Spiriphysical Blog

The Time is Right to Get Out of  the HEAT!

http://www.malibutimes.com/articles/2010/07/15/malibu_life/art4.txt 

http://www.oasisdayspanyc.com/summer2010

In the first news letter I shared with you, I covered the importance of working with cooler temps and how it helps the body heal. There are several factors involved with chilled marble stones

-         Being able to explain to your client the importance of cool/cold stones
-         Speaking with conviction
-         Knowing the proper application
-         Being aware of which part of the body is most sensitive to cold

I work with cold/cool stones in every session I do with hot stones unless medically contraindicated. This means if a client says “I hate cold” that is not good enough for me. This means it is up to you to explain the benefits in a manner they will understand. As body-workers, we need to stand by what we know is right; remember we are the professionals. Over the past 11 years of doing stone massage, I have not had one person turn down a session with cool stones if medically appropriate.

When starting with a new client or trying to make the transition with marble stones, the introduction has to be gradual in order to build confidence. If someone has been saying for many years that they hate cold, well guess what; they will not like it. I suggest you start off with a pillow stone because even if you are not doing a stone session a cool stone at the base of the neck will feel great. When clients have a strong resistance to cooler temps, makes sure the stones are not too cold. Taking marble out of the freezer is about as cold as a stone will get which is not good for a hesitant client. Most often you will be taking the marble out of a cooler and if need be you should take them out a few minutes before using them. There is a direct correlation between the amount of heat and the amount of cool; if the stones are not that cold, the basalt stones will not be that hot. It is important to bring in balance since it is what our body needs and deserves. When speaking to your client about the marble, you will get a much better response by using the word cool as opposed to cold.

Three additional points when applying cool stones

-         Your client should be exhaling when you first apply the cool stones
-         When the stones first make contact, press firmly and do not move them until the client has adjusted to the temperature change.
-         Pressure must be firm and slow and only lighter and maybe faster if your client likes cool stones.

By: Bruce Baltz, LMT
Founder of SpiriPhysical, Inc.
For information on workshops go to:
www.SpiriPhysical.com

Stone work has been used for centuries as a healing practice by most indigenous people. Over the past ten years, stone work has entered the spa industry on many different levels. The use of Reiki/Energy Work, Swedish Massage, and Deep Tissue Therapy are just a few techniques that have been represented in this modality. The least recognized in this group is the use of ‘hot and cold stones’ for deep tissue application.

I have been involved with the body work related industry for the past twenty-three years as a personal trainer and a massage therapist since 1993. My focus as a massage therapist has been working with various facets of the medical community and athletes. This back ground assisted me in the development of Deep Tissue Healing ‘The Art of Stone Massage its application.

Stone massage is in a transitional stage, with the general public and most massage therapists thinking of stone work as a gentle relaxing treatment designed for spas primarily using hot stones only. Over the past five years, my focus has been on the education and development of deep tissue stone work with both hot and cold stones. In the practice of this modality the stones are used as an extension of my hand with direct contact to the body with the use of Prossage Heat (oil/ointment). The strokes that are used will be very familiar to all deep tissue massage therapists from effleurage to myofascial release and trigger point work to mention a few. With a solid foundation and understanding of stone massage a therapist can use that knowledge and utilize it for almost any modality.

The benefits of hydrotherapy are well recognized and supported by the medical community for its therapeutic properties. Stone work should now be added to that list because of its effectiveness in applying contrasting temperatures to the body. When working on an ischemic area, our goal is to increase blood flow to initiate the healing process. The severity of the injury will determine the amount of time that you will spend applying hot or cold stones. When a hot stone is presented into the treatment, the hyperemia will happen faster than with the use of hands alone. Your client’s muscle will relax sooner, which in turn will enable you to work deeper staying within the comfort level of your client.

If chronic pain has to be addressed in the treatment, it is essential that cold stones be applied. The more sensitive the injury the shorter the duration of heat that will be used. Increased blood flow in chronic pain situations can become an irritation if sustained for too long. In this situation cold stones will be used for a longer period of time than hot to reduce that inflammation. It is important to use cold stones in every treatment. The duration will depend on how much heat was used and the condition of the muscle tissue you are working on.

In Deep Tissue Healing basalt/ lava stones are primarily used to transfer heat, where as the hand carved white marble stones are used for the cold application. It has been found that basalt/lava will hold heat longer than other stones, and white marble stones will maintain a cooler temperature more efficiently. Shapes and sizes of stones vary depending upon the treatment area and the size of your client. As your stone work becomes more medical in nature the shapes and sizes are more important. With proper selection, you will be able to engage the affected muscle, tendon or ligament with more accuracy. For example, when accessing subscapularis you will use a stone that is oblong yet flat with a length of approximately five to six inches, depending upon the size of your hand. When the proper stone is chosen, you will find accessing hard to reach areas to be much more effective. During this deeper application the smoothness of the stone and the warmth will relax the affected tissue with little to no discomfort experienced by your client.

The basalt/lava stones are heated in water not in microwaves, crock pots, hot caddies for towels, or electric skillets, because the temperature is harder to control. When stone massage first entered the spa treatment realm we were using ‘turkey roasters’, 18 quarts or larger, yes a kitchen appliance to heat the stones. But now there is NESCO, which manufacture a heater called “Spa Pro.” This heater is better suited for stone massage because of its professional appearance and better quality of components. The cold stones can be made cool in three different ways: (1) refrigerator, (2) cooler with ice, and (3) the freezer. The choice on how to cool the stones is entirely yours along with the client’s tolerance to accept this change in temperature. For those clients who adapt well to the change in temperature, then cooling the stones in the freezer would be ideal. Whenever working with temperature (be it hot or cold) we must keep in mind less is more. As stone massage therapists there are two rules that must not be broken first do not bring a hot or cold stone to the table that you do not feel confident to handle. Then you will have to consider the tolerance your client has for heat or cold being applied directly to their skin. If this is not respected, a contraction to resist your work could occur. We want to avoid this contraction so that the client will obtain the maximum benefit from the treatment.

The preparation and understanding of working to work with stones safely must incorporate proper body mechanics. When I am working with a stone as an extinction of my hand, I take away the ability to work with the back of my hand and the use of my forearm. In this position, the end result is that my wrist could be in a hyper-extended position for most of the session. I can tell you, from experience this is not a good thing. The stones might save your fingers but in exchange you have done damage to your wrist. Using both hands equally and changing the angle of your wrist will help increase your longevity as a stone massage therapist. If you are able to combine this with pinning the stone to the body instead of holding it in your fingers your ability to feel through the stone will be greatly increased.

Stone Massage is still in its infancy, and I am committed to bringing this modality to a higher level in pain management.

Bruce Baltz is an internationally recognized educator with over twenty years experience in the fitness and bodywork industry. Bruce is a licensed massage therapist in New York and Florida and is the founder of SpiriPhysical Inc.

Stone massage as we know it today has gone through many changes as its popularity has grown, from spa sessions to injury treatments. Today, massage therapists have many choices in stone work education. There are almost as many stone work classes as there are modalities in massage. They range from home study classes to several day workshops, from Reiki with stones to deep tissue.

With therapists and businesses trying to keep up with the public’s demands for stone massage, the industry has run into legal setbacks which are not acceptable.

In my opinion, the blame cannot be put on any one party. Therapists must be held responsible for their actions as well as a business that offers any type of service. This means the providing parties need to seek out the proper knowledge so all necessary steps are taken to provide the best treatment possible.

The two elements all these workshops have in common are the use of heat and that a stone is applied to the body whether it is through a drape or directly to the skin.

For this work to be done within a safe range for the therapist and the client, there are several steps that must be taken into consideration:

The ability of the therapist to handle a hot stone
When you take a stone out of the hot water, make sure the temperature of that stone is within your tolerance. If it is too HOT, your ability to apply that stone with confidence, whether through a drape or on the skin, will be greatly hindered. Your client will feel your lack of confidence.

Your client’s tolerance to accept heat
Now that you have a stone you are confident you can handle, we must consider your client’s tolerance for heat. We must take all precautions to assure your client will have the best treatment you can provide. If a hot stone is being placed on the body through a drape, it should be done through a towel, not a sheet. The sheet will often be too thin. It is essential that you check with your client to see how the temperature feels to him. There are some techniques done by laying on stones. The chances of your client being burned by laying stones is greater but can be done with proper training. I tell all my clients that they are in control of the session, which also includes temperature, hot or cold, and pressure. If you do not give your client this permission, he could say to himself, “You are the professional and I guess this is the way it should feel.” We cannot afford to have this thought cross his mind. If your intention is to apply a stone directly to the skin, you need to make sure the heat stays within the client’s tolerance. If the maximum level is 10, and we do not want to be there, we are looking for the 7 to 8 range for deep tissue work. You will also have to acknowledge that the 7 to 8 range could be different on each of your clients, with hot, cold and pressure, and this must be respected. If these steps are taken by the properly trained therapist, it will greatly reduce the chance of injury to the client.

Day Spas, Resorts, and Medical Offices
To add stone massage as a modality for you to assist in the healing process you need to be aware of the learning curve to apply this technique safely. I refer to Deep Tissue Healing, the deep tissue work I teach. When therapists come to me for training with the use of hot and cold stones, I ask the therapist to take a stone in his hand and work with it as though it is part of his hand. It does not matter how long one has been a therapist, the stone will be an equalizer in class because the student therapist has to massage with that stone as though it is an extension of his hand. This process will take time before the stone can be one with the therapist’s hand. The therapist will need time to adapt the stone into the flow of his work. When this time is not taken, the therapist will not develop the technique properly. Thus, the therapist will not feel comfortable and the client will pick up on this feeling and not want the treatment again. This will reflect on all stone massage therapists, which will perpetuate a negative feeling for stone massage.

I do not recommend one therapist be sent to ANY workshop and come back to their place of business and train the rest of the staff in what they have learned. This could be a formula for disaster for the client, therapist, and owner. This could result in a client’s being injured and legal actions could be taken. I do want to thank the businesses that support continuing education for their massage therapists, but I will ask you to allow your therapists the time to perfect their modality whatever it may be. The end result will benefit all involved.