The Therapeutic Environment:
The therapeutic environment is a vital factor in the comfort of the client and, therefore, of utmost importance to the practitioner of Thai Massage. Thai massage is generally considered a unique, expensive, and private experience, and practitioners must take care to ensure that their clients feel comfortable and relaxed throughout the appointment.
For this reason, the space in which the therapy takes place is an important consideration.
Safety, cleanliness, an uninterrupted peaceful atmosphere, soothing lighting, and neat appearance are all vital to the massage center.
Other considerations particular to Thai Massage include:
Mattress
Use a thin mattress on the floor, such as a shiatsu mat or Thai Massage mat, instead of a massage table. A good Thai Massage mat will usually be a pressed-foam slab with a removable washable cover. This material is ideal because it is thin, unsupportive, durable, and lightweight. The best kinds of mats for Thai Massage are those that allow both the client and the practitioner to remain on the mat throughout the entire routine.
Remember, the type of mat you use will partially determine how your massage feels to the client. If your mat is too stiff or too thin, as you press your client’s body into the mat, it will be uncomfortable. Ensuring you have a proper mat is essential and a wise investment.
Props
Keep plenty of pillows of different sizes handy to prop up different body parts throughout the massage. Blocks used for yoga practice also make great supports, although they may be a little hard without additional padding. In the winter, keep a blanket or sheet nearby to cover the parts of the body not being worked with, particularly when using herbal compresses. You may wish to keep a chair, ceiling rope, or walker in the work space for back-walking maneuvers.
Clothing
Thai Massage is always performed fully clothed, and under no circumstances should clients disrobe. Proper attire for the client and practitioner should include light, flexible clothing such as that used for yoga class. The practitioner should keep some clean, suitable clothing on hand, in case a client comes unprepared.
Thai fisherman pants (or khang gang lay) are commonly used in clinics in Thailand for both the client and practitioner, as they provide a comfortable fit for all body types and do not inhibit movement.
Music
Musical rhythms interfere with the natural rhythm of breath and movement that develops during a Thai Massage and should not be used. You can use soothing, nonrhythmic sounds, such as recordings of rain or a bubbling fountain, if it helps a client to relax and enjoy the massage. This ambient noise can also help absorb distracting sounds, such as traffic, that may enter the therapy space.
Washing
In Thailand, it is common practice for the practitioner and client to wash hands and feet before and after each massage. Basins and soap are kept nearby for this purpose. In the West, hand-washing and proper care of bedding are recognized as key components in halting the spread of infectious diseases, and are an intesupportivegral part of any massage clinic’s safety regimen. For a touch of authenticity, you may wish to provide an attractive basin with soap and water and a towel for your client.
Interviewing the Client
It is vital to interview the client before each massage. It is important to be aware of each client’s symptoms and limitations, and of any possible contraindications. Even a familiar client may present different symptoms or concerns at different times. It is important to get as complete an assessment of the client’s total health condition as possible, as well as to discuss specific trouble areas before beginning.
The following are some general considerations to bear in mind when conducting client interviews. The answers to these questions will help you to determine the type of massage you will give each client:
Client’s Age
You will have special considerations for very old and very young clients. The younger the
individual, the more naturally flexible he/she will normally be. Very young clients, such as infants and toddlers, do not require acupressure or yogic stretching. These individuals should
not receive more than light joint mobilization, gentle squeezing of the limbs, and superficial rubbing of the sen. By age 8−10, children may enjoy beginning full-body poses. Older clients will usually be restricted in their movements, particularly in the more advanced stretches.
Elderly individuals usually cannot withstand deep presses or acupressure. They will, however,
benefit greatly from the hot herbal compress massage.
Flexibility of Joints and Muscles
In clients of all ages, you will have special considerations for varying levels of flexibility. who are not as flexible, or those who are extremely flexible and need more of a challenge. Always keep in mind the alignment of the ideal posture, and help your clients to work toward this goal. In time, you will see an increase in their flexibility.
Chronic Injuries, Pains, or Problems on Any Part of the Body
Massage that may aggravate existing injuries should be strictly avoided.
Back Pain or Inflexibility
You may want to avoid many of the back stretches. When you are working on your client’s back, he or she may be more comfortable in Different side position will be described later
Heart, Circulation, or Blood Pressure Problems
Stress and Anxiety You may wish to perform the massage at a slightly slower pace, with more of a relaxing intent.
Fatigue and Low Energy
You may wish to perform the massage at a slightly faster pace, with more of an energizing intent.
Food Intake
Determine if the client has eaten recently. Clients should not eat three hours prior to a massage. If they have, be sure to skip the abdominal massage. You may also have to omit some (or all) of the full-body stretches.
Menstruation
Due to abdominal distention and sensitivity, menstruating women should not receive direct pressure to this region unless the therapist is trained in this specialty and the client requests this service.
Pregnancy
Under no circumstances should pregnant women receive Thai Massage or acupressure from a therapist who is not trained in this particular specialty.
During the interview, the practitioner should also take into consideration the client’s body size and shape in order to predetermine any additional props or equipment that will be needed.
A small practitioner giving a massage to a very large client or a large practitioner giving a massage to a small client will present unique challenges.
The skillful use of bodyweight gives therapists leverage, enabling them to handle even the most mismatched clients. This level of skill takes time and practice to perfect. When faced with any doubt as to your ability to perform specific massage steps, they should simply be avoided.
The practitioner should always use his or her judgment when delivering a Thai Massage.
Working with Specific Conditions
While performing a therapeutic Thai routine, you may run across specific conditions that will affect your approach to the massage. Different clients will present different abilities and challenges for you as a therapist. The object when working with any type of physical limitation is to keep in mind the ideal posture, and to aim for this with your clients, while always respecting their limitations. You will need to keep their movements within their range of ability, while encouraging them to expand their boundaries.
Clients who receive regular massage usually find their range of motion increasing and symptoms such as pain and stiffness lessening, and often many chronic and acute disorders can be improved over the long term.
The following are some considerations for working with specific conditions with Thai Massage. In all cases, remember to use common sense, client feedback, and metta as your guides.
For All Pain and Mobility Issues
Hot compresses used throughout the massage can often increase the client’s flexibility and lessen pain and other adverse symptoms. In most cases, compresses enable such clients to enjoy a therapy session.
Arthritis (or other joint stiffness)
This client will obviously need special care for most of the classic routine steps. It is essential to take clients to their limit gradually, slowly increasing intensity. Do not over-tax the joints. If the client experiences pain, ease off immediately. Hot compresses may be used instead.
Chronic Pain or Fibromyalgia
Many of the more advanced stretches will be contraindicated. Only stretch the client within his or her limitations. Herbal compresses may be used instead of thumb pressure.
Back, Hip, or Sacroiliac Pain
Concentrate on steps that involve loosening the hamstrings and psoas muscles. Do not allow the client to become overexerted, and be sure to skip the advanced stretches.
Lower Gastrointestinal Complaints
These clients may benefit from forward bends and spinal twists, which may help to expel gas and promote digestion and excretion. Be careful with direct abdominal pressure, although in some cases Palm Press Stomach Points may provide relief of symptoms.
Upper Gastrointestinal Complaints
These clients usually will not benefit from forward bends or spinal twists, which may aggravate acid reflux or ulcers. Do not apply direct abdominal pressure.
Respiratory Disease
Such clients may feel constricted or congested while lying down. You may wish to prop them up on a pillow. Perform seated variation, and focus on flushing the chest and abdominal region.
Menstruation, Post Partum, Obesity
Perform back massage from the side position in order not to put too much pressure on the abdomen.
Kidney Disease
Beware of stressing the lower back with intense stretches. Do not press directly on the kidneys
Observing Cultural Protocols
A Thai Massage therapist will always want to familiarize him/herself with cultural protocols prior to embarking on a Thai Massage. These considerations are nearly universal in Thai Massage centers, spa &clinics, and are as much a marker of “authenticity” as the massage techniques themselves.
Many of these protocols have to do with the Thai idea that the head is sacred and that the feet are disrespectful. You will find these protocols are extremely important to ensure comfort when working with clients from most countries. Also, by following cultural customs any practitioner will develop a deeper appreciation and understanding of the richness of this healing art.
While many region may not share these cultural ideas, they still may feel something is amiss if you do not follow these protocols (such as if you use your feet to massage their head or don’t wash your hands before beginning the work). Organizing your massage space well with these principles in mind will allow you to adhere to cultural protocols, which demonstrates your respect for your client:
Setting up an altar in your workspace
If you choose to have an altar in your workspace, you should to adhere to the important traditions on how to treat a Buddha statue. The main Buddha image should face East or North. Since it is common for a massage clinic to have clients dressing and undressing, you will need to have a curtain to seal off the altar space during these activities and reopened when all individuals are fully clothed.
Respect your client’s head
Set up your space so that during the massage you will not need to go behind or reach over the
head to get supplies. If you have an altar in your workspace, orient the client’s mat in such a way that his or her head is pointing toward it.
Don’t step over the client’s body
If you need to get from one side of the client to the other, don’t step over the body. Set up your space so that there is enough room for you to walk around by the feet.
Don’t use your feet near the face or head.
Think through your massage steps and body positions so that you avoid using your feet near the face or head.
Don’t use your feet to flip the client
Always take the time to stop and use your hands to carefully and respectfully move the client into a new position.
Don’t drape yourself or sit on your client
With very few exceptions for particular steps you should avoid resting your body on the client’s.
Clean hands and feet prior to massage
This is both hygienic and a gesture of respect for your client.
At the most basic level, these protocols are about mindfulness of your client’s well-being and comfort. These are also considerations for the integrity of the client’s energy system. Being ever mindful of your environment and interactions with clients will ensure that you always treat your clients’ physical, mental, and energetic equilibrium as your top priority.
After the Massage
Sometimes, despite the best intentions of the practitioner, the client or the practitioner may experience an energy imbalance after a Thai Massage. Often, this is indicated by a feeling of being “wired” or hyperactive with accompanying insomnia, or conversely by a feeling of sluggishness, lethargy, and exhaustion. The causes of these energy imbalances can be numerous.
If it is the client that is feeling this way, this situation could be due to an uneven massage. Perhaps both sides of the body were not treated equally, or the entire body was not massaged. Not following the Four Principles of Thai Massage will talk about later may also cause imbalance.
Imbalance may also be caused by emotional release experienced during the massage, and thus may represent a positive development. Many people respond quite dramatically to massage, especially if they are unaccustomed to being touched in such a manner. Reactions such as tickling sensations, tears, sexual arousal (including erections in men), emotional outbursts, and so forth, are likely to occur — especially with new clients — and the practitioner must be prepared to meet these situations as they arise. Patience and humor can go a long way to diffuse many awkward circumstances.
In most cases, the client may feel embarrassed about their involuntary reactions, but with a few kind words from the practitioner, will continue to enjoy the massage. If it is the practitioner that is feeling imbalanced, this may because of overexertion or exhaustion due to improper body mechanics. If done correctly, Thai Massage techniques employ the principles of physics to ensure a smooth and easy massage every time. The practitioner should not feel strained or drained. Rather, both the client and practitioner should feel invigorated and relaxed by the sequence. Perhaps more practice is needed on particular steps in order to ensure smooth performance. (If you are ever in doubt about a particular step, it is best to skip it with clients and continue to practice it privately until you are more comfortable with it.)
Imbalances experienced by the practitioner may also be caused by subconscious energetic processes. Often, practitioners will internalize the weight of their clients’ emotions, taking these energies into themselves. This must be avoided as it can lead to all sorts of problems in the long run. The therapist must learn to help clients dissipate their own negative energy without contributing to it or taking it upon him/herself. The solution to this problem is the conscious intention of the practitioner to cultivate metta. The practitioner must always envision him/herself imparting good energy and dissolving negativity during the massage.
Recognizing a source of positive energy greater than oneself (such as Jivaka) is also helpful. The practitioner will in time feel that he or she has tapped into an endless source of loving kindness, and will avoid the temptation of falling victim to clients’ negativities. Sometimes the one who needs a massage the most is the one who is always giving them. The practitioner should never neglect him/herself. Under no circumstances should a practitioner give a massage while feeling unbalanced or negative, and sometimes simply receiving a massage helps to get the therapist back on track.
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