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Sticks & Stones

Much like our journey from caveman to a desk jockey who is hunched over a keyboard, all things evolve. Keeping that thought in mind, blending treatment techniques and styles is no different.

September 25, 2009  By Tilman Von der Linde RMT

Much like our journey from caveman to a desk jockey who is hunched over a keyboard, all things evolve. Keeping that thought in mind, blending treatment techniques and styles is no different.

Over the last 50 years we have witnessed many treatment styles that have been rediscovered, reworked and renamed all in the spirit of improving their effectiveness. Be it “new and improved” or simply “looking for a better way” in a quest to “work smarter not harder;” we can all do well to remember that life by nature is characterized by impermanence, and that growth and change require the constant shuffling and re-organization of structures, skills, and shifts in attitude.

stone1.jpgOne quote that speaks to the industrious nature of massage therapists is: “One who follows the crowd will usually get no further than the crowd. One who walks alone is likely to be found in places no one has ever been before. Creativity in living is not without its attendant difficulties, for peculiarity breeds contempt. The unfortunate thing about being ahead of your time is that when people finally realize what you are doing and actually “get it,” they will say it was obvious all along.”

Tools have defined, served and evolved with us and have reshaped the way we do things. Every instructor, consultant/contractor and clinical practitioner who has contributed to the evolution of massage therapy has done so with true pioneering spirit. Whether they used sticks and stones, or moved on to needles and knives or other implements of choice, tools have been used to scrape and cut away that which no longer serves us or the profession.


Think back to the last time you embraced the essence of that true pioneering spirit and decided to modify your treatment approach to adapt to the needs of a patient, or to reduce the level of strain on your body.

After years of experimenting on my own by blending and modifying techniques that share similar properties, both in theory and in treatment methods, new ways have come forth. Be it for the challenge of working with people in new ways or simply catching a glimpse of potential for something different through an experiment, the experience is exiting to say the least.

Three treatment methods that share similar properties are; Active Release Techniques (A.R.T.) Rolfing and Connective Tissue Massage (C.T.M.). All three share similar treatment patterning and approach; an active component to facilitate a stretch, the use of the hands to stabilize, cause a stretch to the fascia, and support that best results are achieved without the use of a lubricant.

Both A.R.T. and Rolfing techniques incorporate movement into their techniques by either using thumbs and
fingers, or the forearm to brace the muscle tissue before causing a passive stretch or by asking the patient to actively move the antagonistic muscle group to cause a stretch on the tissue being treated.

Asking the patient to interact with your treatment by moving a joint or limb allows for the patient to be in control and present in the therapeutic intent. Active movements also help integrate the release into the nervous system which promotes the change in structure and proprioception. C.T.M. on the other hand is defined by two methods, a passive reflex zone method developed by Talreich-Leube and Dr. Head, and a less popular method with a questionable active component for muscles and joints developed by Elizabeth Dickie some 70 years ago.


Sticks come in many shapes and sizes, from the Japanese massage stylus to the Knobble (above).

I can remember my days back in Europe 20 years ago, when I worked as a massage therapist in a large Rehab-Resort facility in Germany. Bruises were developing under the calluses that had formed on my finger tips from treating upwards of 15 patients, out of my daily schedule of
30 to 40 patients, with the C.T.M. styles I had learned.

I also recall that I wasn’t the only therapist to complain about the stress this method caused to the hands and about the patient load in relation to the ratio of C.T.M. treatments on our day sheets.

Some therapists continued to bravely soldier on by using the C.T.M. techniques as they always had while other therapists found their own solutions and ways of coping.

Some started using a wooden dowel known as the Japanese massage stylus; others used a metal scraper made of copper. I happened to find a rock in one of the gardens of the resort and chose to start using it as a stylus instead of using my fingers and thumbs because C.T.M. was causing more stress to my fingers than I was willing to take.

Since then I have accumulated an interesting array of rocks on my window sill at work, most of which I have collected from Dallas Road Beach in Victoria, B.C.

As you know sticks and stones have been around for a long time and are still being used today. Sticks are used as a stylus in acupressure or friction treatments and are also used in treating trigger points.

Sticks come in many shapes and sizes from the Japanese massage stylus to the Knobble. Stones have also been used as a stylus in the past and have gained popularity with the advent of the Hot Stone Massage. Certainly the effect of the Hot Stone Massage methods of tracing meridians with a slow moving stroke, or resting a warm stone on a trigger point or the chakra points are intended to calm and sedate an individual, all techniques
that are understandably preferred to the more vigorous and active techniques.

However, what about those vigorous and active techniques? After blending the C.T.M. method developed by Elizabeth Dickie, by incorporating the active component of A.R.T. and by having the patient facilitate a stretch while the treatment patterning is being applied, a new way of working was beginning to take shape.

Then, one fine day I started storing the rock that I was using as a stylus on my baseboard heater instead of the cold window sill. The results of using the C.T.M. techniques developed by Elizabeth Dickie and or the A.R.T. techniques for that matter, in combination with the heated rock have been really successful. Call it, “ironing out the kinks,” if you will.

If you choose to experiment with these methods, it is necessary to have a good understanding of the patterning and techniques involved as well as a good sense of both fiber direction and action of the muscle being treated because these techniques tend to run along with the grain of the muscle while the muscle is being stretched, as opposed to across the grain as is done with frictions.

Try incorporating an active component into your massage therapy routine by asking your patients to move a joint or limb to facilitate a stretch while you are working on the muscles. Experiment with a stylus and without. If you are using a stylus, let the stylus travel a bit over the skin with firm and moderate pressure while facilitating the stretch along the rope like muscle segments or firmly hold the stylus at the edge of palpable muscle scarring while facilitating the stretch on the tissue. Repeat this move by repositioning the stylus a bit further along the scarred area.

If you choose to heat a rock and use it as a stylus, please remember to ensure that the stone is not too warm by using a heating unit that will maintain the heat at a consistent temperature. The temperature of the stone should not exceed 140 degrees F (47-50 degrees C).

In some circumstances using a heated stone as a stylus to treat a patient is an asset as muscles usually tend to respond better after being warmed.

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