Understanding Pain as a Thai Massage Therapist

While there is no doubt that a well delivered Thai Massage helps to address many common pain issues however as Thai Massage Therapist we can also understand this pain from a anatomical point of view. Most chronic aches and pain have their origins within the musculo-skeletal sysetms which is interconnected with connective tissue matrix. The articles below delve into some of the common aches and pains and how to address them. Do read the articles on Trigger Point Therapy and the relation to Thai Massage. Our Basic and Intermediate courses work from a experiential point by helping you feel areas of trauma on your client and work out the most efficient and effective way to manage them. 


Trigger Points & Thai Massage

There are approximately 650 skeletal muscles in the human body.  They form about 40% of our body weight and 85% of human pain complaints! Almost all muscles can develop dysfunction resulting in pain, loss of flexibility and in some cases the most bizarre diseases. These dysfunctional cells within muscles are called Trigger Points (TrPs). The most common muscles affected are those in the neck, shoulder girdle, lower back and hip girdle. 

A TrP shortens and weakens the muscle. A TrP usually lies within a taut band of muscle, which prevents the muscle from achieving full length. A therapist with well developed tactile skills can identify the taut band and by following the fibres of the muscle, track down to the TrP. A TrP prevents the muscle from achieving full length and is often the reason for pain in the joints where the tendon attachment bears the stress. Key in relieving this pain is the release of the TrPs to achieve full elongation. TrPs can refer pain far away from the site of the point itself (compare the picture of TrPs of the Infraspinatus with the referred pain pattern caused by them below).

TrPs can also cause resistance during contraction this is due to TrPs Trigger points on the Infraspinatus muscle can cause pain in down till the wristgetting compressed during muscle contraction activating the pain receptors at the point.

The main reasons for Trigger Points are

  • Rapid and extreme muscular pulls causing muscle to spasm protectively (like in whiplash)
  • Prolonged contraction (posture, emotion, injury)
  • Compression resulting in loss of blood/ nerve supply to the muscle group.
  • General overuse
  • They can also result from physiological imbalances in lifestyle, diet.

TrP’s are not visible with traditional medical testing such as MRI or X-ray. However, research has shown that around Trigger Points there is a concentration of lactic acid and several other molecules that are typical of an inflammatory response.

From an energetic viewpoint, meditators who could direct better focus and awareness to the point and “breathe into it” perhaps causing dilation of the capillaries at the point could “detoxify” such points.

Similarly, a Thai Massage Therapist’s  aims is to bring the client’s awareness to the TrP causing changes in neurochemistry of the motor plate and consequently enhanced blood supply back into the muscle cell. Once some of the tenderness is relieved and some softness achieved at the point, you can proceed with some careful stretching to the muscle to enhance blood flow even more.

Techniques to handle Trigger Points are dealt with in our Thai Massage Course -- Anatomy of Thai Massage.


Sartorius- Source Visible bodyThe Sartorius' muscle is one of the lesser known muscles of the human body still it plays a crucial role in knee and position of the pelvis and lumbar curve.

The origin of the name Sartorius arises from the word “sartor” which means tailor in Latin. Perhaps the name arose from the position that tailors sat in the old days with the legs folded up such that the Sartorius' muscle was kept in a state of contraction.

Sartorius is the longest muscle in human body even though it is quite thin and it has a significant component of fascia in it. It is divided into several compartments, unlike other skeletal muscles that can be continuous and not divided into sections.

The postural implication of Sartorius.
The Sartorius is critical postural muscle and plays a crucial role in the angle of tilt of the pelvis. The Sartorius connects Anteriorly tilted Pelvisfrom the inner medial portion of the knee and loops upward to attach to the Anterior Superior Iliac Spine. Tightening in the Sartorius results in stress in the medial knee but also pulls the Pelvis forward and tilts it anteriorly. The implication of this anterior tilt is that Lumbar spine gets pulled anteriorly and pushes the abdomen forward. Of course, excessive lordosis of the lumbar spine can results in excessive kyphosis of the thoracic spine and anteriority in the neck.

The result is a lower back pain and issues in digestion, reproductive functions and excretion due to additional pressure on the intestine. It can also lead to stress on the spinal column and potential impediment of the spinal nerves arising from L4 and L5.

Downward, the tight Sartorius can pull the knees inward bring them into a knock-kneed position. You can also check the condition of Sartorius by imagining that there is a direct line from the kneecap outward. If the line points inward, then the Sartorius could be in a tightened situation.

Pain and other chronic implication resulting from a tight Sartorius

Trigger point on the Sartorius results in pain in the inner knee on the location where the muscle attaches to the Tibia. Further, Trigger Points are located along its path up to ASIS. Tight Sartorius can also result in a condition called “Meralgia Paresthetica” which is a condition with numbness in the front and outer thigh.

The most common symptom is the inability to lie on your side with your knees together as the pain the inner knee makes the position uncomfortable.

Trps of the SartoriusCauses of tightening in the Sartorius
If you are a yogi who sits for a long time in lotus position while meditating then, you are likely to find several fire spots on your Sartorius as this keeps the muscle on tightened position. Also a sudden extension of the hip i.e. pushing the leg back like when running without warming up can result in trauma in Sartorius. See the locations of Trps on image (marked in red).
How to release the Sartorius

Trigger Point release with self-treatment
You can sit on the floor or on a chair and palpate the muscle length to locate fire spots that generate a burning sensation. This muscle does not typically make the same kind of pain as other trigger points do, instead they create a burning sensation. You can use double thumbs to compress and release the trigger points. Check if the spots become less tender in about 1 minute and soften. Once done proceed to stretching.

Stretching the Sartorius
Stretching the SartoriusLeaning back while keeping the feet turned out works both sides together. If that is too intense, then you can work them one at a time like shown here. You should feel the stretch along the entire length of the muscle.

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Postural Alignment

Incorrect posture is one of chief causes of musculo-skeletal pain and other diseases affecting the internal organs

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