Transition of Stone Massage

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.