What I’m going to explain about Thai massage might ruffle some feathers, but I want to stress that I’m coming to this from a perspective of advanced education. I was lucky enough to start my career with superb exposure to state-of-the-art skills, thanks in part to that Osteopathic ex. I was with him while he went through residency for Osteopathic Musculoskeletal Manipulation. He came home every day and taught me what he was learning. I combined it with my chiropractic school education (a year of cadaver work!), and my Tuina (deep tissue) and Shiatsu (acupressure) classes I had as part of my Master’s degree in Acupuncture and Oriental Medicine. As a result, I have a unique and comprehensive set of tools – and of course I’ve been collecting roughly twice the required continuing education classes for my license renewals for the past 20 years, as well.
So here’s my hot take: The better your technique is, the less force you need. Aggressively hammering on an unhappy muscle can give you some temporary relief by breaking up fascial adhesions, but the pain involved means they will reform again immediately. I’ve written about this here and here. Instead, I like using myofascial release to ease those stuck layers apart without triggering the alarm response that will lay down scar tissue.
Not all the massage I got in Thailand was bad! The ladies at Golden Hand and the Siladon Spa had a wonderful touch, and being able to indulge in a luxurious three hour treatment was incredible. But I was hoping to learn more useable techniques, and I was disappointed by the focus on brute strength instead.
Bangkok: Chinglian TCM Clinic
My first appointment was for some Traditional Chinese Medicine: Acupuncture and cupping. In a reversal of the “no shirt/shoes, no service” model of American businesses, everyone removed their shoes at the door. The waiting room was full of bare feet. There was a binder containing before & after pics, and ads for the oils she was selling.
The doctor had trained in China and very much adhered to the ancient school of thought regarding energetic organs and the 5 elements. She was convinced that my issues were related to eating too much salt and damaging my Kidney (info on TCM energetic organs here). She had three glass-walled treatment rooms, one with two beds. She did four sets of needles (Face down, face up, left sidelying, right sidelying) and two sets of cupping (face up and down). It was crazy intense! Once she found the Fibromyalgia pain on my outer thighs, she was determined to make it go away, and she kept stimulating and adding more needles. Every time she would poke me where it was tender, and ask if it still hurt. After an hour and half, I couldn’t take the poking anymore. I lied and said it felt better so she would stop. She literally used over a hundred needles on me. The cupping was also quite intense and painful. I had large red sucker marks all over my upper back. I did appreciate the topical oils she gave me afterwards. They were in tiny little self-applicating jars with labels for “sleep,” “gout” (for inflammation – I don’t have gout) and “stress.” They smell wonderful and I’m still using them at my pulse points.
Was her treatment useful? I think so. I had arrived from the airport literally hours before our session. It was my first day in Thailand and spent the next 11 days doing a ton of walking and trying to avoid nightshades (which increase inflammation for me). My FM pain seemed lower for 24 hours or so. I would have liked the opportunity to see her more regularly and give her style of medicine a real chance to work. On the other hand, it was a LOT. My philosophy is that the body is very smart. It just needs a nudge in the right direction to start healing, and this felt more like a sledgehammer. FYI, the cost for the hour and a half session was 1400 bhat, about $41 USD.
Bangkok: Chetawan Massage for Health
The lobby was small, covered in products for sale, and had posted signage with policies they ignored. Literally none of the procedures in the pic below were followed, aside from having an appointment booked ahead. Zero Covid questions were asked. We were each given a small intake form, but half weren’t collected and they clearly did not read them before starting work on us. 480 Baht is about $14 USD.
We were booked for an hour massage and had the option of full body or feet and legs. Those of us who opted for the latter were led to a room with 5 chairs and ottomans. The room was dark. There was no conversation or questions – each student just started work on a pair of legs. It mostly consisted of running thumbs and knuckles over the area as hard as possible. In America, one of the basic rules of massage is to not crush a muscle against a bone – they seem to specialize in that in Thailand. As I said above, it was merciless. I felt like a piece of wood being chopped on. She literally whacked the bottoms of my feet with a stick, and it did not feel good. At the end there was a few minutes of the passive stretching. I would have really liked that if my therapist had been paying attention to the end point of my range of motion. I tipped her more out of a sense of being floored by how hard she worked than any appreciation for her skills.
Left: Taken after getting home – this bruise is now over a week old and turning yellow. Right: I was impressed that she managed to bruise my forearm and thigh in just a few seconds of “rest of the body” work.
Bangkok: Gold Hand Thai Massage
The lady who took care of me here used the exact same techniques as at Wat Pho, but was more gentle and actually interacting with my body. It mostly felt wonderful, although she got a little too rough at some spots. The room was a delight, too, when I arrived. Rows of sumptuous recliners, soothing music… it was lovely. Unfortunately by the time I left, the room was full of loud, jabbering tourists getting their feet massaged.
My favorite new technique: Using a stick to smooth out the fascia between the toes and over the surface of the foot. It tickled like crazy but felt great afterwards! If I remember correctly, this was 600 baht ($17) for an hour. I tipped pretty heavily.
Pattaya: Siladon Spa
After getting beaten up three times, I was ready to try something more recreational. I opted for a “Siladon Indulge” package. Two of my tour buddies accompanied me. This three hour vacation (1600 baht, about $47) started with a quick foot bath while seated on a bench, and an abbreviated version of the same Thai foot massage techniques, but with much less pressure so the effect was closer to lymphatic or Swedish work.
That was followed by a full body massage with warmed herbal ball compresses (there was a helper in the room constantly swapping out the herbs so they stayed hot, and it felt miraculous). Then there was a full body aroma oil massage – I had chosen jasmine as my scent. At the end, I told my massage therapist I loved her (she giggled and said she loved me too), and I tipped her 50%.
While this wasn’t medical massage in the sense of correcting muscle or nerve dysfunction, it was luscious and restorative and exactly what I needed!
Sukhothai: Legendha Hotel
When we arrived at this hotel, with its gorgeous massage stations scattered around the verdant grounds, I had high hopes for another pampering experience.
Unfortunately, it didn’t turn out that way. When I went to the spa for my appointment, nobody was there for me. Some of the other tour folks were getting foot massages on flat beds in the central room. I had booked an hour herbal full body massage, which I assumed would take place in a smaller room or in one of the outside beds with the drapery drawn. None of the therapists spoke English, so after waiting 20 minutes, I went back to reception to find out what was going on. They said someone would be there for me in another 30 minutes. I went back to my room, where I immediately got a text from a travel buddy saying my therapist had shown up, so I went back to the spa.
She steered me towards the flat beds and indicated that I should lie face down. This was obviously different than what I had booked (which would require privacy), and I noticed that everyone was lying flat, with no pillows. Blocking – supporting the body and joints with cushions – is important to maintain comfort. The longer the session, the more essential that becomes. I asked for a belly pillow to keep my lumbar happy, and laid down fully clothed. At this point I figured I was getting a foot massage and was just going to go with it, but the therapist straddled my thighs, strapped her hands across my lower back, and PUSHED. My poor spine screamed – I might have, as well. I jumped up and noped out of there as fast as I politely could.
My overall takeaways:
- Listen to your patients and their bodies
- Provide physical comfort with positioning and support
- Make scheduling easy and be there on time
- Use advanced gentle techniques instead of pulverizing the patient
- COMMUNICATE!!!!
Of course, I’ve been striving to do all these things for the past two decades! In a way, this exploration reinforced my confidence in my abilities and the skills I’ve honed. I was reminded of a few cool moves, like the passive stretching (I used to do this with my clients when I was a personal trainer) and the foot stick treatment – but I’ll skip the part where they did the Thai version of bastinado.