7 tips to prevent spine injury during traditional Thai massage
If you are in Thailand, do not trust your spine to those who offer “authentic Thai massage” at very touristic spots. A skilled Thai massage therapist would never wander the beach looking for clients or provide a “relaxation massage” at the adult entertainment area. These are unqualified amateurs who are doing it. Therefore, they don’t understand how much pressure and intensity they should apply in performing the therapy, what techniques they should use, and how to adapt these techniques to your specific needs and limitations.
Choose one from several tens of thousands of Thai massage practitioners, officially licensed and registered by Thailand’s Department of Health Service Support. At least, such a person once had to study treatment protocols, contraindications, and adverse effects of Thai massage to obtain her or his professional license and registration. Licensed therapists can be found at licensed parlors and spas, which differ from “relaxation venues” by, shall we say, more “discreet” look, suggesting that no “extra services” are provided there.
However, even if there are many impressive-looking certificates on the walls of your selected massage establishment and its staff claim to attended the famous Wat Pho school, this only minimizes the likelihood of potential bad outcomes but doesn’t totally eliminate it. To avoid unpleasant situations, be an informed massage client and take responsibility for your own health by following the tips below.
Most people will be unlikely to go for a CT scan or MRI test of the back if they have mild or no symptoms, “just in case”. However, before heading for traditional Thai massage, it is worth doing a simple straight-leg raising test to check if you have a disc bulge or disc protrusion. This test is straightforward and you can easily perform it on your own.
Lie down on your back, straighten one leg and extend the foot to stretch the nerve roots, and then gradually raise the leg up. When your leg is at an angle of between 30 and 70 degrees, you will begin to feel pain. If this pain is experienced in the hip or the back and it is radiating down the leg, there is a high chance that your disc is herniated as something “pinches” the nerve (in rare cases it might be muscle or bone).
The Internet can find dozens of self-tests for spine conditions, that you can do yourself at home without a therapist
2. Make sure to drink plenty of water before the massage
Water is the main constituent in the spinal discs. They absorb water and increase in size while you are sleeping, and slowly release water and decrease throughout the day. Dehydration causes your body to replenish the moisture reserves from anywhere and from the discs including. It results in abnormal disc shrinkage making the discs no longer able to act as shock absorbers.
This is why in good massage parlors in Thailand client is usually offered water to drink before the session, as is prescribed by treatment protocol (so that’s a good sign). But better do as the locals do: always take a bottle of water with you wherever you go, and sip water from it throughout the day. Drinking at least 2-3 liters of water per day is essential when traveling or living in a tropical climate.
3. Make sure you are able to communicate with your therapist
Choosing a good massage venue is a subject for a whole article. However, even in the best massage parlors and spas, each employee has different qualifications and different attitudes to clients. When you got there, don’t hurry to agree to be treated simply by the masseuse whose turn has come. Try talking for a few minutes with the manager and staff about your doubts concerning your alleged bad back (lăng mâi dee) problem. Ask them if there’s someone here who specializes specifically in Back, Neck & Shoulder Thai Massage (which is usually carried out with a therapeutic purpose).
If they are in no mood to waste time on you, show annoyance with your pickiness, or do not understand what you want at all, then this does not bode well. Just thank them politely and leave. In a favorable case, they will find one who has the most experience working with lăng mâi dee – and, importantly, is willing to communicate with you despite the language barrier. Her or his sociability and friendliness must help you to reach a mutual understanding in the following points.
How to find a GOOD massage parlor in Thailand
4. Don’t put up with the pain
The beliefs that “doctor knows best”, “no pain, no gain”, and “you should suffer in silence when undergoing Thai massage” are wrong. Thai massage can be a bit painful at certain moments, but it must be comfortable for the client overall. Nevertheless, even experienced massage therapist may neglect to read the client’s body and apply more force than necessary. Intense pain signals about potential harm and the need to stop or reduce the action, especially when it comes to a herniated disc.
Don’t rely solely on the masseur’s skills – because only you know your limits! Every time you’re experiencing sharp pain, do not hesitate to let the giver know about this right away. For the instant reactions use the Thai word “jèp!” (it hurts!). To ask to adjust the technique, say “bao-bao” (softly, gently). Note, that some Thais don’t like to be pointed out that they’re doing something wrong. That’s why it would be good if your masseur or masseuse were an easygoing person.
5. Don’t allow forward bending of your back
At a certain point, the masseuse or masseur will start to bend and twist your trunk to “open up” your back, chest, shoulders, and some internal organs. If applied cautiously and without excessive force, backward bending (spinal extension) is relatively safe and may be beneficial for your disc. Remember that the lower back is more flexible than the upper back, so don’t overextend your neck backward.
On the contrary, bending forward (spinal flexion) can make a bulging disc herniate and herniated disc worse. That’s because when you are bending over at the waist, strong pressure builds on the front part of each lower disc, squeezing out the discs’ liquid content to the rear part, towards the spinal nerves. The greatest danger is posed by forward bending and twisting your spine simultaneously, and repetitive forward bending.
Forced forward flexion is a form of physical therapy that must be performed only by a qualified health professional
6. Don’t allow walking on your back
Thai masseuse or masseur might use their feet for acupressure and stretching the same way as they use elbows and knees – leaning on other parts of the body and thus limiting the load. Foot, in fact, isn’t too popular a massage tool among real masters because of its lack of precision and reduced ability to feel the client’s body. But this technique allows the therapist to use the weight and gravity of their own body to save strength, which can facilitate work with such massive areas as the thighs and buttocks.
It’s different when the practitioner is stepping on your back with the leg (or, even more so, with both legs), putting on you most of their body weight. This is only permitted if he or she is a certified and well-trained Thai DeepFeet bar massage therapist. Yes, performing back-walking massage requires bars or similar equipment that the practitioner can hold on to! These bars provide them with balance and prevent them from putting their full weight on the patient’s back at any given time. Standing or kneeling full weight on the back is strictly not allowed!
Ashiatsu massage, known in Thailand as Thai DeepFeet bar therapy, is the deepest form of deep tissue massage. If properly performed by a certified specialist, it can help to increase the space between the discs
7. Don’t allow cracking your neck
Cracking, popping, or grinding sounds coming from your back, knees, or shoulders are quite common during Thai massage. Some people associate them with breaking bones, but nothing to worry about. These noises are just a release of gas inside the joints.
However, your masseuse or masseur may try to mark the end of the massage by placing you into a seated position and sharply twisting or tilting your head to achieve a distinct cracking sound from your neck. If this neck adjustment is too forceful, it can pinch a nerve or, worse, tear the vertebral artery supplying blood to the brain and cause a stroke.
The combination of head rotation and forward flexion might be a very destructive action for the neck bones. It must be performed only by a chiropractor, osteopath, or physiotherapist
