Thai Massage is not medicine. Its aim is relaxation. This can be very beneficial and even healing but it is not an alternative to medical care. When we begin to practise massage the safest approach is to only work on healthy people. As we gain confidence in our practice we might choose to work with patients with medical conditions. In this case we should only do so with the knowledge and blessing of the patient’s doctor. In our practice we might come across patients where something seems wrong. It is our duty to encourage our patient to seek appropriate medical advise.

The routines that I teach and practise use techniques that are as safe as can be and are suited to patients with an ordinary level of flexibility. There are many more techniques. Often these are presented as ‘advanced’. More often they are simply variations on a theme. Some-times they are fun to do in class or with friends. Sometimes they are just plain dangerous.

The blood stop involves applying pressure to major blood vessels to reduce blood supply to a chosen area. The theory behind the technique is that it produces a backpressure which, when released, clears away dead cells that have been loosened during the massage. This ­technique is commonly applied to the femoral arteries supplying the legs. It is less commonly applied to the axillary arteries supplying the arms. It is rarely applied to the common carotid artery supplying the head.

All variations should be avoided. In the UK, many insurers will only offer insurance to Thai massage therapists who agree to avoid this technique. The reason is quite simple. We have no idea of the state of our patient’s cardiovascular system. They may be harbouring undiagnosed weaknesses or clots. Better that it is not our technique that reveals them.

Thai Massage includes the application of yoga asanas. Depending on the practitioner this is a more or less important part of the overall massage. I tend to teach and use very few of the applied yoga postures. The few I use regularly have already been covered in Chapter 8. The following techniques I use occasionally. There are others that I consider too challenging for the patient and/or the practitioner so I disregard them altogether. I prefer that my patients do their own yoga practice and just come to me for the massage.

There are at least four variations on the spinal twist. The one we have already looked at in Chapter 8 (Fig. 8.59) is the best as it is the patient’s own body weight that initiates the rotation in their spine. We do not push the patient’s body and if it is clear that they lack the flexibility or the willingness to turn we do not continue.

When we make contact it is simply to draw the patient’s attention to the way their body tightens a little with inhalation and relaxes a little with exhalation. They learn to breath their way into the rotation (Fig. 9.1).

Fig. 9.1 Applying the spinal twist

Sometimes a patient easily rotates and both their shoulders rest comfortably on the floor. In this case it is possible to increase the rotation by taking the patient by the wrist of the lower arm, asking them to hold on to our wrist and drawing their body up from the floor. Another variation involves physically pulling the patient into a spinal twist.

Both of these variations are best avoided. An imposed rotation may be painful for the patient and encourage a defensive tightening that undoes all the relaxation of the massage. It may also be dangerous if the patient’s spine is already under duress. It is worth remembering that most spinal disc ruptures come as a complete surprise and occur with seemingly insignificant efforts. Strong manipulation of the spine is better left to osteopaths and chiropractors who are trained and equipped to assess the risk before manipulating.

Related posts:

Meditation in movement Working with health Working as a massage therapist Past and present Myofascial pathways – East meets West Ten sen – West meets East

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