by Karen Kowal, R.N., L.M.T., N.C.T.M.B.

Thermal Connective-Tissue Release with Pillossage, MASSAGE MagazinePillossage is a new modality that combines hands-on techniques with specifically designed thermal flax pillows. These innovative protocols deepen the therapeutic effect.

Rather than using heated products or equipment to lay over or under for warmth, Pillossage uses touch, ranging from light to specific deep compressions, through heated flax pillows. This modality is a whole-body sequence that can be added to a massage therapist’s menu selection or custom-tailored to address specific client needs.

Pillossage involves thermal connective-tissue release techniques, such as wave-like compressions. This initiates relaxation to decrease guarding and creates a calming massage session for both body and mind. Attention to skeletal landmarks and soft-tissue attachments allows the therapist to focus on painful regions of the body that may be challenging to address.

Decreasing pain patterns and creating deep relaxation are vital components of this modality. The therapist creates a rhythm of smooth transitional movements, gently re-educating the body, validating the client as tenderness or pain is located. This powerful thermodynamic modality can effectively and rapidly reduce pain patterns, release adhesions and dislodge cellular debris that can linger after injury—without causing discomfort to the client.

Pillossage techniques are ideal for clients who need a gentler touch, such as the elderly or when recovering from surgery, as well as clients who may have fibromyalgia, arthritis, migraine, sinus problems, repetitive stress injuries and low-back pain.

Fantastic flax

Thermal Connective-Tissue Release with Pillossage, MASSAGE MagazineUsing thermal flax pillows of varying shapes, the Pillossage therapist offers assisted stretching, guided breathing patterns and directional compressions to reach deeper layers of connective tissue. The three designs of therapy pillows used to execute the Pillossage technique contain organic golden flax and are constructed with two layers of quality natural cotton fibers.

These pillows offer professional durability to withstand repetitive use for many sessions and are a vital tool for the therapist. These pillows allow for compression, yet without the sensation of being bumpy or so thin the client feels poking fingers. Flax shifts and conforms to the client’s body, becoming an extension of the therapist’s hands to create broad, smooth sensations of compression.

Generously filled, professional flax pillows hold a therapeutic level of heat (or cold) for 45 minutes. You will warm the pillows in a microwave according to directions or in a hot-towel cabinet, or chill in a freezer for cryotherapy.

Dried herbal blends added to flax pillows will add an additional aspect of therapy during Pillossage. Lavender flowers blended with additional herbs and spices offer subtle scents while providing analgesic effects, relaxation and an aromatic memory of the massage experience. Unscented thermal pillows are provided for an aroma-free classroom to respect students’ sensitivity and may also be selected for client use.

“These pillows allow positive touch without invasiveness and help the client transition from the outside world to their session,” says Paula Owens, a massage therapist in Arnold, Missouri. “They offer quick relaxation for muscles and sympathetic nervous system, allowing me to work smarter, rather than harder, as they soften the fascia.”

Starting with Pillossage increases the effectiveness of the other modalities she uses in session, Owens adds. “I call it therapy with a hug.”

Melt away tight layers

Heat has been used for therapeutic purposes for thousands of years. Ancient cultures relied on heat from thermal baths and poultices to ease symptoms of disease and pain. Today we make use of hot stones, grain packs, heating blankets, hot gel or water packs, topical ointments and electric heating pads.

Thermal Connective-Tissue Release with Pillossage, MASSAGE MagazineApplying heat to the body affects the central nervous system, enhances sedation and aides the release of natural pain-reducing hormones, such as endorphins and oxytocin, and increases viscosity of the ground substance of connective tissue.

Heat can behave like radar, locating tender exhausted muscles, adhesions, trigger points, fascial tension or impingements. The basic feature of heat alters the sol-gel state of ground substance of connective tissue. Thermal connective-tissue release creates space by transforming tight, stuck, fuzzy, hard fascia to a more liquid, sliding and gliding state. As tight layers melt away and composition is altered, the therapist can enter deeper tissues to accomplish work without pain to improve range of motion and flexibility.

Just like a pebble in a pond, when touch and compression are blended with heat, a ripple effect is created, altering dysfunctional fascial planes far beyond the area covered while melting tight trigger points.

Results of thermal connective-tissue release are twofold: first, the client experiences relief from pain, a feeling of lightness, greater range of motion and nurturing support; second, the therapist uses body mechanics, reducing strain on her own body during this innovative modality.

Client relief

Slowly and gently, a long, heated thermal pillow is draped down the spine, reaching from T-1 to the sacrum, affecting every spinal nerve. Feather-light directional strokes over the warmed pillow initiate the relaxation response. This introduction to Pillossage is a vital step to reduce guarding, offering no resistance as the therapist continues. The therapist smoothly transitions to rocking, then deeper compressions, working with a variety of flax pillow designed to treat the entire body, head to toe. The session continues as a full-body Pillossage sequence, or portions of it can be integrated to create a custom massage.

Thermal Connective-Tissue Release with Pillossage, MASSAGE Magazine“Pillossage can help treat the fascia and decrease chronic pain,” says massage therapist Terrie Yardley-Nohr of Allied School of Massage in Fenton, Missouri, “and these techniques definitely fit within our scope of practice.”

Pillossage can be performed over a sheet, over bare skin (using washable pillow covers) or while the client remains clothed. Pillossage techniques can be added to chair massage, offered as mini-sessions at wellness fairs, or during pre-and post-sports events.

“I’ve incorporated Pillossage techniques in every therapeutic massage session for over a year now, with great benefit to myself and my clients,” says massage therapist Deborah Jewett of Portsmouth, Ohio. “As a seasoned massage therapist [with] 20 years in private practice, I appreciate this modality that eases stress and trauma on my body while enhancing the therapy session for my clients.”

Easy on the therapist

With Pillossage, the therapist learns to use relaxed body mechanics and slow down, allowing the heat to work through layers of tissue. Using elbows, relaxed, open palms, forearms, soft knuckles and proper stances, the therapist learns to shift her weight to reduce damage to thumbs, shoulders and back. Heat amplifies any compression, so less effort is required of the therapist to achieve tissue transformation.

Thermal Connective-Tissue Release with Pillossage, MASSAGE MagazineIn Level 1 Pillossage, the therapist learns the sequence and advanced techniques for shoulders, adductors, chest wall, cervical spine and hips. Level 2 addresses self-care for the therapist and how to incorporate coaching self-care skills for clients. Clinics, spas and independent therapists find self-care and prevention are an effective marketing focus.

“I am an advocate of teaching my clients how to help themselves, so educating clients using these pillows encourages self-care to my clients while generating extra income for my practice,” explains Theresa “Tess” Contos, owner of ACSEND Spa in Syracuse, New York. “My clients leave with a home treatment plan [that includes] a thermal pillow after every session.”

At Ginger Bay Aveda Spa and Salon in St Louis, Missouri, Pillossage equipment is offered in the retail area, says lead massage therapist Kristin Bowman. “These techniques support our spa’s focus on natural products for self-care, and clients are grateful to find them [here],” she adds.

Diversity and integration

The diversity of Pillossage techniques can be integrated into other modalities, or used as a stand-alone modality.

The mission of Pillossage training is to educate and excite massage therapists to successfully integrate the age-old property of heat with compression and stretching in new and creative ways. There is the hope that a thermal flax pillow will become a massage therapist’s second-favorite tool.

Karen Kowal, R.N., L.M.T., N.C.T.M.B., is founder of Mother Earth Pillows®, CEO of Mother Earth Designs Inc. and creator of MEDINC Education, which offers a variety of classes, including Pillossage. She is a National Certification Board for Therapeutic Massage and Bodywork-approved continuing-education provider. For more information, visit or e-mail