CE INSTITUTE LLC BLOG

By Selena Belisle, Founder/Instructor, CE Institute LLC

Hot Stone Massage Operating Temperature & Placement Stone Practice
Massage stones must remain fully immersed in water to maintain consistent temperature throughout for safe and best practices. At an operating temperature of 135-degrees, stones must be placed through two physical barriers on a client, or kept in motion while using them for massage.

Of course, anyone wishing to practice hot stone massage should seek professional training to do so.

Why Working Stones are Also Called Palm Stones
Also, the 135-degree stones used for massage are frequently called "palm stones" because they are kept in the practitioner's palms during massage, which is some of the thickest skin of the body. A practitioner can usually handle a 135-degree hot stone because it is continually rotated in their palm, and the palms have less sensory neurons than our fingers too.

Proper Stone Bath Retrieval with Hot Stones
We teach that practitioners should use a red or lighter colored slotted spoon because the water is too hot to stick fingers into a stone bath for stone retrieval.

Potential Hot Stone Massage Injury When Utensils Are Not Used
Sticking finger tips which are loaded with sensory neurons and about 1/3 of the thickness of palm skin into a scalding 135-degree bath could desensitize a practitioner's digits to the heat, if they could tolerate it.  Inserting fingers into the hot water bath also risks burn injuries to the practitioner. This is why we use tools to retrieve fully immersed stones in a hot stone bath.

Using Slotted Spoons and Tong Tools to Retrieve Hot Stones
Using tools to retrieve stones have their own issues, but for now this is the best and most commonly practiced method for these reasons and more. We prefer the use of slotted spoons instead of tongs for hot stone retrieval, because tongs tend to drop more stones with 130+degree hot water splashing which can also be dangerous. While it's easy to drop stones in the bath with a slotted spoon, we feel this happens more frequently with tongs.

For proper training in hot stone massage, please visit and register at: https://ceinstitute.com/collections/hot-stone

Here's some more info about skin thickness:

Knowing where skin is thinner or thicker in the body may help you determine a better service for your client.  For example, a hot stone during hot stone massage will be more tolerable over the thicker skin areas of the body which would be more tolerable to heat.  And services such as hot stone massage will require more attention in the thinner skin areas of the body, because the skin is thin and could easily be sensitive or burn to excessive heat.

Thin Skin:  Above is a diagram of thin skin in the axilla/underarm region.  Here, you can see that the outer layer of the epidermis (the stratum corneum) is much thinner than in the previous picture of thicker skin. 

You can also see there is no stratum lucidum, but there are apocrine glands (labeled #8 on the pictured diagram above) which can produce a scent or odor.  Most apocrine glands are found in the armpits, groin, and breast area.

Thick Skin:  Below is a diagram of the skin of the human palm.  Skin is regularly thicker on the palms of the hands and soles of the feet.  This thick skin on the soles of the feet are what can lead to excessive dead skin and calluses. 

The thick skin of your palm is also an ideal place to hold a stone, hence the nickname of "palm stones", also known as "working" stones, which are used to perform the majority of the hot stone massage in motion.

In this image below, you can also see the stratum lucidum layer of the epidermis.  This is an additional translucent layer of skin of the epidermis that is found in few select places such as the palms of hands and soles of the feet, which helps makes the skin thicker than other areas of the body.

As such, it's common to hold hot working stones in your palms during hot stone massage.  The skin of your palm is usually thick enough to tolerate this heat. However, sticking the extremely think skin of one's finger tips into scalding water to collect stones out of a hot bath is an extremely bad idea, and could result in thermal injuries to the practitioner's fingers or any human soft tissue that is placed into close to scalding water of a hot stone bath.

_____________________

Author Selena Belisle is the Founder of CE Institute LLC in Miami FL.  She is a retired professional athlete and has been practicing massage therapy for over 30 years.  Selena is an approved CE Provider with NCBTMB & the Florida Board of Massage.  She now teaches full time for the Complementary and Alternative Health Care Industries. You can learn more about Selena’s training and CE classes at www.CeInstitute.com

#hotstonemassage #bodywork #massage #massagetherapist #lmt #massagetherapy #stonemassage #bodywork #bodyworker #hotstone #hotstonetools #properpractice #LMT #hotrock #hotrockmassage #massageontherocks

 

 

by Selena Belisle, Founder/Instructor, CE Institute LLC

Research Shows Chair Massage Reduces Anxiety

A 1996 study titled: The Effectiveness of Massage Therapy Intervention on Reducing Anxiety in the Workplace by Karen R. Shulman, Gwen E. Jones, showed chair massage can reduce anxiety:

“For 15 minutes weekly, subjects either received a massage or were allowed a break, depending on their assignment to either the treatment or control condition…Significant reductions in anxiety levels were found for the massage group.”

Corporate Onsite Chair Massage Reduces Stress

Back in 1998, the Boston Business Journal featured our onsite chair massage work on their cover with a full-color photo.  The full-color photo that mentions us is no longer available in their online archives which can be accessed here:  https://www.bizjournals.com/boston/stories/1998/04/13/story3.html

The title of the Boston Business Journal article is:  "Massages, exercise help accountants deal with stress."

The Ease of Onsite Chair Massage

Onsite chair massage is fairly easy to execute with proper education.  In fact, after a couple events and experience, some therapists prefer these quicker sessions over private one-hour full body massage sessions.

Chair events allow practitioners to see a greater number of clients each day.  Seeing a greater number of clients allows for a greater number of positive changes with each massage session, which is extremely rewarding.

Chair massage events also lead to innumerous referrals for a greater amount of massage appointments.  Some clients will want additional massage time which can lead to another appointment, back at the office when one is provided.

LMTs who want to learn more about how to offer their own corporate onsite chair massage event, or how to practice chair massage itself can register for CE class with us at:  https://ceinstitute.com/collections/chair-massage-event-work

#LMT #chairmassage #onsite #corporate #massage #massagetherapy #massagetherapist #bodywork #bodyworker #onsitemassage #corporatemassage #onsitechairmassage #businessperks #employers #employeebenefit #painrelief #rom #increaserom #increasedrom #happy #employmentbenefit #office #officeworkers #secretarial #staff #computerjob #deskwork

 

 

 

 

by Selena Belisle, Founder/Instructor, CE Institute LLC

As evidence-based massage becomes more prevalent in the massage and bodywork industry, we've seen a growing number of LMTs dismiss an increasing number of studies due to perceived study deficiencies.  Sometimes these dismissals are for good reason, and sometimes the dismissals of research are for reasons that do not seem to be fully understood nor appreciated.  Here's some examples:

Health Care and Medicine Does Not Provide 100% Cures for All
There are no absolutes, such as any method being 100% effective in health care practices. That is just unheard of and an unreasonable expectation in the healthcare arena given human factors and variables. As such, many massage and health care studies will adopt soft language that generalizes conclusions, without absolute certainties. Expecting a study to conclude more than a generalization is arbitrary.  Massage therapists should not be seeking hard language that massage cured something, or was proven without a doubt, given the many human variables that will prevent this for the entire study population.

Massage therapists cannot be replaced by tools or machines.  True professional massage requires a human being to administer the appointment.  People namely trained therapists, are able to observe the tissue they are massaging to ensure no harm is done.

A 2021 study in the Physical Therapy Rehabilitation Journal from Oxford Academic reported a case of rhabdomyolysis after massage gun use.  According to the CDC,  rhabdomyolysis "is a serious medical condition that can be fatal or result in permanent disability. Rhabdomyolysis occurs when damaged muscle tissue releases its proteins and electrolytes into the blood. These substances can damage the heart and kidneys and cause permanent disability or even death."

In the case study, a young woman with pain in her thighs received muscle gun treatment from her coach to relieve her pain. This resulted in muscle bruising and a severe case of rhabdomyolysis.

Massage guns have been trendy with increased use.  Sharper image has sold thumper devices for years, and within the past decade, the number of massage gun manufacturers and sales have increased.  Most notably Mark Whalburg was recently reported to gift a massage gun to one of his movie costars who thought the massage gun was for something other than therapeutic purpose.

Massage guns are fairly easy to apply, except when they are used by untrained professionals.  That's because, when a massage gun is used over a contraindicated site, such as the carotid artery or a ruptured vertebral disc, it could likely do more harm than good.

Sports event use has seen perhaps one of the largest massage gun use increases, given it's fast application. Although again, when used by an individual who does not have proper training, a massage gun could be applied incorrectly to soft tissues which could result in medical harm.

The following image is an example of what a massage gun looks like; however, this is not the massage gun nor is it the massage gun brand that contributed to the rhabdomyolysis injury. Below is only an image to provide readers an example of what a massage gun looks like, and there are many different examples beyond this one image: 

In the end, massage guns will never replace massage therapists given the real harm that could result with massage gun use.  Furthermore, repeated machine compression to a soft tissue could be extremely harmful and result in cases such as rhabdomyolysis.  

For now, we continue to recommend massage therapists simply use their hands for massage, and when properly trained, use hot stones and cups for manual soft tissue manipulation.  Stones and cups still have to be applied by a trained practitioner who knows where and where not to apply such equipment.

So fear not massage therapists, massage guns will never replace us, unless we're at the time where causing possible and real life threatening harm by using a machine is desirable to replacing a real human being.

To learn more, please register for quality, affordable, professional training at: https://ceinstitute.com/

#massagegun #massagetherapist #lmt #massage #massagetherapy #health #healthcare #mt #manualtherapy #rhabdomyolysis #massagecontraindication #evidencebased

 

 

by Selena Belisle, Founder/Instructor, CE Institute LLC

 

Evidence Informed Massage Practices

LMTs can share research and evidence to support the validity of massage work on websites or with clients, such as Swedish massage can be used to treat headaches.  That in-part is of an evidence-informed practice when you have that research.

 

Evidence-Based Massage Practices

Using the actual hands-on massage protocol itself, from the research for any type of beneficial outcome, creates an evidence-based massage practice. 

 

Massage-related Research which includes Machine, Equipment or Product Use

Some massage-related studies use machines, equipment and products because their manufacturers usually have larger budgets to produce research, to demonstrate efficacy for sales.

 

Practicing massage with manufactured items would require additional information and/or training for manufactured item use and more considerations beyond anything discussed in this article.

 

 

Other Variables

There are other variables and considerations that can be applied to define evidence-based and evidence-informed practices.  These two explained above are simplified examples for evidenced massage therapy practices.

 

 

Practicing Evidence-Informed and Evidence-Based Massage
Sometimes a massage instructor will collect published research study data and provide the information in a neat, consolidated presentation.  And there are plentiful industry trade articles available free of charge for LMTs to learn more about research terms and language, on their own.

 

In Summary

We hope this brief summary helps clarify the difference between evidence-based and evidence-informed massage.  You can this and more by registering for training with us at:  https://ceinstitute.com/

 

 

 

by Selena Belisle, Founder/Instructor of CE Institute LLC

All CE Institute LLC hands-on classes are taught from an evidence informed and evidence-based stance.  It is important to practice from evidence and research to validate the work itself.

Here are some tips for practicing massage from evidence:

 

Seek Large Sample Size Research Studies for Use

When using researched protocols for hands-on practice, one recommendation is to review studies with large subject numbers. Following hands-on protocols that are provided to a large control group is preferred to using something practiced in a single case study.

Unfortunately, usually due to budgetary constraints, most massage studies are researched with exceedingly small subject numbers. However, in research, there are other studies called a meta-analysis and systematic reviews. These can collect similar massage studies, regardless of size, to review their data in totality to provide a broader and enhanced picture of results and outcomes from similar studies.

 

Finding Massage-Related Research

There are thousands of massage-related published studies with valuable information that can be used to improve massage efficacy, notably when using resources such as pubmed.gov. Unfortunately, there are still many massage topics that have not been studied or published yet, and when they are published, they might not provide the specific information you are seeking given there are millions of possible variables.

Do not let this information process frustrate you. Instead, we should all be grateful. There is a massive amount of available information, only seconds away at the stroke of a keyboard, which provides incredible and increasing access for evidence-based practices.

Sometimes you will find rare or unknown information while reviewing research because foreign published studies often fail regular massage keyword searches from language translations. Research can be a lot of fun, but it can also take a lot of time and practice to become efficient in finding what you need, if it is published.

I have spent decades scouring massage-related studies in both journals and online. Seeking usable researched hands-on protocols for evidence-based massage training can be long and hard work. However, it is always worth it when you learn something new.

 

What to do if a client is not Benefiting from Massage

Sometimes clients may not benefit from massage at all, regardless of research, training, protocols used or hands-on work. Every available method in your bodywork arsenal may not work! If or when this happens, the client could be suffering with an undetected underlying disease causing whatever prompted their reason to schedule their massage appointments.

Massage therapist should refer their client back to their doctor for further medical recommendations when the client is not reasonably achieving mutually agreed massage goals.

 

How to Learn which Massage Studies are Considered Better Quality

There are many industry trade magazine articles that provide language of how to read or interpret a research study.  LMTs can learn much of the language interpretation on their own with these magazines.

We now spend twelve hours teaching about this and more in an evidence-based massage CE course, so there are various opportunities available for practitioners to learn more about how to use research to establish an evidence-based massage.  You can this and more by registering for training with us at:  https://ceinstitute.com/

 

 

by Selena Belisle, Founder/Instructor, CE Institute LLC

Corporate massage including business onsite chair massage is an incredible benefit for employers to offer, especially during labor shortages. It's the perfect wellness perk. Chair massage has a number of healthy benefits and is likely to boost employee morale and performance.

The following is a 2011 research study to review when considering chair massage at a workplace.  The research title of this published study was called:  The Effect of a Corporate Chair Massage Program on Musculoskeletal Discomfort and Joint Range of Motion in Office Workers by Polona Kršmanc Šiško, Mateja Videmšek, Damir Karpljuk.  

The study stated:  “Between the first and the last measurements, a significant increase in range of motion was found for cervical lateral flexion and cervical extension. A significant decrease in Musculoskeletal Discomfort was found in the neck and the upper back.

On-site massage sessions twice per week for 1 month are the most effective interventions (compared to one session or no massage intervention) for decreasing the duration of musculoskeletal ache, pain, or discomfort and for increasing range of motion.”

Readers can purchase and view the study in its entirety at:  https://doi.org/10.1089/acm.2010.0400

These are incredible health benefits to achieve during a chair massage. Massage is well known to relieve pain, and this study showed that pain relief was achieved even when the client was massaged in a seated position. 

Improving range of motion is also associated as an aid to decrease pain.  Improving range of motion may help an employee with their physical function at work as well.

Chair massage is a wonderful way for LMTs to meet new clients.  It is great for a quick session during work. It can also be performed clothed so the client does not have to disrobe at work to receive their chair massage appointment.

Licensed massage therapists who want to learn more about how to offer their own corporate onsite chair massage event, or how to practice chair massage itself can register for training with us at:  https://ceinstitute.com/collections/chair-massage-event-work

#LMT #chairmassage #onsite #corporate #massage #massagetherapy #massagetherapist #bodywork #bodyworker #onsitemassage #corporatemassage #onsitechairmassage #businessperks #employers #employeebenefit #painrelief #rom #increaserom #increasedrom #happy #employmentbenefit #office #officeworkers #secretarial #staff #computerjob #deskwork

 

 

by Selena Belisle, Founder/Instructor, CE Institute LLC

Massage sheets are supposed to cover a client for warmth, modesty and protection.  Massage draping is provided to prevent nudity, excessive exposure and demonstrate a clear and professional line between a massage therapist and client.  There is no excuse to provide excess nudity in a professional massage therapy session when the draping itself is supposed to be a physical barrier to prevent it.

 

Massage Clients Who Do Not Want Any Massage Draping

So what should massage therapists do when a client doesn't want to be draped or use a sheet to cover themselves.  Massage therapists and bodyworkers should simply explain to the client that the draping is required as a professional standard and that the service cannot proceed without.

If the client requests to remove their drape after the massage has started, repeat the standard that it is required or that you can terminate the service if the client does not want to be professionally draped.

 

How to Drape When it's Too Hot

Women who are experiencing hot flashes, or any client who's overly warm can expose their feet, legs and arms to minimize the draping or heat, but removing the draping or using a hand towel should never be an option. 

 

An NFL Player Who Wanted Only Minimal Massage Draping

Recently, there were several massage therapists who publicly complained about an NFL player who only wanted to use a hand towel to drape himself, and he exposed himself to the therapists as well by removing the hand towel.  This is unacceptable behavior on the behalf of the client.  More so, the practitioner should have never started the service with just a hand towel over a client's genitals.

When a client is draped minimally with a hand towel, there is a larger chance that they could expose themselves, whether it was intentional or not.

 

A Doctor's Office Experience with Draping

Think about when you go to the doctor's office.  Your annual physical might be a lot more violating than a massage!  But what does the doctor's office provide you for your invasive exam?  Most clients are regularly provided a full paper gown and sometimes even a paper sheet to place on top of your paper gown.  

Doctor's could provide paper panties or a small paper towel if that was professional, but it's not.  It would be cheaper to give out paper panties or a paper towel but they don't.  So why would a massage therapist think it is acceptable for a client to drape themselves with a hand towel when this standard is not practiced anywhere in modern day medicine?  

 

Unacceptable Massage Draping Practice Standards

The NFL player who insisted on only using a hand towel and exposed himself to unsuspecting therapists stated he was allowed to do this with other therapists.  And indeed he was.  There were massage therapists that spoke up on his behalf, saying they were fine in just using a hand towel.  In our opinion, this is an unacceptable standard and practice.  Massage therapists need to provide more than a hand towel to provide comfort, warmth, protection and professionalism.

Very large bath sheet towels are acceptable to use as a massage drape.  A hand towel is not.  Remember, draping is to prevent excess nudity, so proper and professional draping should be practiced at all times. 

 

Draping for a Professional Massage Therapy Session

Draping is provided for professional reasoning.  Draping is not a suggestion, nor is it a client dictated protocol.  Massage therapists must execute and reliably practice professional draping standards at all times if they want to be seen as massage professionals.

Professional massage therapy draping with a sheet or very large towel should always cover the buttocks, genitalia and the client's chest area.  The draping should be large enough to cover the entire client if so desired.

Therapists should only undrape the area that they are working on, and that area should be immediately draped and covered again, once the work has concluded in that area.

 

 

The Only Time a Hand Towel Could be Incorporated Into Professional Draping Practices

Practitioners may use a hand towel to work on a client's abdomen when a client is lying in supine position on the treatment table.  The hand towel would usually be folded in half long-ways or horizontally, depending on the amount of coverage required.  Then the hand towel would cover the client's breast area as the top draping sheet is lowered to expose the abdomen.  At no time should the client's breast area be exposed during this draping practice.

Massage therapists should seek additional training if they do not know how to use a second drape such as a hand towel to cover a client's breast while exposing the abdomen.

 

Business Standards with Draping

Massage therapists can incorporate a draping policy within their massage therapy or bodywork practice.  Adding a draping policy will help provide a standard that can be shared with clients if or when they are demanding something different.  

Preplanning ahead of time by creating a standard draping policy could help a therapist prevent an awkward situation by simply falling back on the policy. Therapists can always state they are simply following company policies whenever a client wishes for different draping, especially if it feels like the request is for nefarious purposes.  Citing a company policy may feel less confrontational or less uncomfortable than telling the client no for other reasons.

If a client continually requests less draping, simply inform them that they are requesting you to violate a company policy, which cannot be done.  The only action you have beyond breaking the company policy is to either proceed with the service in accordance with your policies, or to provide no service at all because their request cannot be provided within the company's policies.

In addition to adding a draping policy to your website, a practitioner could also print their draping policy on any standard client intake form or paperwork.  Having a standard preprinted policy in writing where it is accessible to the client may help prevent clients from approaching your business for something different than what is professionally practiced.

To learn more, please register for quality, affordable, professional training at: https://ceinstitute.com/

#massage #draping #massagetherapy #massagetherapist #manualtherapy #bodywork #bodyworker #cosmetology #sportsmassage #massagebusiness #massagepractices #LMT