profound ways. First, a significant reduction in the patient’s symptoms can be witnessed with the usage of acupressure. This benefit was demonstrated by a research study in Russia conducted in 2011. Reflexology and Gua Sha technique were also utilized in this study involving Chinese medicine theory in addressing hypothyroidism.

A second benefit of massage therapy for the hypothyroid patient is aiding improved blood and lymphatic circulation. Since proper blood and lymphatic flow is vital for all endocrine organs, the thyroid could benefit from improved circulation.

Reduced inflammation is a third benefit derived from massage therapy and related bodywork. Research through the Buck Institute for Research on Aging in Novato, California, and McMaster University in Ontario, Canada, indicates that massage therapy may create a result similar to anti-inflammatory medications at a cellular level. This benefit will aid the hypothyroid patient with Hashimoto’s thyroiditis or similar inflammatory concerns.

A fourth benefit of massage treatment is reduced stress within the body. This benefit can decrease cortisol and other stress hormones to help manage weight healthily.

Finally, increasing muscle strength will combat the fatigue and weakness often felt by the hypothyroid patient. A Swedish massage including a large percentage of petrissage strokes can enhance the size, strength and stamina of muscle tissue.

Whether you have two years’ experience or 20, you have no doubt discovered that building and maintaining a full-time massage therapy practice places a large physical demand on your body. Massage therapists often develop overuse injuries from repetitive movements of the upper extremities. Many learn too late that self-care is critical for enjoying a long and pain-free massage therapy career.

These physical demands are growing, too, as the size of our clients grows. According to the U.S. Centers for Disease Control and Prevention as reported by CBS Atlanta, American men’s average weight is approximately 30 pounds more now than it was in 1960; American women’s weight is approximately 26 pounds more.

How can we respect and protect our maturing, possibly injured bodies—and continue to deliver consistently superior sessions?

Here are my favorite career-extending self-care strategies:

1. Clothes-On, No-Oil Treatments
I made the switch to clothes-on treatment more than 20 years ago and have never looked back. The clothes-on approach enhances a client’s mobility, resolves potential modesty issues, and brings a more clinical focus to your practice.

I ask clients to wear a well-worn, cotton T-shirt and sweatpants, because both offer a modest amount of friction; I can take a position and press through the clothes, and my fingers do not slide.

It takes more effort and energy from me to deliver deep pressure and glide at the same time on oiled skin. Through clothing, I can deliver consistent, sustained pressure with less force coming from me. Less force means fewer repetitive injuries for the therapist.

Another benefit of the clothes-on approach is that it frees you from using oil or lotions. From a practical standpoint, it’s a treat to not have that continual cleanup and expense.

2. Side-Lying Position
Clothes-on massage eliminates draping, which opens up the all-important side-lying position. You’ve likely had many times you were out of position, leaning over a client in prone or supine position, using poor body mechanics, stressing yourself to get into an area that needed to be addressed. The side-lying position solves that.

I use pillows under the head, knee and feet to make a client comfortable, relaxed with muscles on slack, and therefore much more approachable. Treatments then require less pressure from me and are delivered from a place of proper posture, my back straight, without leaning over.

Also, in the side-lying position you don’t have to lift a heavy arm or leg to massage it properly.

side-lying massage position
David Morin demonstrates clothes-on, no-oil massage with the client in a side-lying position.

3. Use Tools
In the late 1970s, when I studied Neuromuscular Therapy with Paul St. John, the training included work in the lamina groove using wooden tools with a soft tip. One was rounded and one was beveled. The design didn’t fit my hand very well, so I redesigned the T-shape into an L-bar, changed the dimensions a bit, and ended up with what I have for 20 years been calling the Thumbsaver and the Beveled L-Bar.

I turned to these tools to save my career because my thumbs gave out; in fact, repetitive glides and strokes have left my thumbs profoundly changed. This wasn’t caused so much by delivering direct pressure as it was by turning and twisting to get my thumb into the right place. Pressing in with my thumb tool cradled comfortably in the palm of my hand, I can provide sustained pressure—moderate or deep—for as long as needed without using my thumbs. For sensory input, I use the tips of my fingers to track alongside the rubber point of the tool, so I can feel for just the right amount of pressure in just the right spots.

Especially though clothes, your clients will not be able to tell the difference between a tool and your overused thumbs.

4. Use More Pull, Less Push
Massage is all about pushing and pulling—usually much more pushing than pulling. In the side-lying position particularly, I can brace one hand on a client’s arm or leg to provide a stabilizing, opposing pressure, and with the other hand work a variety of pulls that greatly reduce the wear and tear on my body. Again, less repetitive pushing and greater diversity, using pulls, mean fewer injuries for the therapist.

Examples:

Cross-fiber Tibialis anterior in side-lying position. Brace the client’s ankle with one hand while using your fingertips to cross-fiber the entire length of the muscle.
Brace the ankle as above while using a thumb tool to apply direct compression along the lateral head of the gastrocnemius and soleus. Notice how little pressure it takes to get excellent results.
Forearm to Vastus lateralis in side-lying position. With one hand on the client’s lateral knee, either brace or move in opposition to the opposite forearm that is applying direct compression or cross-fiber treatment the entire length of the muscle.
Brace the elbow when treating anterior and medial deltoids in supine position.
Stabilize opposite forehead when treating suboccipital muscles.
Brace foot in the air in prone position while pulling on peroneals, gastrocnemius and soleus.

5. Specialize
Particularly valuable to therapists who are so damaged they are ready to give up their careers is the move to specialize in treating the head, neck and jaw exclusively. This greatly reduces the mechanical stress on the therapist, and at the same time opens the door to establishing a referral network with both physicians and dentists for treatments on headaches and temporomandibular joint dysfunction.

I specialize in medical massage therapy and employ the full range of clinical protocols: assessments, measurements, treatment plans, remedial exercises and more. So for me, a client session is more diverse than just hands-on manipulation. That means less wear and tear on my body.

Clients come to me to achieve targeted results on specific problem areas, and we work toward those goals. I rarely, if ever, give a full-body massage. This allows me to focus and position myself in the most beneficial posture to do what must be done.

6. Invest in a Rolling, Adjustable Stool
Clients with painful conditions and injuries usually require extensive treatment in specific areas. Neck and jaw treatment, for example, have always been paramount in my practice. It takes time to be thorough, and being seated on a rolling stool brings my body back into good posture.

7. Teach Client Self-Care
Teach your clients a self-care program of using daily hydrotherapy and active range-of-motion exercises to enhance their care. Clients often get better more quickly, and the therapist’s work becomes easier. This therapeutic relationship encourages personal responsibility and eases the expectation that healing is only the responsibility of the massage therapist. However, note that in some states even recommending exercise is outside the scope of practice of massage therapy. First, make sure you are acting within the law.

8. Take Care of Yourself
We all need to counterbalance the repetitive nature of giving massage with regular active range-of-motion exercises for the shoulders, back, arms and hands. A comprehensive self-care program is an important key to a long and healthy massage therapy career.