Unit 2 - Lesson 4: Stone Massage Contraindications and Considerations

Learn about contraindications & consideration with stone massage therapy

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Today’s video is about contraindications and considerations.


So we spoke about the treatment plan and we’re going to refer back to that as I read the contraindications and considerations to you out of the LaStone manual. On page 140, some common contraindications and considerations, these are just the average/most common ones we encounter with our clients. Any places where there has been surgery and nerves have been cut. Usually there is a loss of feeling in these areas. Especially in the back region and the client may not register correct temperatures in these places. Any disease where there has been nerve damage, neuropathy or diabetics.


We spoke a little bit about diabetics yesterday and how we don’t want to incorporate hot and cold with a diabetic as well as move that blood and lymph too fast. It’s too hard on their pancreas. So what you want to do is design a treatment that is best for them. They, sometimes depending on the level of their diabetes, will change whether or not they can feel temperature adequately on their epidermis and you have to be careful about that. So 130/135 would be the hottest you would work that diabetic.


Somebody who has had nerve damage due to a car accident, or an injury/a sports injury, what have you, a work injury/accident, surgery, they may only have a path of that nerve that is damaged and that epidermis itself along that nerve path isn’t feeling temperature adequately or pressure. So what you do is you go on the opposite side of the body and you work that part of the body that the nerves are functioning correctly. You talk to the client about the temperature and about the pressure. Whether it be a hot stone or a cold stone. That way when you do get to the side where the nerve has been damaged the client will be able to know that you are in a safe range of temperature for them as well as pressure and technique. So it’s important to have that knowledge going on between you and your client when you’re working with nerve damage.


Any skin conditions which may be aggravated by moisture or heat. You, as a therapist and some estheticians depending on where you live in the world, are not allowed to treat skin disorders. We’re not supposed to be massaging acne that’s oozing, or a sore that’s oozing, or go over incisions or anything of that nature, stitches, anything where the skin has been irritated for one reason or another, psoriasis, eczema, you know the list.


So we are going to avoid skin irritations. We certainly don’t want to put a lot of heat on that and you’re not medically trained to do so. Some conditions require heat to heal. Some skin conditions require cold to heal and if you are not educated and licensed in that ability you must avoid that.


If it’s the full body, if they came in and they had poison ivy or poison oak you are going to want to send them home. But if it is eczema, psoriasis, severe acne you are going to be able to do stone placement for them and be able to cool the area down, but you are not going to massage that area.


Pregnancy: Heat is a variable to be concerned with. In the hands of a highly skilled therapist or hydro therapist treatment can be adapted to a safe application. You can do hot and cold therapies to a pregnant woman if you understand prenatal therapy. You must understand prenatal therapy before you do that and you’re not going to do a lot of stone placement on a pregnant woman. The spinal layout will be avoided and most of the chakra layout will be avoided and you absolutely won’t do piezoelectric effect on them. And at one time on the videos you will learn more about piezoelectric effect. You can do isolated work. If their neck hurts you can do hot and cold on that neck to give them relief. If their low back hurts, if their legs hurt, if they have edema, you can do certain things with hot and cold on a pregnant woman in isolated areas, but not full body massage with the hot and cold stones. It’s a little difficult for the fetus. Not so much for the woman.


Anyone on prescription medications that may have side effects due to the temperature of treatment challenges, all individuals who are not sure should consult their doctor. If somebody comes in and on their intake form they talk about different body conditions, health issues where they’re being medicated such as the people in these categories, and there’s lots of different levels of these categories, and why someone would need to be medicated. Whether they’re doing it allopathically, homeopathy, or through conventional medications or also watching their diet, you’re going to want to know if they can get in to a hot tub, if they can get in to a steam room, or in to a sauna room, if they can allow their body to get overheated. If they can and their medication isn’t compromised because of that or their health, then you can design a safe treatment that’s going to work for them. And by following some of the guidelines here you’ll know do I start at treatment one, treatment five and that will be able to help you and the client know that you are starting at a safe application.


Time wise, is this going to be a 30 minute treatment, a 60, 70, 90? Or is it going to be 110 degrees hot/room temperature cold or can we work at 135 hot and 32 degrees cold? So you’ll want to have that understanding with them before you choose. If they are uncertain you can always ask if they can ask their doctor if they are allowed to get in to a hot tub or a steam room. That’s your little key to know do I really need to start down low.


Heart disease: Temperature challenges the circulatory system. Because the hot and the cold vassal constrict and vassal dilate the skin/the epidermis, which accelerates the nervous system, and the blood and the lymph to move faster you are going to want to be sure that you’re not challenging the circulatory system too fast on certain heart conditions. So again, you’re going to look at your chart you’re going to then come over here and decide can I start at treatment three or do I have to start at treatment one?


Anyone who is considered over weight or obese may be challenged owing to the stress of the heart. Sometimes when someone is obese their heart is not under-stressed, but a lot of times it is, and often they get hot too easy. So you may not want to use as much hot. With a cold stone and cold application if you use cold long enough you can create what is called the heathtean within inside their body, a heathtean response because of the length of time you offer cold. So you can achieve a heating experience with a cold stone as well as you can with a hot stone and you won’t overwork that heart for that client in that way.


Anyone you perceive as under weight may be challenged owing to the lack of muscle density. Whether they’re under weight because they have a high metabolism or whether they’re under weight because they have chosen not to eat properly for their body, their body does not have enough adipose tissue, enough fat to move the fluid quickly. You need the different various fluids in the body to move when you are applying that temperature. You don’t want to have that hot stone resting on their organ areas of their body. It’s so important, on someone who’s under weight, that the organ area of stone placement is not hot stone. If you don’t want to put cold stones there then don’t put stones there, in that spinal layout or that chakra layout. You have to be very, very careful because they are the individuals that tend to get burned the most.


Anyone in a very weak or debilitated state before the treatment begins where the body cannot balance itself after being challenged by the temperatures. Well obviously if someone is in a weak/debilitated state they’re sick or they’re not sure what’s going on with their health, you shouldn’t be doing Swedish application to their body. You might be able to do castle building or stone placement, but you wouldn’t want to do a vigorous massage on them, be that Lomi Lomi, or any type of Swedish massage or technique that would be moving blood and lymph too quickly.


Varicose veins. Heat is not good. Cold is beneficial. It’s awesome to pack those cold stones in pillowcases, something really thin material, it cannot be a thick material, it has to be a very thin material. So a pillowcase works best and you pack them around those varicose veins and then you can wrap the pillowcase around to hold those stones in place. It’s going to reduce the inflammation and encourage the blood to move slowly and naturally. You will not massage that area and you will not pack it with hot. Please.


All autoimmune dysfunctions such as chronic fatigue syndrome, Epstein Barr syndrome, aids and cancers and their acute and worse conditions, where the immune system is already taxed. Obviously as a body therapist in most of the world, we are not trained or licensed to treat people that have severe illnesses or have issues going on with their health that require heavy medication. You are going to want to make sure you are working with their therapist/their physician and find out what they advise us to do. Whether we’re allowed to use how hot, how cold, how long and can it be applied with certain different body techniques/different modalities. Swedish massage might be contraindicated, but Shiatsu probably would be okay. So you’re going to have to check with their physician to find out what they are going to approve for you.


Once you’ve gotten approval from their physician and an understanding of where they want to go with some treatments for them you want to make sure you choose what part of the treatment plan you’re going to start at. Is it going to be treatment one, treatment two, treatment three. More than likely if somebody is working with cancer in their body in one way or another, you’re going to want to start at treatment one. You’re going to want to do a 30 minute treatment, stone placement, castle building, energy work and see how they do for those 72 hours. Then if they do well you can move it up to treatment two and then so on and so on like we spoke to earlier. It’s so important that you take your time and go slow with people. The more compromised their health is the slower and gentle you want that treatment. And over a period of time, week by week by week, you tonify and strengthen that treatment. If you don’t take your time you can cause harm. So it’s better to be gentle and add time and temperature week by week only if they have three good days. It takes three days for the body to figure it out, chemically.


Exercise caution when there is epilepsy, depression and mental disorders. Any condition where the brain and nervous systems are challenged alternating temperatures may affect the brain activity. So when you’re dealing with somebody who’s on medication that’s trying to keep that brain in an even balance and you offer extreme temperature hot and cold to the bare skin of the body, it’s going to stimulate that nervous system. It’s a sympathetic response. The brain has to respond to that threat of temperature. So be it a hot stone or a cold stone, instantaneously the brain has to decide am I in thermo-threat? Is this going to burn me or is this going to be frostbite? When the brain hast to work that hard and the brain is already working hard you want to do it a more gentle way so it’s not going to be as hot and as cold as it normally would. You may want to start with them at 120 degrees instead of 130 or 135 so that it’s less of a distance from body core temperature. Always think like that. If it’s a condition in the system where the body is being challenged, how far can I pull that temperature, be that hot or cold, from the body core temperature and still challenge the body chemically but not challenge it so much that it throws the system off/that it throws the client or their body out of balance? Just enough to get a chemical change is all you need.


The thin skin of the elderly or someone taking cortisone medication should be dealt with carefully using lighter pressure, lesser temperatures than you would normally use. So because when they’re on cortisones or prednisones they bruise easy and their skin can actually rip. You can’t press deep in with that. When you’re doing a hot stone massage or cold stones you have to press in deep. The pressure cannot be light. It’s not superficial application. In order for the muscle and the fascia and the bones to respond, and the fluids to respond to the temperature application, the pressure has to be adequate. It has to be deeper than what you normally do in a Swedish massage. Therefore somebody who’s on medication that causes their skin to get thinner or bruise easy you have to lighten up your pressure. Therefore you have to change the degree of your hot stone and your cold stone. It can’t be as hot and it can’t be as cold. It must be cool and warm so the pressure doesn’t have to be so deep and you won’t cause harm to their epidermis.


Young children need very little to stimulate their systems. They require less time and less extreme temperatures. If a child is under the age of ten, ask the parent or guardian to take the child’s bath water temperature. Then I raise the heating unit temperature five degrees Fahrenheit above the child’s normal bath water. And I adjust the marble stones to fit the heating unit’s temperatures as well. The kids love to play with the stones. Once you become a stone walker and you bring your stones home, if you have children, they are going to want to play with those stones.   They are also going to want a treatment and feel that. All their friends are going to enjoy playing with the stones and the children are really still very attached to Mother Earth. They understand that vibration of the Earth and they like bringing that stone to the body. They are going to enjoy the treatment from you and/or giving to each of their friends. Kids also like to have the stones in their bath water or take them to bed so explore what this opportunity is going to give you with the children and don’t hesitate to massage children. I started massaging my grandson the day he was born and he was two months premature. So use the stones warm and cool for them not hot and cold. They don’t need much to stimulate their system. Their little system responds quickly to the vibration of the stone as well as to the temperature. Just enjoy the game that the kids will let you play with them.


Any condition where Swedish massage is contraindicated the application of heated and chilled stones will enhance the body’s response to the treatment. In this case I design an energy treatment involving alternating temperatures and avoid all Swedish massage application to the body. We spoke about that when we did the treatment plan and you heard me talk about castle building. Treatment one starts off with 30 minutes of just energy work. There’s no Swedish, there’s no cranial sacral, there’s no reflexology, there’s no Lomi Lomi deep tissue work. It’s just stone placement, which we call castle building, and you can put a little energy work in there if you want. It’s placing those hot and cold stones along the body where the body needs chemical change.


As we go on with our videos you’ll learn about why would I choose hot in one place and why would I choose cold in another place to support the body’s needs. You don’t want to over work that client when they first come to you that have health issues. They need to take it easy. You need to take it slow. And over time, as I keep saying, you will build and tonify the internal body system and they will get stronger if you take it easy and go slowly.


After reading the list of contraindications you may feel less confident about giving a LaStone treatment to anyone with one or more of these conditions, however by following some of the basic principles of temperature application many of these conditions can be addressed safely. First and foremost you must have as much information as possible regarding your client’s health. By understanding and following the two primary rules of geo-thermotherapy, most contraindications can be treated safely and effectively.


Remember that the results of your treatment are going to depend on two main things, the temperature being applied and just as importantly, the duration of that temperature. As the body strengthens so to the treatment becomes stronger. As the client becomes healthier they will be able to tolerate a treatment of more extreme temperatures and duration without negative reactions. Hence, less is more.