Unit 2 - Lesson 2: Creating an Effective & Safe Treatment Plan

Learn how to create an effective and safe treatment plan for massage stone therapy

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Let’s say somebody comes in and they are on a lot of medication from their doctor and one of the things they can not do is experience a hot tub or a Jacuzzi or a sauna room. Right a way when you find out, you do their intake you realize that this person is not allowed to, either because of their health issue or because of the medication they are on, not sit in a hot tub or sit in a Jacuzzi or a steam room. That gives you a clue that you can’t use too hot of a stone on them or even challenge them possibly with cold. You are going to want to start on what we call the treatment one.


Treatment one is a 30 minute treatment. It’s full energy work or just stone placement. You are not going to move a stone on the body. You are not going to oil up the client. You are just going to allow this body to experience hot and cold stones through towel or several layers of sheets. It’s going to be only 110 degrees Fahrenheit and only room temperature cold. That’s the most challenge you are going to offer the client because they are not allowed in that hot tub. They are not allowed to over heat for various reasons.   You are only going to do it for 30 minutes and then you’ll send them on their way.


Now, that doesn’t seem like a lot. Especially if the client comes in and they want an hour treatment or they want a 70 minute or 90 minute treatment. But because you found out what’s going on with their internal system, you made an educated decision that you want to help them over a period of time tonify and strengthen their internal body system. You explain to them over a period of time we will add more temperature and add more technique, but to begin with we need to see how the body handles this exchange of temperature for 72 hours.


It takes the body 72 hours to figure out what happened when you applied temperature. Whether that’s a hot tub, a Jacuzzi, a steam room, hydrotherapy tubs, Vichy showers, hot and cold stone massage, whenever you offer temperature to the system, whether that’s isolated temperature or whether that’s full body experience, the body takes 72 hours to process that information.   That’s because the liver has to do that. It’s the slowest regeneration of our organs and it takes the liver that long to do that. So you need to monitor your client for 72 hours.


I know that’s kind of like whoa, you mean I have to call them or text them or email them to find out how they did for 72 hours? The answer is yes. When you are working with people that have health issues you are responsible for knowing how they respond for 72 hours when you apply temperature to their body. It doesn’t matter if it’s stone massage or that Vichy shower or that hydrotherapy tub, you have to know. Or, the next week when they come in you can’t decide to strengthen the treatment. And that’s the goal. You start off easy and over a period of time we’re going to strengthen that treatment just like you do when you are body building or learning anything new like hiking or climbing, whatever.


Now days we have texting and I love that because that’s what I do with my clients. I text my clients. I don’t call anybody. I have one client I have to email. Everybody else I can text. I want to know….three words…How you felt this evening after your treatment. It’s important to know how that was. If it was that 30 minute treatment with just castle building or just energy work (no stone moving) they’re going to have responded really well. Even if they’re pre and post surgery they are going to have responded really well. Then you want to check in the next day and do it again. And, you’ll do it on the third day. It’s important to know how they responded all three days so that you know the following week you can go up to treatment two. If there was a positive response for all three days then you can move up to treatment two for 45 minutes and you’ll repeat whatever you did the last week. It will still be 110 degrees Fahrenheit. It will still be room temperature for cold stones or cool stones. It will be 45 minutes with still stone placement. No moving yet. We’re not going to push blood and lymph around on these people manually. The hot and the cold stones will gently encourage the fluids to move around. But we’re not going with mechanism, a technique, move hot and cold stones on the body, yet.


Same deal. You’re going to call them three nights in a row, or text them or email them. If you are going to call them on the phone you are going to have to seed in their head that you don’t want to infringe on their private time. That you only need one minute of their time, in their evening, to find out how they did after their treatment on that first day, and one minute of time on the second evening and one minute of time on the third.   And you must help them understand that you are not infringing on their time because if not, they are going to infringe on yours and they are not paying you to make these phone calls. You have already been paid. You are going to have to, somehow, get them to understand that you don’t want to take up your time and you don’t want to take up their time, in a very polite, supportive way. But you need these answers. That’s why texting is so nice, or an email.


If you don’t do this homework, if you don’t choose to journalize and write down now hot it was, how cold it was, how long it was, what technique you used, and how they did for 72 hours you should not work on people that fall in to these categories because these people require you to journalize and take notes and monitor, can I strengthen the treatment the following week when you’re using temperature?


So, you get a good result on the second week, the second treatment. Ideally these should be every seven days. These are your bread and butter people because they need to come every seven days.


Third week we are going to increase the temperature to 120 degrees Fahrenheit and we are now going to use 50 degree cool stones. It’s going to be for 45 minutes and it’s this treatment where you can start adding some technique. Maybe reflexology, maybe face and neck work, maybe they have low back pain and you can do some hot and cold on their lower back. It will be isolated work because you don’t have time in 45 minutes to do a full body session. But you certainly have time to offer temperature through stone placement and through some technique to help them feel comfort and relief in specific body parts.


Again, you have to take your notes. You have to text, you have to call, you have to email. Whatever your choices are for you and your client. Don’t expect them to write it down on a piece of paper and bring it back to you the following week. They’re not going to remember that paper or if they do they will leave the paper at home. Then they won’t remember if day two is sort of iffy and day three was great, day one was awesome. You have to check in at that time, first day, second day, third day.


Treatment four the following week you’re going to increase the time now, but we’re going to stay at 120 degrees Fahrenheit and 50 degrees cold. Now we can add a little bit more. We have 15 more minutes, but our temperature is the same as the week before. Now we’re adding more technique. Depending on what condition they fall in to in these different categories will determine what technique is appropriate for that client’s health. Swedish massage is not always appropriate. I personally don’t ever do Swedish massage with a diabetic and hot and cold stones. I do Shiatsu with them, reflexology, any energy work you can think of, compression, but not Swedish application or Lomi Lomi type strokes. That’s too much fluid moving through their system too fast with temperature because when you add temperature to a stroke you ten-fold what’s going to happen with the fluids within the system. It’s not just the circulatory system, the heart, it’s also the lymph and it’s also the digestive juices. So you don’t want to push their fluids too fast. It’s too hard on that diabetic. Especially if you are not aware of how their diet is and you’re not sure if they are following the protocol for their needs.


In treatment five you are going to bring the temperature up to 130 degrees Fahrenheit and 40 degrees cold and it’s going to be 60 minutes. So from treatment four we were at 60 minutes at this temperature, 120 and 150. Treatment five is 60 minutes again, but we’ve increased the temperature, hot and cold getting farther and farther away from body core temperature. This is more and more challenging the body. So each time we lengthen the treatment, make the duration longer, or we take the temperature farther away from body core temperature we challenge the system to make changes. And each time you do that when you are dealing with somebody that has a health issue you take the opportunity to ask that body to change chemically. And that’s what you want to do. Your goal is to help them change chemically over a period of time. But do it in such a way that it’s gentle and it’s not going to challenge them too much. You don’t want them having bad results.


Typically between the fourth and fifth week is when people that have health issues start to have one or two days not so good results. They might feel a little dizzy, they might be a little nauseous, they might be irritable, they might be sluggish, it’s not consistent as to how they are going to respond to that. But that’s typically what happens because now we’ve expanded the time and increased the temperature experience from body core. That’s when the body starts to go OHHH this is kind of work. This is aerobic exercise for your fluids within your system. This is where they start to tonify and strengthen. So sometimes when you are bodybuilding, or you’re doing rock climbing or whatever, you start to get those sore muscles. The same thing is going to happen with your fluids in your system. Your heart, your lymph, your digestive juices. They’re now working overtime. More so than what they’ve been exposed to so far. The order of when their day isn’t all that great isn’t the same either. There’s no consistency to that. Sometimes it’s the first day, sometimes it’s the second and sometimes it’s the third.


If it’s only one day that they had a challenge with, then you’re just going to repeat treatment five again that next week. If the second time you repeat treatment five they still have a bad day, you’re going to repeat treatment five again. Now, if they had two days that they didn’t feel so great then you’re going to drop down and go back to number four and you are going to stay on four until they feel strong. Until all three days are good.


Each time you go up this ladder, each time you go from treatment to treatment, they have to have all three days positive before you can expand the temperature and increase the duration of time. So once you get them back, say you have to do treatment five three times before they get strong to that treatment and have three good days. They you’ll get them to treatment six.


Now we’re going to increase our time. So now we’re at 70 minutes and we’re going to stay at that 130 degrees Fahrenheit and that 40 degrees Fahrenheit. Here you have more time. You have 70 minutes so now you can add more technique. If you’re a Swedish massage therapist you can do a full body session at this point with stones. Or you can do Shiatsu work, reflexology work, what ever is going to work for that client for their needs for that day.


Now were going to come up to treatment six and it’s going to be 70 minutes long so that’s expanding the time/the duration of the treatment and it’s going to be 130 degrees, just like it was for treatment five and it’s going to be 40 degrees Fahrenheit. This time, now we’re at 70 minutes. This gives you the opportunity to do a full body massage with the stones. You have that chance to offer Swedish massage or Shiatsu, reflexology, Lomi Lomi whatever it is that client’s needs, whatever is going to serve the goals for that day. You now have expanded it long enough that you can do full body for them.


This is where you would want to make sure, with a diabetic, that you’re only going to do that Shiatsu work or that energy work or that more of a passive and not so much pushing blood and lymph on them. But you can still offer them that longer period of time with that extended temperature.


Someone, depending on their heart condition and their lymphatic condition, will also be allowed to have this going on for them. Having that time that 70 minutes, that full body experience.


You’re still going to keep calling them even if you massage somebody that falls in to these categories for a year. Every week you’re going to still text them every night for three nights, you’re still going to call them, you’re still going to email them. You need to know every week because if you don’t know, you don’t know if you can tonify and strengthen that treatment. People go on vacation, they eat differently, they sleep differently, they exercise differently, they are more active usually on vacation so that’s going to change how their body does the week when they come back from vacation. If they miss a treatment a week or two when they are in this category and they are being medicated you may want to drop down. If you were on week six with they left for vacation when they come back you may want to do treatment five instead of treatment six unless they went to a retreat that was for rejuvenation and for proper eating and things of that nature.


You are going to keep going up the chart as they have three good days. If they don’t have three good days then, if it’s one day that’s not good, you will stay at that treatment, at treatment six, over and over until they have three good days. If they have two days that the results are poor or not as positive as you would like or the client would like then you will drop down a runner. Each time they do three good days you get to go up.


So now we can increase to treatment seven at 70 minutes, but now we’re at 135 degrees Fahrenheit and 32 degrees Fahrenheit for the cold. This is as hot and as cold as I get with a diabetic and some people with lymphatic conditions, somebody who’s doing chemotherapy, radiation. This is as hot as you get them and as cold as you get them. This is as long as you go…70 minutes. But somebody could have had a pacemaker in and they can be working their way up this chart. And we’ll talk about different options. We have a chart that you can use for reference.


As we have three good days we get to go up to treatment eight. 90 minutes now. Now this is a full-blown Original Body stroke with LaStone Therapy it’s a 90 minute session. We feel it takes a full 90 minutes to offer a true LaStone therapy session, the beginning parts of LaStone Therapy. We’re at 135 degrees still just like in treatment seven and 32 degrees Fahrehneit for cold. If they do great with treatment eight you get to bring them to treatment nine.


Nine is the highest, 140 degrees Fahrenheit and 25 degrees for the cold. Most spas won’t let you work over 130 degrees, just so you know. A lot of spas and resorts want to keep you at 130 and then they use the cold at 32 degrees on ice. The temperature from cold from body core is not as crucial as the temperature from heat from body core. In another lecture we’ll talk more about that and why.


Some people, if you work privately at or depending on where you work, you may be able to get to that 140 degrees and that 25 degrees which you have. Ice is only 32 degrees, remember when we did that with calibrating the thermometer? So to get 25 that it means you have to use a mini freezer or a mini refrigerator. Freezers are normally zero or minus four degrees in Fahrenheit where a little mini refrigerator if you turn it up to max it will get to be about 25 to 27 degrees. This is where I personally work, at that temperature, if the health allows me to with the client. It’s all about the client’s health. It’s not about what I want to do. It’s about how can I serve the client’s health. What’s best to help strengthen and tonify over a period of time. So that’s important for you to do.


It could take a year, two years to get a client up this far depending on what’s going on with their system. Especially if they have a combination that falls in to these categories and a lot of people do. They don’t just have one thing. They have three or four things wrong with them, or challenging them, excuse me.


So let’s move over here to these other charts for a second and get an idea because not everybody has to start at treatment one. Some people, depending on what’s going on with them, say for instance somebody with arthritis, they don’t have to start at treatment one. Somebody with arthritis, you could start them at treatment four. So then you look at treatment four and treatment four is 60 minutes at 120 degrees and 50 degrees Fahrenheit for your cold.


You keep going over on your chart and this gives you all different/common conditions of the system, not all of them, obviously and it will help you understand where you can start. What if somebody has a headache? You know they come in and they suffer from migraines. Well you can start them at treatment five. So treatment five is going to have some Swedish in there because you have the time to do that and it’s going to increase the time and the temperature.


If somebody has a combination of these conditions then you are going to take the lowest denominator. So you will figure out which has the least challenging to the system and you won’t start with a higher treatment, you’ll start with a lower treatment.


This chart is going to help you with your client and it’s something you can show your client. That this is where we can start. We get to start on treatment three for you. And treatment three would be where you would start to add a little bit of technique. Remember treatment one and treatment two there was only stone placement and in treatment three you were allowed to start moving that stone on that body. Doing some hot and cold on the neck if they need it or on their hip or their low back, where ever they are looking for a change in a muscle or a joint. So treatment three gets you to start adding technique. And as you go up those treatments there is more time so you have more time to offer different techniques. And the more things you have in your tool bag as a body therapist, whether that’s reflexology, Shiatsu, various energy work, Lomi Lomi, Swedish application, deep tissue, Myofascia work, cranial sacral, then you have all those things to add to the experience of hot and cold stones. Every modality can be enhanced by adding temperature to the system.


So this is our treatment plan. This gives you a little bit of guidelines to help you with choosing how hot, how cold and how long do I offer temperature to someone that has a condition that’s a concern or a contraindication for Swedish massage. It’s very important that you understand that and that your clients understand that you both need to do a little homework in order to know if you can tonify and strengthen the treatment week, by week, by week. Without doing your homework it’s a guessing game as to whether or not you can go up this chart. So it’s important that you both agree to do that.


It’s important that these individuals that have health issues are willing to come weekly so I highly suggest that you offer them some kind of a package deal or a cut rate because they are your bread and butter. They have got to come every week it’s not like somebody that just wants to feel good/it’s a relaxing thing for them. Once they start to see the results of what’s going on with them inside their system they are going to see that they are stronger. They are going to see that they get sick less. They are going to see that their medication is absorbing better. So they will want to come back week, by week, by week in order to tonify and strengthen that internal body system and feel stronger internally.


So take your time with it and research it with your client and enjoy the process because here’s where you will learn what hydrotherapy really means/what temperature to the body really means.


Thank you.