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What is hot stone massage about?   Are any special preparations necessary before going to get a hot stone massage? Why do people get a stone hot massage as opposed to any other form/type of massage?

Hot stone massage is a specialty massage where the therapist uses smooth, heated stones, either as an extension of their own hands, or by placing them on the body while they massage other parts of the body. The heat can be both deeply relaxing and help warm up tight muscles so the therapist can work more deeply, more quickly.    It is also is a style of massage therapy in which water-treated stones are placed at specific sites on the client’s body to promote relaxation and to help open up the meridians (energy pathways). The muscles are pretreated with the heated stones to allow the therapist to more easily perform deep tissue manipulations. Cool stones are sometimes used alternately with hot stones. Massage oils are usually incorporated into the massage treatment.

People also get hot stone massage for a variety of health conditions and some other benefits of Hot Stone Massage could include:   (1) Back pain and aches; (2) Poor circulation; (3) Arthritis; (4) Osteoarthritis; (5) Stress, anxiety and tension; (6) Insomnia; (7) Depression; (8) Promotes deep muscle and tissue relaxation; (9) It alleviates stress; (10) Releases toxins; (11) Relieves pain; (12) Improves circulation; and (13) Calms the psyche.

Some of the Origins of Hot Stone Massage

Hot stones warmed by fire were used by Native Americans to treat aching muscles, but the modern revival of hot stones in massage is generally credited to Mary Nelson, a native of Tucson, Arizona. She trademarked her style of hot stone massage, called La Stone Therapy, which has a Native American spiritual component and requires training and certification.

Most spas offer their own versions of hot stone massage (they might call it lava stone massage, river rock massage, warm stone massage and so on.) A hot stone massage, however, takes a lot of skill and sensitivity on the part of the therapist. One of my most memorable spa treatments was a hot stone massage.

The quality of the treatment depends on how well the therapist has been trained, how skilled he or she is, and whether he or she enjoys doing the treatment. Some therapists don’t like to do it because the hot stones are difficult to handle.    Even a terrific massage therapist can be so-so at hot stone.   An excellent suggestion for making sure you get a great hot stone massage is to get a La Stone Therapy, because you know the therapist has been well-trained and has made a serious investment in training. You can also ask where the therapist learned hot stone massage, and how long he or she has been doing it.

Another approach is to ask the front desk if there is someone who is a specialist in hot stone massage. Some massage therapists love doing this treatment, while others aren’t so hot on it. A good front desk will know which therapist to recommend.

This is also a treatment where you’re counting on the spa and the therapist to be impeccable with sanitation, because those stones have been on someone else’s body. I wouldn’t get it at anything done at or go to somewhere that looks like a discount spa.

What Happens During a Hot Stone Massage?

Before you arrive, the massage therapist sanitizes the stones and heats them in bath of 120 to 150 degree water. The stones themselves are usually basalt, a black volcanic rock that absorbs and retains heat well, and have been smoothed by natural forces in the river or sea.

You usually start face down, with the therapist working on your back. First, the therapist warms up the body with traditional Swedish massage, and then massages you while holding a heated stone. As the stone cools, the therapist replaces it with another. The therapist uses many stones of various shapes and sizes — big ones on the big muscles, smaller ones on smaller muscles.

The therapist might also leave heated stones in specific points along your spine, in the palms of your hand, on your belly, or even between your toes to improve the flow of energy in your body. Many therapists believe that the stones themselves have an energetic charge and that needs to be maintained by placing them in a spiral pattern, placing them in a full moon periodically.

Be sure to speak up if the stones are too warm or the pressure too intense. And you can always ask them to stop using the stones if you don’t like how it feels.    If you like heat but not the stones, lava shells and steamed towels are another way to get heat into a massage.

Hot Stone massage is not appropriate if you have diabetes, high blood pressure, heart disease, or are on medication that thins your blood. You shouldn’t get a hot stone massage if you are pregnant or have sunburn. You also may want to reconsider if you are menopausal, as it may trigger a hot flash.

The hot stone massage is not recommended for:   (a) People with infectious skin disease, rash, neuropathy, or open wounds; (b) Immediately after surgery; (c) Immediately after chemotherapy or radiation, unless recommended by your doctor; (d) People prone to blood clots. There is a risk of blood clots being dislodged. If you have heart disease, diabetes, or circulatory conditions, check with your doctor before having a massage; (e) Pregnant women should check with their doctor first if they are considering getting a massage during pregnancy. A full body hot stone massage or placement of hot stones over the abdomen is not recommended during pregnancy, however a massage therapist trained in prenatal massage may be able to do a spot treatment for certain areas of muscle tension. In pregnancy, the core body temperature should not be raised during treatment. Women with high risk pregnancy should avoid hot stone massage; and (f) People with rheumatoid arthritis should avoid hot stone massage, because the heat of the stones may trigger a flare-up.

Massage should not be done directly over bruises, inflamed skin, unhealed wounds, tumors, abdominal hernia, or areas of recent fractures.

In order to provide a successful hot stone massage that is safe and comfortable here are some guidelines to be mindful of:   (1) Begin by sanitizing the stones and heater you are using by washing (scrubbing) in hot, soapy water and drying stones and heater thoroughly; (2) A white hand towel or washcloth in the bottom of the pot helps you see the stones and quiets the noise the stones make while you are in session: (3) Leave the lid off; when you place the lid on squarely, the heat gets trapped and the stones tend to overheat – even on low or warm; (4) Regardless of which type of heater used, be sure to use a thermometer to accurately gauge the temperature of the stones, keeping the temperature well under 140 degrees. Be sure you can reach in and grab a stone in your hand; (5) Try keeping a small bowl of cold water for too hot stones. If the stones are accidentally overheated, use this bowl of cold water to cool them down by dipping the hot stones in quickly. This allows you to work with the stones while you wait for the heater to cool down; (6) Try using cold stones (quarts or granite) on the face for contrast. Allow stones to rest in a small bowl of ice water to get them cold; (7) When working with stones, be sure to avoid hyperextending the wrist as this can lead to fatigue and pain in the therapists’ wrists, hands and forearms; (8) Heat will absorb faster in different areas of the body so be on the lookout for this. It typically feels great for the client when you slow the stones and allow the heat to be absorbed in these areas. Also, stones can be used to address trigger points or to activate tsubos (shiatsu points), and reflexology points. Other nice touches are tapping one stone with another over trigger points or placing a large stone to rest (on a towel) on the abdomen and rotating clockwise; and (9) Do not allow the stones to rest in a static position on bare skin or place the stones under the client. Also be aware that damp towels, sheets or blankets will transfer heat very fast so be sure the towel, sheet or blanket is dry before placing a hot stone to rest on it.

Any type of heater can be used to heat stones for massage therapy, but it is the responsibility of the therapist to be sure they do not become overheated. It is also important that the stones and heater be cleaned and sanitized properly between each client. Therapist must also be aware of the additional risks and contraindications that may arise due to the addition of hot stones and be able to work with clients to ensure they receive appropriate services.

Kathy Kiefer



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