CE INSTITUTE LLC BLOG

Hot stone massage has been normally contraindicated for past oncology clients; however, as oncology treatments have improved, our hot stone massage treatment options have as well.

According to the National Cancer Institute, it is estimated that there are more than 16.9 million cancer survivors alive in the U.S. today and that number will grow to more than 22.1 million by 2030. Additional statistics show that almost half of men and one-third of women in the US will receive a cancer diagnosis in their lifetime. Because our oncology population continues to grow, most massage therapists will find themselves working with both cancer patients and survivors at some point in their careers.  

This increasing oncology populace is due, in part, to the advances in oncology treatments that are used to prolong life and fight cancer. And while cancer is not a general bodywork contraindication, some oncology treatments are, especially with the application of hot stone massage. 

Luckily, today we have better academic recognition of how hot stone massage can and cannot be applied with several oncology treatments. After all, fighting cancer should not end all possibilities of enjoying a hot stone massage for those who love it or just want to try it. Instead, oncology practitioners should review how a hot stone massage service can be provided or modified with various oncology treatments for this vulnerable and rising population.  

And with full disclaimer, this article specifically speaks to the application of hot stone massage with three popular forms of oncology treatments. This article does not speak to working with oncology or massage as a whole. 

Primary Oncology Treatments 

The three primary forms of oncology treatments used to fight cancer today are surgery, radiation, and chemotherapy. Most will receive at least one or a combination of the three to combat their cancer diagnosis. Let’s look at how these three oncology treatments affect hot stone massage practice. 

Oncology Surgery 

Surgery creates an acute medical situation. In simplified terms, tissues are cut, inflamed, and then heal, in most circumstances. After healing, the surgical site scar may be sensitive and is prone to further damage. Placement and working stones should never be applied directly over a dermal scar.  

Nervous system innervation can be cut or pierced during oncology surgery. And in some surgeries, major nerves can be briefly retracted from a surgical site, which could cause a temporary, delayed or permanent dysfunction of sensory abilities. 

Aside from the immediate surgical site, most cancer survivors should be able to receive hot stone massage after oncology surgery without adverse effect, minus a few exceptions, such as nervous system damage or additional oncology treatments. 

Oncology Radiation 

Healthy tissues, including nervous system innervation, are often destroyed alongside cancer cells in radiation treatments. Survivors who received external radiation decades ago have likely lost some or all sensation in the treated area. Areas that have had been treated with internal or external radiation can be severely damaged and are a permanent local contraindication for hot stone massage. Do not ever place or move hot stones over radiated tissues.  

Modern day oncology radiation recipients may have less damage due to incredible technological advances; however, all radiated tissue is susceptible to a lifetime potential of greater injury, regardless of when the radiation was administered.  

Some radiation clients will have tiny dot tattoos that show where their external radiation was focused. Practitioners can work around a radiated tissue if they are 100% certain they are able to avoid all of it. Consider using a cooler stone bath for these clients. 

Oncology Chemotherapy  

An oncology client who has received a recent dose of chemotherapy is not a good candidate for hot stone massage. Practitioners should not promote thermal therapy manual circulation during the tissue metabolism of chemotherapy without specific approval from the prescribing oncologist.  

An active chemotherapy cancer patient may also have a port or another external device affixed to their body.  All externally affixed body devices are a local contraindication for both placement and working stones. 

A cancer survivor who has completed their chemotherapy treatments may be a great fit for hot stone massage. However, there are a few caveats.  For example, those who have lost nervous sensation. Chemotherapy can damage nerve cells throughout the body, which can result in neuropathies and more. 

Hot Stone Massage and the Nervous System 

All hot stone massage recipients must be able to feel the heat of a stone to help avoid the potential of being burned by it. Hence, their nervous system’s sensory capabilities must be intact and fully functioning. Practitioners should avoid areas that have lost sensation as a local contraindication and not administer any hot stone massage at all if the entire body’s nervous sensation is impaired.  

Chilling with Oncology Treatments 

Many oncology treatments can leave a client feeling cold. The thermal therapy effects of hot stone massage can be remedial for a chilled client, once all other bodywork considerations have been addressed.  

Other hot stone massage considerations for oncology surgery, radiation and chemotherapy treatments include: 

• Lymph Nodes and Swelling  

Oncology treatments often focus on lymph nodes because they are a common area for metastatic cancer. Lymph node cancer treatments can create swelling in the localized treatment area. Do not apply hot stones or massage therapy to any areas of swelling.  

• Fatigue and Frailty 

Oncology treatments can cause extreme fatigue. These treatments can also cause a deterioration of skin, muscle, bone or any combination of the three.

If an oncology client seems excessively frail or in need of a colossal doze, consider switching the hot stone service to a bodywork that does not require frequent verbal communication and solely uses the hands instead of the harder surface of a stone. Frail and fatigued oncology clients will normally benefit from some adequate rest and doubly so with the correct massage. 

• Additional Side Effects 

Almost all cancer survivors will have a lifelong impact from their oncology treatment(s). However, survivors are usually better candidates for hot stone massage than those who are actively fighting cancer. 

Active oncology treatment recipients have an extensive list of possible side effects, such as mouth sores, lowered immunity or hand-foot syndrome, which all create additional oncology bodywork considerations. Sometimes, these side effects can last longer than the oncology treatment that caused them, but the severity does lessen for most survivors over time. 

Modifying Hot Stone Massage for Oncology Treatments 

In review, we have shown that these three primary oncology treatments chiefly create local contraindication sites more than full-body or total service contraindications for hot stone massage. As such, think about how hot stone massage can be adapted for local contraindications. For example, the arms and legs make up over half of the human body’s surface area.

Applying hot stone massage to an oncology client’s extremities is a great modification to work the majority of the body when the head, chest or organ areas have local contraindication(s). Even with a modified application, the thermal therapy effects of hot stone massage may be a wonderful relief for oncology clients who have pain, feel cold, or just want a special volcanic retreat from their everyday life. 

Still, because there are so many medical considerations with oncology treatments, partial or full body hot stone massage should only be provided on a case-by-case basis for multiple reasons beyond any single list that can be conceived here or anywhere. Keep in mind that all general hot stone and oncology bodywork contraindications, such as fever, active vomiting, infection and more, are still applicable. 

Consultation and Training in Oncology and Hot Stone Massage  

Unfortunately, like many bodywork subspecialties, we have very little research with oncology hot stone massage. Until we do, it is safest and best practice to consult with the client’s oncologist prior to administering hot stone massage for individual concerns and needs.  

While we have addressed hot stone application with three different oncology treatments here, general oncology bodywork and hot stone massage education is another matter. Specific oncology and hot stone massage CE classes should be sought prior to practicing either. Training in both should help provide knowledge of the adaptations, precautions and contraindications necessary to practice hot stone massage with cancer patients and survivors.  

CE Institute LLC Oncology & Hot Stone Massage Instructor Selena Belisle will share some ideas of how hot stone massage could be applied for cancer patients and survivors in this brief 18-minute video.

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

For more comprehensive oncology and hot stone bodywork training please visit and register at: https://ceinstitute.com/collections/oncology

To review this oncology hot stone massage article on Massage Magazine, please visit: https://www.massagemag.com/hot-stone-massage-with-oncology-treatments-128680/

 #hotstonemassage #bodywork #oncologymassage #oncology #cancer #oncologytreatments #massage #massagetherapist #lmt #massagetherapy #stonemassage #bodywork #bodyworker

Communicating the therapeutic benefits of aromatherapy today can be like walking a tight-rope.  Common claims once shared amongst aromatherapists may no longer be used due to a FDA crack down on aromatherapy and essential oil language.  Some practitioners have unfortunately made unsubstantiated claims which have created greater government oversight to ensure that the public is not deceived by false claims or practices. 

Ensuring professional and efficacious practice is any modality is extremely important, so it is more than acceptable that proper oversight is governing how therapeutic benefits are communicated within the public to avoid fraud.

In this brief 7-minute video, we'll share some guidelines of how to responsibly communicate your aromatherapy bodywork and practice with your clients.

For comprehensive aromatherapy massage and bodywork training, please visit and register at: https://ceinstitute.com/collections/aromatherapy

#aromatherapy #aromatherapist #massage #massagetherapy #massagebusiness #massagetherapist #bodywork #bodyworker #essentialoil #essentialoiluse

Some schools and instructors have claimed that prenatal massage in the 1st trimester is not safe.   This is untrue.  Prenatal massage in any trimester is perfectly safe, as long as proper training, contraindications and service precautions are observed and followed by the prenatal massage therapist.

There are some pregnancy medical conditions that are unsafe for massage practices in ANY trimester, which is why it is important to see appropriate prenatal massage therapy training PRIOR to working on this vulnerable population.

In this brief 5-minute video, we'll share our thoughts of why we feel prenatal massage in perfectly safe in the first trimester for practitioners who are professional trained to provide prenatal services.  

For comprehensive prenatal massage training please visit and register for training at: https://ceinstitute.com/collections/prenatal

#prenatalmassage #pregnancy #prenatal #massage #massagetherapy #massagetherapist #bodywork #bodyworker

When you're self-employed, it can be difficult to determine what price you should be charging for your services.  In this brief 10-minute video, we'll review this information in detail, with some thoughts on how to set massage therapy or bodywork service prices.

For comprehensive massage and bodywork training, please visit our website with many subspeciality modality classes at: https://ceinstitute.com/

To review our blog about setting massage prices on Massage Study Buddy, please visit: https://www.massagestudybuddy.com/setting-massage-prices

#massage #massagebusiness #business #massageappointments #lmt #massagetherapist #massagetherapy #bodywork #bodyworker

Manual lymphatic drainage (aka MLD or simply "lymphatic drainage") is a light-touch modality that is applied to reduce swelling of the face or body through specialized skills, techniques and practices. It is often applied by massage therapists, despite being quite different from massage.

In "regular" massage, clients can request work almost anywhere they wish, in any order they wish, with a variety of pressures that can be changed from one appointment to the next. In lymphatic drainage, a specific order or routine is followed, with minimal pressure that cannot be altered without medical reasoning.

Why Massage Therapists Learn and Practice Lymphatic Drainage

Lymphatic drainage can be practiced on clients who are contraindicated for massage therapy because of swelling. A reduction of excess swelling will often decrease pain and increase healing, especially in most oncology, sports injury and post-surgical medical situations. That is why massage therapists learn and practice lymphatic drainage. Lymphatic drainage skills can provide extra appointments for clients who would be normally contraindicated for massage.

For example: A client with a strained, swollen ankle might book a full-body massage appointment because they are in pain. However, it is contraindicated to massage an acutely swollen ankle. As such, the practitioner can provide lymphatic drainage on the swollen ankle and regular massage skills throughout the rest of the body. A trained lymphatic drainage practitioner is more likely to relieve this client’s pain rather than send them home without working on the one area the client might want or need it most: their swollen ankle.

The Practice of True Lymphatic Drainage

A practitioner’s lymphatic drainage goal is to encourage excess interstitial fluid—swelling or edema—within the body’s tissues to enter the lymphatic capillaries to form lymph. When this fluid is within the body’s interstitial tissues, it is called interstitial fluid. Once the interstitial fluid enters a lymphatic capillary, it is called lymph.

This fluid transference is known as forming lymph. This newly formed lymph is then gently manipulated toward regional lymph nodes where it is filtered and then travels through progressively larger lymphatic vessels back to the cardiovascular system.

Lymphatic drainage follows different pathways than a typical Swedish massage therapy session. Massage is generally provided in one direction—toward the heart—to increase overall cardiovascular circulation through venous return. Lymphatic drainage has several different pathways that include working toward the cervical, inguinal or axillary nodes. These sophisticated pathways become complicated when a client has an obstruction due to surgery, oncology treatment, birth defect or other physical trauma. (A high-quality CE course in lymphatic drainage will explain the different directions, pressures and tissues that are manipulated and used in this highly specialized bodywork.)

Lymphatic Drainage Bodywork Pressure and Application Explained

True lymphatic drainage is commonly called capillary work because practitioners work to encourage permeable superficial lymphatic capillaries to absorb excess interstitial fluid to form lymph, with extremely light touch and highly specialized skills. Gentle techniques are then applied to encourage this newly formed lymph to travel to lymph nodes and progressively larger lymphatic vessels.

Extremely light pressure is used because applying any type of moderate-to-deep pressure around a swollen or stretched tissue could further stretch or tear the swollen tissue. Also, too much pressure bypasses the initial lymphatics where most of the interstitial fluid is collected to form lymph and reduce swelling.

Despite this fact, there are some who perform lymphatic massage, skipping the light, skilled touch of lymphatic capillary work by claiming to do greater work on larger lymphatic vessels. A lymphatic massage applies kneading or ischemic compression over the lymphatic system’s unique pathways with moderate pressure, which is not a true holistic application of lymphatic drainage, nor is it an appropriate amount of pressure to work with on swollen tissues. Some of these lymphatic massages are performed through clothing, which requires a practitioner to apply even more pressure which could harm a swollen client.

It is critical to properly advertise and provide lymphatic drainage services. In the State of Florida, a licensed massage therapist was recently served an emergency restraining order for advertising lymphatic drainage as forcibly expelling bodily fluids out of their client’s surgical incisions. In the emergency restraining order, the state focused on the fact that lymphatic drainage bodywork is a gentle application that would not include any such forceful practice.

Is Your Lymphatic Drainage Client Taking Opioids?

Many acute medical conditions that cause swelling are indicated for lymphatic drainage but contraindicated for massage. Most acute medical conditions such as surgery, sports injuries or oncology treatments can be traumatic to the body, which could result in that client’s doctor prescribing an opioid.

Lymphatic drainage is one of the lightest forms of hands-on bodywork. It is difficult for a client to feel the light touch of lymphatic drainage bodywork when they are swollen and in pain but on opioids. As such, a client on opioids may ask a practitioner for more pressure during their lymphatic drainage session so they can “feel it working.”

Unfortunately, the excessive use of opioids over the past few decades has likely led to practitioners feeling compelled to apply greater pressure in lymphatic drainage to satisfy their clients’ request to feel the work.

Instead of applying more pressure, it is a practitioner’s ethical duty to explain how lymphatic drainage works with light, skilled touch and to find different ways to show the client how their lymphatic drainage is working, especially when the client cannot feel it.

How to Show Lymphatic Drainage Therapeutic Results

Practitioners should physically show a client their tangible lymphatic drainage appointment results though pre-treatment and post-treatment measurements or pictures. This is important because some lymphatic drainage clients might not be able to feel their lymphatic drainage bodywork for various reasons. Cloth-type measuring tapes can be used to measure a swollen extremity and photos are the best option to review any reduction of swelling or puffiness in the face.

To conclude, almost the only thing in common between massage and lymphatic drainage is it can be offered by a massage therapist on a standard massage therapy table. Beyond the practitioner and table, these two modalities are extremely different for important therapeutic reasons, which becomes increasingly apparent with greater lymphatic drainage training.

In this brief 17-minute video below, we'll review this information in detail, and review why the lightest pressure is used to relieve swelling amongst other medical reasonings.

For comprehensive Lymphatic Drainage training please visit and register at: https://ceinstitute.com/collections/lymphatics

To review this Lymphatic drainage article in greater details please visit Massage Magazine at: https://www.massagemag.com/manual-lymphatic-drainage-128255/

#MLD #manuallymphaticdrainage #lymphaticdrainage #lymphatic #lymph #massage #massagetherapist #massagetherapy #bodywork #bodyworker

Hot stone massage has become a favored choice by clients, especially during vacations or in colder climates, but not practicing hot stone safety could leave a practitioner in hot water. An internet search shows that some clients were injured once the massage industry started rocking these popular appointments.

130-degree Fahrenheit water can burn human tissue within one minute, according to the American Burn Association, yet the average operating temperature of a hot stone bath is approximately 130 degrees. Additionally, a practitioner’s hands can become increasingly desensitized with repeated hot stone treatments.

As such, a practitioner could unintentionally yet easily burn a client with their mineral marvels. This has created some significant safety protocol updates for the practice of hot stone massage.

The Massage Stone Heater (aka Stone Bath Unit)
Practitioners are using turkey roasters, crock pots, kitchen griddles, hot towel cabins, kettles, heating pads and other types of heating devices, in addition to professional stone massage bath units, to heat their stones. For best practices, all stones must be fully immersed in water within a heating unit. This is known as the bath. Stone bath units that have a built-in temperature gauge within a hot stone bath operating range are preferred.

Alternative heating sources that do not include a total water immersion can create uneven stone surface temperatures. Unevenly heated stones are not reliable or safe to use, especially when working near maximum operating temperatures.

Stone bath units must also have an adjustable temperature control. Practitioners must continually adjust the bath temperature as needed, especially if cooler stones are returned to the bath, to maintain a proper operating temperature.

Temperature Measuring Devices
Because of various logistics, including unreliable gauges, temperature accuracy comparisons, and temporarily lost thermometers in the stone bath, it is now advisable to use two temperature measuring devices during hot stone massage. A meat thermometer and stone bath unit with a built-in temperature gauge are the most popular choices. Measuring devices should be easy to view in a dark treatment room setting and have available readings within a proper hot stone massage temperature operating range.

Temperature Operating Range
At CE Institute LLC, we teach our students to operate their hot stone baths between 120 to 135 degrees Fahrenheit. A hot stone bath should be operated between 120 to 135 degrees Fahrenheit.

There are some schools, instructors and practitioners who work at slightly higher and lower operating temperatures, which is an individual choice. Best practices should instill a conservative approach to balance safety and comfort with thermal therapy enjoyment.

Temperature Management
Check the stone bath temperature every time the stones are removed from the bath and at least once every five minutes during any hot stone service. That means the operating temperature should be visually inspected a minimum of 12 times during a one-hour hot stone massage appointment.

It is critical to frequently monitor the stone bath operating temperature and adjust it accordingly when the calefaction is headed in the wrong direction. Regular checks will allow for manual temperature adjustments as needed, to maintain a proper temperature operating range.

Heating (and Overheating) Stones
Provide ample time to heat your stones prior to an appointment. Cranking the stone bath unit to preheat mode or absurd temperatures to quickly heat the stones will usually result in the outside surface of the stone becoming hot but leave a colder core inside the stone. That is an unsatisfactory effect when the stones quickly cool during hot stone massage application.

Conversely, in an attempt to quickly heat stones, the bath and stones can overheat. Never cool the bath with cold water or ice. Cold water or ice can cool the outside surface of the stone while the inside core temperature could still be burning hot. Eventually, that core temperature inside an overheated stone will make its way to the stone’s outer surface. A roguishly cooled 200-plus-degree inner core stone can burn the client once that inner temperature reaches the stone’s outer surface.

It is recommended to turn off the stone bath unit and continue with regular massage when a bath has overheated. Do not use overheated stones under any circumstance.

Placement Stone Use
Placement stones are arranged on the body without movement. They are also called static stones. A minimum of two barriers are required between the client’s skin and a placement stone. The two barriers can be a sheet plus a blanket, or a sheet plus a towel or any two barriers that seem appropriate.

Common areas for placement stones include laying stones over the sternum, sacrum, back, palms of hands or soles of feet. (You might need to explain the need for the two barriers to the client, because more than half of stone massage stock photos that depict a client receiving a stone massage show a placement stone sitting on a client’s bare skin. Hot stone massage advertisements should depict updated applications that demonstrate either working stones in motion or placement stones applied over a minimum of two barriers—or both.)

A practitioner should inspect the client’s skin periodically after a placement stone is applied over two barriers. That means removing the barriers (without overly exposing the client) and looking at the client’s skin to ensure it is not welting, blistering, unnaturally discolored or showing any other sign(s) of distress. The practitioner should also touch the skin to ensure it is not excessively hot. The goal is to safeguard the client from being burned.

Retired Placement Stones
The following placement stone applications have been discontinued in most work settings:

Facial stones and cozy stones between the toes, because two barriers are difficult to achieve with either.
Abdominal stones, because it is awkward and difficult to make visual safety observations on the sensitive skin of a client’s tummy.
Back stones while a client is in supine position, because a client should never lay their full body weight on top of a heated modality that has the potential to burn or harm them.

Any stones that cannot be placed with a minimum of two barriers between the stone and client.

For modified practice, room temperature placement stones can be used when hot stones cannot be safely applied with two barriers. Most hot stone massage appointments continue to include both placement stones and working stones in motion.

Hot Stone Safety and Gloves
Never wear gloves for hot stone massage. That is because any stone that is too hot for a practitioner’s hands is likely too hot for a client as well, regardless of what the thermometer says.

Never trust a temperature measurement if the stones feel too hot. If the temperature feels wrong, simply stop using the stones until the temperature devices can be verified for accuracy prior to reuse.

Practitioner Skin and Heat Sensitivities
Practitioners should reconsider the provision of hot stone service if they are uncomfortable with a 120- to 130-degree Fahrenheit hot stone operating range. It is critical to be able to handle a hot stone comfortably so that it is not improperly applied due to practitioner discomfort.

Hot Stone Safety and Bone
In addition to a potential burn, an injury can happen when the hard surface of a stone inappropriately contacts human bone. Avoid applying pressure with stones into superficial or protruding bone.

Hot Stone Safety Client Communication
Practitioners should frequently check in with a client about stone temperature, especially with each new work area, such as when the bodywork moves from the arms to the legs. Immediately remove all stones if a client says it is too hot or painful and do not continue unless it can be assured that the:

• Bath temperature is within operating range.
• Client is comfortable and wants to continue with hot stones.
• Client has not been injured or burned.
• Do not rely on client communication for a proper hot stone operating temperature. A client could fall too far into their mental vacation to provide critical feedback during a hot stone massage.

Practitioners must engage in active strategies to ensure practical safety beyond verbal communication. This includes frequently checking the bath temperature plus visually inspecting and touching the skin among other available remedies, to prevent injury.

Infection Prevention
Anything that comes in direct or indirect contact with a client must be sanitized between every consumer – period.

Hot Stone Safety Training
The thermal ritual of hot stone massage can offer an incredible vacation on a table experience but this service does require special training. While this article focuses on hot stone massage safety, a quality CE class can provide a more complete education of stone massage safety advisories, practices, applications, precautions, protocols, and contraindications.

In this 25-minute video below, we'll review these up-to-date practices of hot stone massage in better detail, as well as those older hot stone massage practices that have been "retired" (or discontinued).

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

To review this hot stone massage safety update article in greater details please visit Massage Magazine at: https://www.massagemag.com/hot-stone-safety-128263/

#hotstonemassage #hotstone #stonemassage #hotstonesafety #massage #hotrockmassage #hotrock #massagetherapy #lmt #massagetherapist #bodywork #safety 

Lomi Lomi massage should be considered to be part of Hawaiin healing practices.  It was developed with the spirit of aloha within the Hawaiian islands.  There are two primary and distinct practices of Lomi Lomi massage which are discussed in the video below.

When practicing Lomilomi massage, it’s best to create a peaceful harmony within yourself and workspace by turning down artificial noise. This includes tuning out needless thoughts or feelings in our own mind, body and soul as well as removing physical objects that increase negative distraction from the workspace.

Think about how personal freedom can come through body movement. Many of our clients hold their shoulders to their ears (the “no-neck” syndrome) or they work in sedentary jobs. Lomilomi often creates a new sense of freedom for these clients. It can melt feelings and that “protective armor” we hold over our bodies with its fluid, noninvasive strokes.

You may have to restructure the way you work for Lomilomi if you practice neuromuscular therapy, myofascial, trigger-point or similar techniques. In Lomilomi massage, we do not dig or use excessive pressure. (There are other Hawaiian bodyworks, such as bone washing, which are more appropriate for therapists who seek a more anatomical or tactical technique.) Lomilomi massage should be about creating a beautiful, peaceful, healing space to allow the positive energy and feeling to envelop its existence.

To that end, we suggest using coconut or kukui nut oil to promote a smooth glide with long, flowing strokes; we do not allow for any skin friction whatsoever.

The practice of Lomilomi slightly evolves with every therapist and each generation’s application; however, the basic principles of being one with nature in a peaceful, healing, aloha environment should remain consistent.  

This brief 12-minute video will review some of the most basic theoretical concepts of Lomi Lomi Massage.

For comprehensive Lomi Lomi training please visit and register at: https://ceinstitute.com/collections/lomi-lomi

To review this Lomi Lomi article in greater details please visit Massage Magazine at: https://www.massagemag.com/at-one-with-nature-the-technique-and-art-of-lomilomi-massage-124701/

#lomi #lomilomi #lomilomimassage #hawaii #hawaiian #hawaiianhealing #aloha #massage #lmt #massagetherapist #massagetherapy #bodywork #bodyworker

Orthopedic Cupping Massage is a western medicine methodology of cupping practice. Cupping is usually practiced as part of TCM aka Traditional Chinese Medicine.  Orthopedic cupping massage uses western musculoskeletal anatomy and more for practical application instead of energetical meridians.

Orthopedic cupping massage has emerged as a new, distinct form of bodywork.
The practice of cupping has highly evolved since Michael Phelps’ 2016 Rio Olympic cupping marks exploded over the internet.

A growing number of massage therapists have purchased and intuitively used cups in their respective practices over the past five years. What transpired was a bodywork evolution. The playbook of traditional meridian cupping was set aside, and orthopedic cupping massage emerged as a new distinct form of bodywork.

Orthopedic cupping massage stretches and releases soft tissue restrictions, which can create a human domino effect of better tissue metabolism and greater range of motion that can lead to better athletic performance and other health-related benefits.

While stationary cups applied along meridians are still practiced today with Traditional Chinese Medicine (TCM), orthopedic cupping massage provides a new bodywork approach.

Aim for These 10 Points with Orthopedic Cupping Massage

Orthopedic cupping massage can be:

1. Easy to provide for a massage therapist who does not know the body’s meridians.

2. Modified for client comfort.

3. Practiced at a sporting event and other on-the-go settings.

4. Applied as a spot treatment.

5. Effective to stretch soft tissues in an opposite direction from mainstream bodywork.

6. Provided in difficult-to-work areas.

7. Utilized with passive and active joint range of motion.

8. Similar to myofascial skin rolling.

9. Less unsightly than the marks caused with stationary cupping.

10. Exercised within most massage therapy scopes of practice.

Here’s how the 10 points of orthopedic cupping massage work:

1. Practice with Anatomy instead of Meridians
Orthopedic cupping massage is practiced with anatomical references. Superficial soft tissues are stretched and manipulated with cupping movements to improve orthopedic function. Cups are generally moved from a superficial muscle’s origin to insertion and vice versa, in a variety of skillful applications.

2. Vary Pressure and Intensity for Client Comfort
A practitioner can choose from over a dozen skillful massage techniques, such as circling or twisting with the cups, for client needs or comfort. Different techniques have different pressures and intensity levels. Working within a client’s tolerance is essential to successful bodywork, especially when a client is already in pain.

When plastic cups with a hand pump are used, the practitioner can also control the intensity and pressure of the treatment by the amount of air that the practitioner pumps into or releases within the cup.

Between techniques, cup choices and applications, orthopedic cupping massage provides a practitioner exceptional control over how much soft tissue can be manipulated or stretched.

3. Sporting Events and On-the-Go Settings
Orthopedic cupping massage can be applied in different positions and settings beyond standard prone or supine table massage, which may provide greater or easier access for the practitioner as well. Examples include:

• A client who is in severe back pain and unable to climb onto or lie on a massage table could lean slightly forward in almost any chair for a practitioner to work cups up and down the erector spinae of the back.

• An athlete could lie supine on the ground with their lower leg raised over the seat of a chair for orthopedic cupping massage on a shin splint.

• A frozen shoulder client might be more comfortable while sitting in a chair instead of lying on a table.

4. Spot Treatments
Orthopedic cupping massage is most useful when it is applied to chronically tense areas. It puts cups in motion over orthopedic dysfunction such as scoliosis, tennis elbow or frozen shoulder, to stretch shortened and contracted tissues.

5. Stretch Soft Tissue in an Opposite Direction
Orthopedic cupping massage is a great alternative for practitioners who feel stuck with bodywork that is mostly applied in one direction. Most bodywork applications such as neuromuscular therapy (NMT), deep tissue massage or trigger-point therapy would focus on a practitioner applying pressure downwards, into the body.

Conversely, cupping provides reverse suction to pull soft tissues upwards, in an opposite direction. Orthopedic cupping massage additionally requires the practitioner to pull the cups with upwards and outwards movements with their hands, to generate the greatest amount of tolerable stretch to the underlying tissues.

Because orthopedic cupping massage stretches soft tissue in an opposite direction, it can also be used as a warm-up or in conjunction with deeper tissue modalities.

6. Difficult Bodywork Areas
A small cup can also provide extensive work within small work areas, such as the thenar eminence. Orthopedic cupping massage may be the only bodywork where a practitioner would not send their own thumbs to hell while sending their client’s thumb to heaven when working in such an arduous area.

7. Passive and Active Range of Motion Application
Orthopedic cupping massage can be additionally utilized with active or passive joint range of motion. With shin splints, a small cup can massage inferior to superior and back, along the lateral side of the mid to upper tibia. To increase the stretch of the underlying soft tissue, the ankle joint can be actively or passively flexed and extended during this anterior tibialis work.

8. Similar to Myofascial Skin Rolling
The intention in this evolving bodywork is to simply lift and separate the underlying soft tissues, like myofascial skin rolling—both are applied in motion. The difference between orthopedic cupping massage and skin rolling is that the cups can grasp a greater amount of underlying tissue with better comfort for the client than what a practitioner might achieve with their hands alone.

9. Less Cupping Marks and Bruising
Another win for orthopedic cupping massage is a client should have less bruising or marks than traditional stationary cupping applications. A little pinking of the skin is natural when suction or friction movements are applied; however, purposely causing hematomas or sending a client home full of bruises should never be the goal.

A practitioner is likely pressing down instead of pulling up on the cups during movement, performing too much work in the affected area, using too much suction or unnecessarily aggressive techniques if there are excessive marks or bruising during orthopedic cupping massage.

10. Scope of Massage Therapy Practice
Orthopedic cupping massage primarily uses plastic and silicone cups which are within most massage therapy scopes of practice because the client’s soft tissue is constantly being massaged with a tool in movement, which is the cup.

Stationary TCM cupping application with fire and glass cups along meridians are regularly considered beyond a massage therapist’s scope of practice and are not considered to be within a standard orthopedic cupping massage application.

In this brief 15-minute video below, we'll review the 10 Points of Orthopedic Cupping Massage in detail.

For comprehensive Cupping training please visit and register for training at: https://ceinstitute.com/collections/eastern

To review this ORTHOPEDIC CUPPING MASSAGE: A DISTINCT FORM OF BODYWORK article that is reviewed in this video in greater detail, please visit Massage Magazine at: https://www.massagemag.com/orthopedic-cupping-massage-127635/

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Gout is a bodywork and massage therapy contraindication.  In this brief 3-minute video, we'll briefly review the medical condition of gout.  In general, any medical condition that results with swelling would be contraindicated.  Massage therapists should never press, pull or manipulate swollen soft tissue with massage techniques.  Please view the video below to learn more about gout.

To learn more about gout or advanced medical foot conditions and treatment, please visit our advanced training offerings at: https://ceinstitute.com/collections/advanced

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