
Thai Massage therapy is a wonderful and rewarding profession. It is great to talk about all the benefits, how we can help our clients, how we have an ethical obligation to never discriminate against anyone, etc.
But what happens when we run up against our limits? What happens when we don’t know how to manage our physical and mental energies properly?
Being honest with yourself: Acknowledging challenges
That’s not a very juicy or popular subject, but the fact is that massage therapy as a profession is often short-lived with a high dropout rate. So let’s talk about potential issues and their solutions.
Massage therapy is not just about techniques. And it is not just about your clients. It is also very much about your own health, your energy, and your attitude.
Therapist, heal thyself
Unless you, the therapist, are in good shape and in good spirit, you won’t be able to help your clients much – at least not for very long.
As massage therapists, we have to protect our bodies and our energy. Our most precious tool is our body. If it malfunctions, our career can stop dead in its tracks.
Many therapists assume that it is their sacred duty to work on anyone and everyone, to give all they can. While this sounds very noble, here is a reality that we should not and cannot disregard: Sometimes we have to know when to say NO.
Let me explain by using my own career as an example.
My first exposure to potential problems in my new career

When I first started learning Thai Massage, we were taught many – actually way too many – techniques that required strong thumb pressure on legs, arms, and back.
It only took me a few months of daily Thai Massage work to develop problems in my thumb joints. Actually it was so bad that it almost killed my new career before it had even started.
I soon realized that I had to use different techniques if I wanted to survive as a Thai Massage therapist.
How saying NO turned a problem into an opportunity

As a result, I developed a massage style that is clearly Thai Massage, but is much easier on the thumbs and wrists – it is more therapist-friendly.
So the original problem resulted in many new and innovative techniques which have contributed a lot to my success as a Thai Massage therapist and teacher. It happened because I said NO to all the thumb and wrist stressing methods.
Are you sure you can handle this client?

Occasionally someone requests a session from me who is very large, heavy, and stiff. Over time I have come to terms with what I can do and what I need to stay away from.
As long as you are in private practice as a massage therapist, there is no obligation to work on anyone and everyone. However, if you work in a hotel or spa, you generally don’t have as much choice who you work on.
Assuming you do work for yourself and have a choice of clients, let’s say that someone who is very heavy wants a session. This is not so much a problem in oil massage, but in Thai Massage you actually have to move and lift (potentially heavy) body parts around a lot.
Size and weight considerations in Thai Massage sessions
Someone might say that very obese people have the same right to get a massage as everyone else.

Sure they do. Nobody disputes that. And it doesn’t even have to be an obese person. It could be a large, muscled man.
Ethically, such people should be able to get a massage just like everyone else. But they don’t have the right to get a massage from just anyone.
If you weigh 100 lbs (48 kg), and the client weighs 250 pounds (120 kg), that’s simply not a good match.
For the same reason, 100 lbs featherweight wrestlers or boxers are not matched up with 250 lbs heavyweights, but with someone from their own class. That’s just common sense.
If you are able to work effectively with Thai Massage on a client who is much larger and heavier than you – great.
But if you feel that you just cannot handle a client well, then you should not force yourself to work on this client.
There are larger and stronger therapists around who are better suited for such a client, and much more effective than you might be.
Don’t delude yourself. Wearing yourself out or risking injury does not serve you or your client.
How I learned my lesson
I once had a client, a giant of a man, who needed shoulder work. I worked on him with all my power for 2 hours.
But after the session, my hands, wrists, and arms were totally worn out and hurt for several days. That was a lesson for me.
After a session, both therapist and client should feel good. It’s not that one should feel good, and the other is exhausted and in pain.
My wife is good at that. She tells her Thai Massage clients right up front what she is capable of and what she cannot do. No pretense there, just self-knowledge and honesty.
If someone tells her that they want really strong and deep work, and if she senses that she cannot deliver that on this person, she tells the client what she can do and asks the client if that is good enough or not.
Mental or energetic considerations
Sometimes the chemistry between you and a client is just not right. It is not a matter whose so-called ‘fault’ it is. There are cases where the energies of two people just don’t match for whatever reason.
If you notice that there is such a mismatched energy between you and a client, then forcing yourself to continue sessions on this person will deplete your energy and depress your enthusiasm.
Again, it doesn’t serve you or your client. Instead of insisting that it is your moral duty to work on anyone, acknowledge that the client might be better served by someone else who does not have an energetic block or friction with this client.
Such cases are rare, but it has happened to me a few times in my career, and I have learned to listen to my inner self instead of climbing on my moral and ethical soapbox.
Therapeutic considerations in Thai Massage

There are situations where you notice during a session that for whatever reason you are not able to help the client effectively with a certain issue that they need help with.
Instead of struggling with the issue, it would be more honest and fairer to such clients to tell them that you feel that they would be better served by another therapist or by another modality.
It is better to let go of some dollars in missed sessions than to lose your integrity with your clients and your self-respect.

In the early days of my career, I thought that I had to work on anyone who asked for a session. Today I am much more discriminating.
I make sure that my massage clients and myself are a reasonably good match, that my style of massage therapy is right for them, and that I feel I can be effective on a particular person.
I believe that this is an important reason why I am still going strong after two decades as a massage therapist.
To whom do your ethics apply?
Granted, the above-mentioned scenarios are quite rare for most therapists. But they do happen, as I know from personal experience. And when they do happen, we should know how to act.
We don’t just have an ethical obligation to our clients. We also have an ethical obligation to ourselves. There is a bigger picture involved here.
We need to preserve our physical and mental health in order to best serve our clients in the long run. This may sometimes involve saying NO if this is in the best interest of our client and ourselves, or even just in the best interest of ourselves.
What is a good Thai Massage session?

The result of a good session is that the client feels better. But if the therapist feels exhausted and drained with hurting wrists, then it was not a good session.
Both parties have to come out ahead. As a Thai Massage therapist, you need to have your priorities straight – namely your health, your energy, and your longevity as a practitioner.
The risk of burn out for a massage therapist
I have met quite a few massage therapists who burned out physically and energetically because they did not set their boundaries, did not manage their health and their energy, and they could not say NO.
If you work in a way that depletes your physical and mental energy, you live on borrowed time as a therapist.
I remember, in the early days of my career, I sometimes accepted bookings that went beyond my capacity. I knew how many sessions I could handle a day while still feeling good.
But every time I violated this knowledge by adding an extra client because I could not say NO, I felt exhausted later on or even on the next day.
Practical steps for Thai Massage therapists

There are quite a few things you can do to stay healthy and feel good. They include exercise, meditation, Qigong, nature walks, enough sleep, yoga, healthy food, and a myriad of other options.
All of them will help your longevity in this profession. Last but not least, you have to know when to say NO to too many sessions, too heavy clients, negative people, and clients whom you do not resonate with.
A few reminders of good habits for a massage therapist
- Work with your entire body, not just with your arms
- Use body weight instead of muscle power as much as possible
- Learn how to improve your ergonomics
- Get massage yourself regularly
- Keep learning to remain inspired in your profession
- If possible, avoid working on clients who stress your body too much
What about the money?

You might think that this approach will result in less income.
While this might be true in the short term, in the long run, you will extend your career, you will preserve your health and you will keep your energy and enthusiasm high.
You will feel much better if you learn how to say NO sometimes. You will end up with a better and more dedicated circle of clients, more self-confidence, a better quality of your massage work, and a happier career as a Thai Massage therapist.
Solutions for better Thai Massage with no stress
One way to deal with situations that are difficult to handle is to say NO. However you can avoid some of these situations with special training.
At Thai Healing Massage Academy we have created courses that help you with preserving your health while practicing Thai Massage.
All our online Thai Massage training courses are designed to be very therapist-friendly. And we have specialized courses that help even more when it comes to the health of the therapist.
Examples are our Thai Rocking Massage course and our Hands-Free Thai Massage course. You will find them all on the page below:


The author, Shama Kern, has been practicing and teaching Thai Massage for over two decades. He is the founder of Thai Healing Massage Academy and the creator of 20 Thai Massage online training courses.

Thank you for the reminders, I really needed to see this today! Saying no is not easy for me but I am learning and your article reinforced what I know to be true about my body, my self and what I am capable of! I have aligned my career to include esthetic work, but still need to watch my body mechanics regardless if I am doing facials, waxing or massage!
All my best and I really enjoy your articles!
Paula
Thanks for your comment Paula, I really appreciate it!
thank you very much with this beautiful articles it is really difficult to say No to our clients, but exactly we have to be honest to them and specially to yourself
Absolutely, Shama! I always say that the best Thai Massage is as much about the health and well-being of the practitioner as it is about the welfare of the client. Otherwise its less than half as good. Great article.
Deon
I couldn’t have read this at a better time. I’m experiencing some beginning pain in my left thenar and it’s entirely due to my bad bad tendency to overuse my thumbs, particularly in the thai work around and in the multifidi. Shame on me!! And thanks to YOU for your long distance reprimand!
Namasté
Dale, you might want to take a look at my Thai Rocking Massage system which I have developed partly in response to the thumb overuse issue which is quite common in Thai Massage. The rocking techniques have saved not only my career but those of quite a few students of mine. You can check it out here:
https://thaihealingmassage.com/thai-rocking-massage/
So true. Thanks Shama
What exactly is the Thai rocking system please ?
I am interested.
Thank-you
Constance
Constance, the Thai Rocking Massage system is an enhanced and refined way of doing Thai Massage (and other types of massage as well). I created this system when I found out during many years of therapy work that I got much better results with it, and it was much easier on my body.
You can find more information and a demo video on this page:
https://thaihealingmassage.com/thai-rocking-massage/
When having to say no to potential clients, what exactly are you supposed to say and still be professional?
That will of course depend on the situation. When you see a client for the first time, you won’t know how large they are, how easy or how hard they are to work on etc. But you do have a choice for the second time.
You can either mention that you have no availability, or you can just be honest. Now you wouldn’t come out and say “hey buddy, you are too heavy or too fat”, of course. But you can say that you can see that they could use more power than you are able to provide, and that you can refer them to someone who would be better at providing exactly what they need.
I am sure there are other polite ways of stating it depending on the client and the situation. Just remember you have no obligation to jeopardize your health for anyone. That needs to be your first consideration if you want to have staying power in this business.
Another approach is that you can learn techniques which are better suited for working on much larger clients. This has always been my expertise, and this is reflected in all my training courses.
Thai Massage lends itself to this better than other modalities since you can work very effectively with your body weight, and you can use hands, forearms, elbows, knees and feet. There are hundreds of techniques and variations to choose from, and I always try to present alternative techniques for working on different sizes and shapes of clients in my courses.
Thank you Shama! That was a very helpful explanation. I tend to stumble over my words sometimes and that gives me a direction to go in.
namaste shama
I have never met a heart warming person online with the character you portray. I hope to pursue a career in thai massage and you have been so informative in your online courses. god bless you and keep those hands strong.
Thank you Nazeera for your kind comment – I really appreciate it!
Hi Shama,
I read all of your articles and find them so informative, thank you for sharing them with us. This one in particular resonated with me as I have been off work for 10 weeks due to severe tendinitis in my arm. The recovery is extremely slow and potential return to work is April/May 2020 , but my question is how do we overcome an injury and will our body ever be as good at providing massage as it once was? Thank you Laura
I am glad you like my articles.
I believe that our bodies can overcome many issues as long as we support them properly. This can be in the form of a healthier diet, appropriate exercise, positive affirmations, enough rest, and various natural remedies, etc.
There is of course the fact that we are running up against an aging process which can slow recovery time. Some conditions can be sufficiently reversed to allow us to continue our massage work, even if our body doesn’t revert 100% to how it was before.
However sometimes we have to make adjustments in how we work. That’s one reason why I am such a proponent of Thai Massage which allows us to use our body in a much more creative way.
We get to use more body parts, have more control of our body mechanics, and can be more effective with less effort. The biggie is that we use our hands a lot less than in table massage styles.
There is of course no way to know if a particular condition will be totally healed over time or not. There are so many lifestyle factors and mental/emotional factors involved.
And it depends on our ability to find the most effective methods to support our body with things like yoga, breathing, energy work, Qigong, visualization, herbs, and whatever else is available.
There are plenty of people who have cured themselves of AIDS, cancer, and other degenerative diseases, so there is a good chance that we can do so if we put our minds to it.
April/May 2020 ?
Interesting…
Possibly, the pandemic was just what your body needed.
So interesting that I am reading this very well put article today….. today my right shoulder (the rotator cuff) is unpleasantly reminding me, that I should have said NO to my last (overweight) client who was in pain and was asking for relief of her shoulder and back pain.
Indeed she felt great after the session, but already during the session I felt not well (more on an energetic level rather than physically). I felt like “taken advantage of”. Unfortunately, I did not listen to my intuition and stepped back, rather than satisfied my ego, who put it on its agenda, to help this person! Oh my!!
Three days later I am still paying the price and my shoulder is reminding me to listen to my Inner Guidance and that we are working with energies and BOTH….. client and therapist are supposed to feel good after a session!
Thank you for this great and super helpful article, Shama!!!!
I have heard quite a few such stories. In fact, I have been one of them at one time. That’s why I wrote this article to hopefully prevent more such cases.
I absolutely agree with what you say. Of course the masseur has to be careful with his own Health. It took me few months to learn how to protect my thumbs & wrist as you said. Most of the time, potentiel big clients understand.
Thank you Shama for another very helpful article, always a pleasure to read you. As I approach my last years of working, I decided to limit my massage work to women, as men are often more muscled/heavier. I suppose the problem is worse in the States with the greater numbers of obese people there. I know there are traditional thai massage tools that can save your hands, I don’t personally use them, but I have adopted wooden mushroom shaped maracas for children, which I heat in a heat bag and use to release traps and paravertebrals. Clients love it! They only cost 5 or 6 euros each and can be washed with soapy water between clients.