Hot stone massage protocol

Are your massage stones cooked, roasted or heated?

by Pat Mayrhofer

There has been much discussion on how to warm massage stones. Many technicians choose to take the less expensive route by purchasing a slow cooker, such as a Crock-Pot, or turkey roaster. However, these units lack professional standards and go against the manufacturer’s requirements for use. Other technicians use a variety of methods, such as electric fry pans, warming trays, heating pads, woks and towel cabbies. The only safe, professional way to heat massage stones is in a massage-stone heater.

Let’s explore some different heating methods. Those technicians who use a slow cooker do so because it is small, inexpensive and fits well within a crowded work space. But a slow cooker only has a high and low temperature setting, which makes it difficult to regulate the temperature of massage stones. Due to the small size and shape of a slow cooker, the massage stones fall to the bottom of the pot, which makes it difficult to retrieve a matched pair of stones or a particular shaped stone for a specific technique.

A turkey roaster was the original method for heating massage stones before companies like The Metal Ware Corporation and Amber Products designed professional massage-stone units. While the turkey roaster does the job of safely heating stones, and it provides the interior space to lay out the massage stones in a workable form, it is in fact a kitchen appliance. If you read the manufacturer’s product information, it states the product is for kitchen use only. If you are ever sued for burning a client, you could face a legal backlash for using a kitchen appliance for something other than what it was intended. Furthermore, the turkey roaster looks like a kitchen appliance, featuring such words on the temperature indicator as “bake” and “roast.” If massage therapists want to be recognized as professionals, then they need to present themselves as professionals and work with professional products.

Electric fry pans, warming trays, woks and heating pads are not safe professional units for heating stones. A technician cannot properly monitor the temperature of massage stones when using these appliances. Electric fry pans and woks are not deep enough to completely cover the massage stones with water, which allows the massage stones to heat evenly. Instead, the water evaporates quickly and when not covered by water, the massage stones become too hot. Warming trays and heating pads do not provide a way to adequately monitor the temperature of massage stones.

Many spas utilize towel cabbies to heat massage stones. While this is a professional unit for warming towels, it does not provide a way for a massage therapist or esthetician to monitor the temperature of the massage stones. An additional factor with using a towel cabbie or other dry heating method is the massage stones may dry out and eventually crack or break.

There are professional massage-stone heaters available for purchase, with The Spa~Pro Massage Stone Heaters and Amber Products’ massage-stone heaters being the most popular.* The Spa~Pro Massage Stone Heaters are available in 18-quart and 6-quart units in 120-volt and 220-volt versions. Amber Products also has a variety of units in several sizes and price ranges. The above units range in price from about $60 to $600. Less expensive massage-stone heaters are available from several other companies.

The Spa~Pro Massage Stone Heaters are the most widely purchased units. The 18-quart heater offers a large bottom surface, allowing for a user-friendly layout of stones, which provides access for easy retrieval of matched pairs of stones. The heating element encircles the side of the heating unit to provide even warming of the water and massage stones. An adjustable temperature control permits the therapist to adjust the temperature for safe stone massage. The removable water reservoir permits for easy cleaning of the unit and massage stones. The 6-quart unit is functional for full-body massage as well as hot-stone facials, hot-stone pedicures/manicures and hot-stone reflexology. These units range in price from $60 to $110.

Amber Products offers massage-stone heaters in several shapes and sizes. These heaters also have an attractive appeal for spas. The company’s large heaters offer a deep well, which allows for a functional layout of massage stones as well as for the stones to be completely covered with water. Other features include a brass drain system and valve and a solar battery thermometer. These massage-stone heaters are available from $99 to $600.

As a professional, how do you heat your massage stones? Are your massage stones cooked in a slow cooker, roasted in a turkey roaster or heated in a massage-stone heater?

Please look for future articles on, as I explore the exciting arena of stone massage. I will write about safety issues, contraindications, the expansion of stone therapy to different modalities, the evolution into cold-stone therapy with marble stones and now the resurgence of stone massage with the innovation of carved basalt stones. I will also discuss accessory products, such as massage oil, essential oils, heaters, textiles, DVDs and seminars. I look forward to an ongoing conversation with you.

*Note: The products mentioned in this article are not endorsed by MASSAGE Magazine, and are included for information purposes at the request of the author.

Pat Mayrhofer is president and founder of Nature’s Stones Inc., an international massage-stone, education and supply company. She is a massage therapist with more than 15 years of experience, having taught for 13 of those years in Italy, Austria, the Dominican Republic and the U.S. Mayrhofer and her staff have created a comprehensive series of live, hands-on training programs, educational DVDs available for distance learning and a line of associated stone and textile products. For more information, visit

Your Guide to Hot Stone Massage Therapy: Which Stones are Best?

As a massage therapist, you’re always looking to broaden your knowledge base and add another technique to your toolkit. Whether it’s sports massage, chair massage, or any number of other approaches to bodywork, there are lots of options out there when it comes to massage therapy courses. While you were in school for massage, you probably learned at least a little bit about hot stone massage therapy. Depending on which program you attended, you may have even learned a significant amount about this treatment modality. If so, you’re probably already quite confident in your ability to offer hot stone therapy for those clients with conditions that might benefit from it.

More often than not, though, hot stone massage is something that massage therapists are only familiar with on a basic level. Sure, you can use the technique to help clients relax — but couldn’t you be getting more out of it? You know that there’s more to hot stones than just helping clients unwind, but you’re not confident enough in your knowledge to take the next step and integrate hot stones into a big picture treatment plan.

If this is how you’re feeling, you’re not alone. That’s why we’ve put together this guide to hot stone massage therapy. In this guide, we’ll touch on a number of topics related to hot stone massage, including:

  • What is hot stone massage therapy?
  • The history of hot stone usage
  • How stones can allow heat to penetrate deeper into musculature
  • Giving your hands a break
  • Reducing pain for clients
  • The best stones for hot stone massage
  • Massage therapy courses for hot stone techniques

One of the biggest questions that massage therapists tend to ask when it comes to this modality is, “Which stones should I use?” We’ll answer that question below. But first, let’s learn more about hot stone therapy as a whole. What is it? How does it work? How can it help your clients?

Ready to find out? Let’s get started.

What Is Hot Stone Massage?

Simply put, hot stone massage involves the application of smooth, flat stones to a client’s body as part of an overall treatment strategy. The stones are often heated, although cold stone massage therapy is also used in certain instances. It’s not uncommon for a practitioner to blend these two techniques together, alternating thermotherapy and cryotherapy.

Generally speaking, stones are used in a couple of ways with clients:

  • In some cases, stones are placed on top of a client while they’re lying in a prone or supine position. Clients might also be positioned on top of stones, depending on what sort of therapeutic effect is sought. The heat from the stones is then transferred into the client’s musculature, working in combination with pressure exerted from the weight of the stones (or from the weight of the client’s body on the stones, in certain instances).
  • Alternatively, stones can be used as a massage tool by a trained therapist. Using stones in this way can cut down on practitioner fatigue, as the stones can act as an effective means of transferring force into a client’s musculature. We’ll discuss this potential advantage of massage in a separate section below.

Hot stone techniques can work according to a wide variety of both physiological and “energetic” systems, depending on which massage tradition you’re adhering to. From an energetic standpoint, many massage therapists use hot stones in order to activate a client’s meridians and channels (in connection with traditional Chinese medicine) or chakras (as references in Ayurvedic medicine). For other massage therapists, hot stones are intended to target a client’s muscular, lymphatic, and/or central nervous systems.

Of course, these physiological and energetic approaches don’t have to be mutually exclusive: in some cases, a therapist might intend for hot stones to serve both physiological and energetic purposes. It all comes down to the intention and treatment goals of the individual therapist.

Now that we know a little bit more about what exactly hot stone massage is and how it works, let’s move on to the history of the modality.

The History of Hot Stone Therapy

Hot stone massage is old. And we mean really, really old. Some sources claim that various forms of hot stone treatment were used in the ancient Mayan civilization. More verifiably, though, we can say for certain that the practice goes back at least 5,000 years to the earliest records of the Ayurvedic Indian tradition.

According to Ayurvedic medicine, the human body is imbued with something called “prana,” which translates roughly as “life-breath.” This is not unlike the “qi” energy referred to in classical Chinese medicine. Traditionally, Ayurvedic yogis would use a variety of techniques to harness, redirect, and correct the flow of prana in the body, including breathing, physical movements, and massage. In addition to physical manipulation by hand, these yogis would also use natural objects as part of their approach to healing. This is where hot stones come in: yogis would use them to access the prana in the body, sometimes in combination with specific chakras.

Of course, hot stones weren’t limited to India or the Mayan civilization. They show up throughout history in other cultures as well, including various Native American tribes, ancient Greece and Rome, Africa, and China. To learn more about the history of hot stone massage, we’d recommend taking a massage therapy course specifically focused on this technique.

Heat Penetration and Saving Your Hands

As mentioned above, hot stone massage is particularly useful for accomplishing to specific goals: introducing therapeutic heat into a client’s body and cutting down on fatigue for massage therapists. Let’s take a close look at how this works.

There are all sorts of ways to introduce heat into a client’s body. Some massage therapists will use a heated massage table for a diffuse, full-body warming effect. Others prefer to use heating pads, hot water bottles, or even warm towels.

That said, there’s something particularly effective and unique about using hot stones for heat application. There are a couple of reasons why stones can be particularly effective when it comes to warming up a client’s musculature. First of all, the physical weight of the stones helps direct the heat into the client’s musculature. By simply laying stones on a client’s back for instance, the weight of the stone will conduct heat down into the client’s musculature more effectively than simply laying a heating pad on the client without any downward pressure. The weight of the rock can also be calming and relaxing for clients, resulting in a reduction of anxiety and a sense of greater security on the massage table.

On top of this, the heat from stones tends to offer deeper penetration into a client’s musculature than other forms of heat therapy. Many therapists report better results from hot stones than from heating pads or warm towels.

Additionally — and, in the long run, just as importantly — hot stones are a great way of reducing strain and fatigue for massage therapists.

If you’ve been a bodywork professional for some time, you know how tiring the job can be. There’s no doubt that it’s a great occupation; but, let’s face it: giving massages is tiring. Even with the proper body mechanics and techniques in place, there’s no getting around the fact that giving massages will wear you out.

Over time, repetitive activities such as deep tissue massage can cause strain and general wear and tear for a massage therapist’s hands, fingers, wrists, arms, shoulders, and joints. So, whenever the opportunity presents itself to reduce the amount of physical work you have to perform while achieving the same (or better) results, it’s generally a good idea to take advantage of it.

Hot stones are a great way to perform specific techniques which can be particularly exhausting for bodyworkers. Trigger point therapy is a great example. While performing trigger point therapy with your fingers is extremely taxing, using a stone can take the strain off of your fingers and hands.

Pain Reduction for Clients

At the end of the day, the vast majority of massage clients come to you because they’re experiencing some sort of pain. Whether it’s minor physical discomfort accompanied by stress, an acute injury to a specific body part, or chronic pain in their shoulders, neck, or back, most clients come in for a massage because they’re looking for pain reduction.

For this reason, it’s important to implement techniques in your practice that can effectively reduce pain for clients. Fortunately, hot stone massage therapy is an excellent way to reduce pain.

Hot stones can be incredibly effective for strains, sprains, muscular issues, and more. Many clients come in experiencing acute levels of pain, and that can make it incredibly difficult to perform deep tissue techniques. These clients may need massage work that results in deep penetration into muscle tissue, but deep tissue massage is so painful that they simply can’t (or won’t) stand for it.

In these sorts of situations, hot stone massage can be a life saver. By using the heat transferring and deep penetration effects of stones, it’s possible to offer clients significant pain relief without the discomfort often associated with deep tissue massage.

Additionally, the relief that clients feel will usually be accompanied by a reduction in stress and a greater sense of relaxation. Hot stones tend to have that effect on clients. As a result, they’ll be more likely to come back for another appointment (and another, and another).

Which Hot Stones Are Best for Hot Stone Massage?

With all of this in mind, you’re ready to start using stones as part of your standard approach to a treatment strategy. There’s just one (big) lingering question: what kind of stones should you use?

If you run an internet search for massage stones, you’ll turn up all sorts of results. It can be a bit confusing to know which stones are best suited for what, and what exactly makes a “quality” stone.

There are three types of stones often used for hot stone massage:

  • Igneous rocks
  • Sedimentary rocks
  • Metamorphic rocks

What’s the difference between these three?

Igneous rocks are formed as a result of volcanic activity. When magma from a volcano cools into basalt, it’s considered to be an igneous rock.

Sedimentary rocks are formed over extremely long periods of time, as small bits and pieces of earth are compacted and compressed into solid rock.

Metamorphic rocks start out as either igneous or sedimentary rocks. Over time, extreme heat and pressure underground cause them to “morph” into a new type of rock.

So, which stones are best for hot stone massage?

Igneous rocks such as basalt tend to be the most commonly used by massage therapists. Metamorphic rocks are a close second. This is due to the fact that both igneous and metamorphic rocks typically contain significant amounts of iron ore. When heated, their high iron content allows them to stay warm for long periods of time. Of the two, basalt (igneous rock) tends to hold heat better than metamorphic rock, and it’s also usually smoother.

Some therapists do prefer to use sedimentary rocks such as marine stones, sandstone, or limestone. This is due to their mineral properties, which some therapists believe to confer extra benefits on clients.

Generally speaking, though, the best choice of stone for hot stone massage therapy is basalt.

Hot Stone Massage Therapy Course

You’ve learned a lot about hot stone massage, and you’re itching to put your new knowledge into practice. However, there’s still a lot more to learn. If you’d like to make hot stone techniques a part of your everyday practice, we highly recommend the Panda™ Hot Stone Massage Therapy Course.

In this course, you’ll learn to:

  • Understand the history of hot stone massage in greater detail
  • Identify the benefits of hot stone massage for clients
  • Recognize both indications and contraindications
  • Bend thermotherapy and cryotherapy with hot stones
  • Perform a full sequence of hot stone massage techniques

At Panda, we pride ourselves on offering the best online massage CEU courses available anywhere. Our affordable prices, professional narration, quality content, and course variety are second to none.

You’ve seen it before, maybe on a glossy insert or ad found at a hotel or on a cruise ship: an image advertising hot stone massage. The rocks are uniformly black and smooth, laid out in a straight line down a relaxed lady’s spine.

If you’re not familiar with hot stone massage, this image might be simultaneously inviting and baffling. Why would I want hot rocks placed on me? And why would I pay extra for the privilege?

These are legitimate questions. Here are some legitimate answers.

But first, some myth-busting
This popular image of hot stone massage is somewhat misleading and confusing. You may have guessed that applying heat in a massage can be beneficial. But this principle isn’t properly applied by placing and leaving exposed hot stones directly on the skin. This could result in first or second degree burns.

You also might infer from the smooth blackness of the stones used in photos like this that there is supposed to be some kind of special property in them to somehow magic your tension away. This isn’t the case.

Our stones aren’t manufactured: they’re individually plucked from the shores of the Pacific Northwest with our own hands.

Any smooth stones will work for a hot stone massage. While most spas and clinics will use cut or synthetic stones that come with that uniformly black shape and color, we have opted to go with stones pulled from rivers and shorelines right here in the Pacific Northwest. These stones have been handpicked by our experienced owners to be the best possible tools in the hands of our therapists.

Note, also, that the person in these ads looks completely dry. In practice, hot stone massage involves a lot of oil, or at least much more than would be typically used in a massage. While it’s true that the stones are smooth, oil is still necessary. We typically use grape seed oil. If you’re allergic to grape seed oil, we carry a variety of other vegetable and synthetic oils that can be used as alternatives.

The most common misconception is that hot stone is good for deep tissue and treatment work. This isn’t the case. Hot stone massage is primarily a relaxing experience. It’s like a combination of a good, thorough massage and a long soak in a bubble bath. These qualities made it a favorite in spa settings and on cruise ships.

Having said that, the heat of the stones accomplishes quite a lot. It helps the muscle fibers and connective tissue relax and loosen so that the massage can do more good with less discomfort.

It doesn’t matter how experienced you are at getting regular massage. If you’ve never had a hot stone massage, you really don’t know what you’re missing.

What a real hot stone massage is and why you’ll really want one
Hot stone massage is a session of 90 minutes or more that involves stones heated to 120 – 135 degrees, Farenheit. The stones are heated in water inside of a slow cooker. When the stones are used, they are coated in oil and used by the therapists as massage tools. While the stones do make contact with the skin, the therapists generally keeps the stones moving. This is to ensure the maximum benefit to sore or inflamed muscles and connective tissues, and also prevents the burns that would result if placed and left on the skin.

The therapists may place the stones on an area of your body that could use extra heat, but this is done with a hot, moistened towel between the skin and the stones to prevent burns. In this way, the stones act like a second set of hands for the therapist, applying heat and pressure to one area while the therapist starts work on another.

At the end of the massage, the stones are carefully cleaned and sanitized.

What if I get burned?
There’s nothing to worry about. All our therapists have been carefully trained and are fully certified to give this kind of massage safely.

What could be better? This, that’s what
A number of our available session enhancements are well suited to this kind of massage.

  • Aromatherapy: citrus or lavender are optimal choices when paired with a hot stone massage
  • Hand or Foot Scrub
  • Cold Stone Treatment
  • Ice Treatment

A hot stone session is a great time to try one of our cold treatments since the heat of the session tends to make the cold more bearable.

Be sure to add one of these enhancements when you book your session.

Keep in mind, too, that hot stone is available for couples sessions.

Visit our main page to book your couples session or give us a call if you have any questions.

Tom Gunn is the marketing director and blog editor at The Good Life Massage. Follow him on Twitter @tomgunnpoet.

The Placement of Hot Stones

The smooth stones are placed in a stationary position on the client while the other parts of the body are being massaged. There are two ways to use the stone placements – under the body and on top of the body.

In a hot stone massage, the techniques are incorporated through the use of basalt stones or dark river stones, heated in a warmer. They are placed under different muscle groups to encourage relaxation of particular muscles.

The massage techniques vary from practitioner to practitioner. But they all have the underlying principles of inducing a deep relaxation and offering penetrating and soothing heat.

There are two types of stones. The massage stones and the stationary stones. The smooth stones are often the massage stones, which are used in gliding around the body and the placement stones are those remaining stationary on the body.

Stones under the body

The client lies down on is the spinal layout stones. These stones are thin oval paired that are placed on the table. They should be 1.5 inches apart in a vertical line. The stones are placed to line up with the erector muscles which run down on each side of the client’s spine.

The spinal layout stones should be flat but not extremely thin because it will sink too low when the client lies down on the massage table. There should be consistent thickness of the stones to avoid a thrusting feeling on the patient’s back. It is important that the position of the stones is correct and not resting directly on the spine. The placement stones are cooler than the massage stones because they are the ones which have longer contact with the person’s skin. When the heat is too much to bear, a towel can be put between the stones and the skin. It is better to dip these stationary stones in a cool water before placing on the body.

The other type of placement stone which is the pillow stone is about 1.5 inches thick and 4 to 5 inches long. They are placed in hollow of a person’s neck just like a pillow when they are laying down. Trapezius stones which are long placement stones are usually positioned along the top of the upper trapezius between the shoulder and neck.

However, hand placement stones are placed under the palm of the hands while the client is lying on their back. The ideal shape is round on top like the tennis ball. This will allow the hands to relax in curved position on top of the stone.

Stones on top of the body

The chakra stones are placed on top of the body’s chakras and have different shapes to correspond each part of the body.

However, the spinal layout stones are positioned on top of the body when the client is lying face down.

The 8 toe stones are generally small flat thin stone and will fit between the toes. The finger stones are inserted between the fingers while the client is having a manicure or hand treatment. These placement stones are re-heated at some point of the massage for at least 5-10 minutes. It is better to have sets of stones for the easy replacement during the massage. You don’t need to wait for the stones to be heated again.

The massage therapist does not actually touch you so there will be no kneading or pressing action. Thus, there is no slightest pain which is the typical feature in a regular massage. So when your body have some problem spots where a regular massage generates a lot of pain, the hot stone massage is the one for you.

The massage treatments should be given slowly. Each individual stone and individual movement should be identified clearly. For you to amplify the effect of stones, you can knock or vibrate the stones during the massage to further release their warmth. It helps to gradually release blockages and the body’s energy can flow freely.

Contact us today for the best hot stone massage available.

What is a Hot Stone Massage?

Hot stone massage is a variation on classic massage therapy. Heated smooth, flat stones are placed on key points on the body. The massage therapist also holds the stones and use them to massage certain areas of the body. The use of hot stones for healing dates back to ancient times, as it has been developed and incorporated with massages over time by massage therapists and spas using heated, smooth rocks.

Benefits of Hot Stone Massage

A common question people have is whether to get hot stone massage vs Swedish massage or a regular massage. Some people find the warmth of the hot stones to be comforting and get this type of massage for relaxation.

Hot stone massage is suited to people who tend to feel chilly or who have cold feet. It’s also suited for people who have muscle tension but prefer a lighter massage. The heat relaxes muscles, allowing the therapist to work the muscles without using deep pressure.

People also get hot stone massage for a variety of health conditions:

  • Back pain and aches
  • Poor circulation
  • Arthritis
  • Osteoarthritis
  • Stress, anxiety and tension
  • Insomnia
  • Depression

Description of the Stones

The hot stones are usually made of basalt, a type of rock that is rich in iron, so they retain heat. River rocks are normally used because they are smooth – they are smoothed over time by the river current.

The stones are immersed in water and heated in an electric heater until they are within a certain temperature range. The placement of the stones is usually at specific points on the back and in the palms of the hand but may vary depending on the client’s condition. The warmth of the hot stones improves circulation and calms the nervous system. Some massage therapists place stones on points that are thought to be energy centers of the body to re-balance the body and mind. The heat of the stones warm and relax the muscles, which allows the therapist to apply deeper pressure, if desired.

How Do the Stones Feel?

The hot stones are never rough. They are always flat and smooth. The hot stones used on the back are about the size of a large egg, only flat. The stones are heated in an electrical heater that either provides a temperature reading or has an adjustable thermostat control. The massage therapist always holds the stones first before touching them to your body, which ensures that the temperature will not be too hot. Everyone, however, has their own comfort range. Be sure to speak up if the stones are too hot for you. Cool marble stones are occasionally used during a treatment, particularly if there is inflammation.

What Can I Expect During my Hot Stone Massage?

Every message therapist have their own technique and my incorporate other techniques with the hot stone massage based on the level of tension, knots, pain or other factors you may specify on our consultation form. However, generally the massage therapist often begins by applying oil to the body, which allows the hot stones to glide smoothly along the muscles. You are lying face down, and the massage therapist often then uses the hot stones to massage the back.

After the hot stones have relaxed the muscles, the massage therapist may put down the stones and use his or her hands to directly massage the skin.The hot stones may then be placed back on to the body and left for a short period of time.

You are then asked to turn over onto your back. The massage therapist may place small hot stones between your toes or in the palm of your hand and repeats the sequence.

Not Recommended if…

  • People with infectious skin disease, rash, neuropathy, or open wounds
  • Immediately after surgery
  • Immediately after chemotherapy or radiation, unless recommended by your doctor
  • 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.
  • 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.
  • 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.

If you are considering getting a massage, talk with your doctor first. Keep in mind that alternative medicine should not be used as a substitute for standard care in the treatment of any health condition.

Additional Tips

  • Don’t eat a heavy meal before the massage
  • If it’s your first time at the clinic or spa, arrive at least 10 minutes early to complete the necessary forms. Otherwise, arrive 5 minutes early so you can have a few minutes to rest and relax before starting the massage.

Disclaimer: The information contained on this site is intended for educational purposes only and is not a substitute for advice, diagnosis or treatment by a licensed physician. It is not meant to cover all possible precautions, drug interactions, circumstances or adverse effects. You should seek prompt medical care for any health issues and consult your doctor before using alternative medicine or making a change to your regimen.

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