There are massage tools that have literally been around since Earth cooled. And humankind has known about the multiple benefits of hot stones since prehistoric times. Now, 21st century massage therapists are increasingly turning to stones—both hot and cold—as a way to offer a client-pleasing service that’s easy on the hands and good for the bottom line.  

Massage therapists thinking of adding stone therapy to their professional repertoire, however, should be warned: there are certain risks involved. It’s not a technique to be attempted after simply watching a video or hearing a co-worker share a few pointers. Below are some points to ponder regarding stone therapy.

1. Photos often get it wrong

You know the ones: massage clients relaxing on a towel with stones placed artfully along their naked spines. “Those photos make my hair stand up,” says Nina Gart, founder and director of Stone Therapy School in Coquitlam, British Columbia. “That’s not how to do it. That’s dangerous! The only hot stones that should be placed directly on the body are the toe stones because they’re tiny and don’t contain all that super-heated energy at their core. All other stones must be insulated,” she says.

Unfortunately, all those incorrect photos may lead to clients who are disappointed if the stones aren’t placed on their body like in the ads. So China Facchini, a massage therapist and owner of Healing Stone Massage in Clinton, Connecticut, will sometimes place warm stones directly on a client’s body, but never hot ones. That’s also why she won’t use the tongs or rubber gloves some manufacturers shortsightedly include with their stone heaters. “If you can’t stick your hand in the water or hold the stone in your hand, you definitely shouldn’t put it on someone’s body.”

Just keep a hot stone moving across the body as you hold it in your hand, advises Pat Mayrhofer, president of Nature’s Stones, of Churchville, Pennsylvania. “And the hotter the stone is, the faster you move it,” she says. Since different people have different tolerances for heat, be sure to ask clients if the stones are too hot for them.

2. What’s special about the stones?

Different stones are made of different materials. Heated massage stones are typically a kind of basalt, which are usually (but not always) dark, while cool massage stones usually are light-colored marble. What makes basalt special is its chemical structure. Born in volcanos, basalt contains metals such as iron and magnesium, which help it to absorb and hold heat. Marble, on the other hand, contains calcium carbonate, which has a different crystalline structure. It’s a cold rock.

3. Shape and size matter 

To do the actual massage, you want a stone that fits easily in your palm. Smaller stones are available for specialized work, and many stones are advertised as belly stones, foot stones, finger stones, etc. Specialty stones are also available, such as the Y-shaped Rothstone—a hand-cut stone designed and patented by Henry Roth, a New Jersey-based chiropractor and massage therapist—which is a unique shape, and functions as an extension of the hand. As far as choosing black and white versus colored stones, that’s pretty much a question of personal aesthetics. Gart likes to go with black and white out of deference to balance, yin and yang, day and night. “But in reality, it’s all about the presence of metal in the stones and their density. Color doesn’t really matter,” she says. 

4. Don’t learn this on your own

“Stone massage has the highest rate of insurance claims of any type of massage,”  Mayrhofer warns. “It’s because people aren’t trained properly.” Take a class or at least a hands-on seminar to learn how to properly work with stones, experts advise. It’s not the massage strokes you’ll need to learn. You already know those. It’s how to handle the heat.

“I get so frustrated when someone calls me up to buy stones, and I ask if they’ve ever had stones in their hand and they say no,” Mayrhofer says. “I’ve heard this over and over: someone goes in to work and they’re told they have a hot stone massage coming in at two o’clock, so here’s a video to watch. Or someone else goes to a seminar and is expected to come back and teach everyone else on the staff. The training gets watered down very quickly, and just because someone is a good therapist doesn’t mean he or she is a good teacher.”

5. Turkey roasters aren’t for rocks

Yes, you can heat the stones in a turkey roaster, a Crockpot, or a frying pan, but is that really the sort of professional image you want to project? “If we want to be seen as professionals, then we must act professional, and that means professional equipment,” Mayrhofer says. Kitchen equipment is meant to heat foods, and it’s very difficult to regulate the temperature as precisely as hot stone massage requires. Most experts recommend stones be heated to between 120 and 130 degrees, and a Crockpot with high, medium, and low settings won’t give you that precision.

Maybe it’s time to purchase a professional stone heater. A good one can be had for around $100. “These are one-time investments, so it’s worth getting something that’s made for this,” says Tom Wellman, owner and president of TH Stone in Tamarac, Florida.

6. Stones require care

You’ll want to wash your stones with hot water and dish detergent after every use; then they need to be dried and disinfected. Don’t forget to change the water in your stone heater after every use, too. “The biggest complaint I hear from therapists is ‘I don’t have enough time between clients’ to wash the stones,” Mayrhofer says. Point taken. Her advice is to include extra clean-up time into your higher fee for a stone massage, or keep a second set of stones and a second heater available for back-to-back treatments. “Each client deserves to have clean stones,” she says.

You absolutely don’t want to leave stones wet and exposed to air for a long time, because they have minerals in them, including iron. “If you don’t clean and dry them, you can get rust spots,” Wellman warns.

7. Stones may need a vacation

Wellman recognizes that different individuals have different levels of spiritual connection with their stones. “Many massage therapists believe that the stones have their own energy, and they pass along that energy and help balance the energy in the human body,” he says.

Gart calls the stones “energy beings” that need time to recharge and replenish their energy. In addition to washing them after every use, she advises giving stones a weekly rest on a tray of salt, which, also being crystalline in structure, will recharge a stone. And for a real vacation, give them some time back on, or even in, Mother Earth. “Your backyard can be good,” she says. “Bring them out, let them bathe under the moon, under the sun. That’s their element.”

Gart says to be creative in your connection with the stones. “It should be your intention to say thank-you to them for helping you. Take care of them, and they will pay you back.”

8. Stone work is art and science

“Under the Stone” is what Roth calls his technique. “It’s an art,” he says. “It’s slow and deliberate.”

For Gart, “Dances with Stones” explains her work. “It’s about the slow delivery of heat,” she says. “You must be totally relaxed and meditative.”

Utilizing proper lubricants is a necessary aspect of working with stones. Experts say to stay away from heavy lotions or gels because they’ll cut down on glide and foul up the stones. But proper intention is equally important, Mayrhofer says. “What’s in your heart comes out in your hands—if you really want to help somebody, you’ll do it. Even if your technique isn’t exactly right, you’ll help that person.”

9. Stone massage is not for everyone

Heat dilates blood vessels, so don’t try this work on a client with uncontrolled high blood pressure, Mayrhofer warns. Also, be careful with geriatric clients and with diabetics. “Someone with diabetes has decreased sensation in the extremities. Don’t go by what they say, because if you ask them if it’s too hot, they may not feel it and tell you no,” she says.

Expectant mothers also pose special concerns. “You never want to raise their core temperature, so if you do hot stone work with them, give them a cold rag to keep their temperatures down,” she says. Also, don’t do hot stone work on multiple sclerosis clients, she says, though cold stone work would be fine for them.

10. Some clients can especially benefit

“Stone therapy is one of the best things for fibromyalgia,” Mayrhofer says. “You can work deep without putting on a lot of pressure.” Ditto for people who have had rotator cuff surgery or those who suffer with frozen shoulder. The heat helps tissues open up quickly.

“For the most part, stone massage is misunderstood,” she says. “People think it’s just fluff and buff, a relaxing massage. But it’s very therapeutic. Anything you can do with your hands, you can do with stones. Trigger-point work. Myofascial release. It’s incredible. It’s a great therapeutic tool.”

  Rebecca Jones is a Denver-based freelance writer. Contact her at killarneyrose@comcast.net.