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How To Get Better Therapeutic Results With Thai Massage

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How to increase the therapeutic effects of Thai Massage

What can you accomplish with Thai Massage? What is its purpose, and what are its limits? Is there a way to take it to a higher level?

Thai Massage is a holistic system, meaning it focuses at more than just a symptom. Let’s look at some scenarios.

Example #1: A client comes to you with shoulder pain. Now you have two options to approach this.

One is to simply rub and massage and stretch the shoulder area. The other one is to first try to find out why this person has shoulder pain in the first place, and then treat it.

Woman with shoulder bag
Bags can throw your shoulders out of alignment, causing neck/shoulder pain

If you are observant, you might notice that your client has bad posture, like one shoulder being higher than the other. 

Or you might notice that your client always carries a handbag on one shoulder. When you address the likely cause, your treatment will be much more complete.

How do you address it? Often it is just a matter of making the client aware of it and making a suggestion, like switching sides regularly for carrying the handbag.

What might be instantly obvious to you when observing someone’s body might not even have entered into a client’s awareness.

Example #2: A client comes to you with neck pain. You could just rub away on the neck which will most likely help.

Woman with neck pain
Neck pain is often caused by bad posture

But, if you are observant, you might notice that your client has a collapsed posture with the shoulders hunched forward and the head tilted forward which will result in neck muscle strain.

Without doing something about this postural issue, the neck pain will always come back, and your massaging will just be a stop-gap solution.

How would you specifically address this? The first thing is to make the client aware of it.

The second thing is to offer suggestions, like doing yoga, or some simple shoulder exercises, or demonstrating what good posture looks like. 

Example #3: A male client has lower back pain. Doing some Thai Massage work on it will feel good and will help. However a little investigation might go a long way. You could, for example, ask the client where he carries his wallet.

If you find out that he carries a big fat wallet in the back pocket of his pants, you can be pretty certain that this will throw his hips and lower back out of alignment.

And again, a posture check might reveal that bad posture is a likely culprit. 

You can also inquire about life style habits. Sitting for most of the day will have a negative impact on the lower back.

How do you address these issues? With the wallet it’s easy – you can suggest to carry it in the front pocket of the pants. For the posture you can again suggest yoga, exercises, Feldenkrais exercises, or whatever else you might have knowledge of.

Example #4: A client has foot problems – let’s say Mortons Neuroma – which is a nerve compression between the metatarsal bones. You can just do a good Thai foot massage which will be very helpful.

Woman in high heels
High heels and narrow toe boxes are enemies of healthy feet

But then again, if you are observant, you might notice that the client wears high heels and narrow shoes with a narrow toe box which pushes the metatarsal bones together. This is exactly what can cause the neuroma. 

Unless you point out to the client that they need to permanently change their shoeware if they want this condition to improve, you can massage their feet every day, and the condition will not improve, because the cause is still there.

The whole point is to find and point out likely causes which the client can work on remedying.

==> Clients need to understand that they cannot expect a massage therapist to improve a condition if they continue with life style habits which are causing them to exist in the first place. 

Is this part of your job description?

At this point some therapists will object and say that this is not within the scope of massage therapy. Well, that depends on how you define it.

Not every session is meant to be highly therapeutic, and even highly skilled therapists will often give a general massage. However when a client shows up who has problems and needs specialized work, that’s the time when those more advanced and holistic skills are essential.

Let’s take a look at your professional situation and your interests.There are two kinds of massage therapy. (I know, this is a bit generalized, but read on…)

Two kinds of massage therapists

Style #1: This therapist mostly works on symptoms and does not get involved any further.

This is often the only option when you work in a massage chain or spa where your time and interaction is strictly controlled and limited.

Style #2: This therapist uses a more holistic approach which requires more communication, and more education on the part of the therapist.

This is often only possible when you work for yourself and can control your time and level of interaction yourself.

Pros and cons of the two styles

Scenarios where the first style might apply:

  • Your job environment might not permit you the second style.
  • You might be a new therapist with limited training and experience and have not developed any additional or more refined skills yet.
  • You are not interested in going beyond style #1 and educating yourself to acquire the necessary skills.
  • You have a personal belief that massage is only a system of symptomatic or relaxing treatments.
  • You live in a country where access to education and training is limited due to language or financial conditions. This is often the case in Thailand, for example, where massage is a low paying profession and many therapists are just barely making a living.

Scenarios where the second style can apply:

This second style takes Thai Massage therapy to another level. It requires more skills, more knowledge, good communication skills, and a sincere interest in helping your clients at the highest level possible. This is feasible under the following conditions.

  • You are working for yourself or for someone who encourages this type of interaction.
  • You have a desire to work in a holistic way and are not satisfied by just working on symptoms.
  • You have the financial means and access to a more well rounded education than just the massage techniques. 
  • You have a passion for helping others in as many ways as possible.


I have heard therapists say that they are not psychologists, counselors, or pathologists, and this is of course true. However you don’t need to be any of those things. We are talking about:

  • Some simple observational skills
  • Evaluating life style habits
  • Using some additional skills which you have acquired.

You don’t need to be a pathologist to point out that a wallet in the back pocket can throw your spine out of alignment.

You don’t need to be a podologist to know that a narrow toe box in your client’s shoes can cause bunions.

You don’t need to be a trained yoga instructor to suggest yoga classes or exercises to a client – just like a sports reporter doesn’t need to be a football star himself.

You don’t need to be a chiropractor to know that working all day long on a computer will cause problems with your back, and possibly arms, shoulders and hands as well.

These are all just basic common sense observations which many clients are nevertheless totally unaware of.

But is it legal?

That’s another common concern. The answer depends on where you live.

Some countries don’t have very stringent laws regarding diagnosis and healing claims, and some countries have very strict laws. 

I am not suggesting to make any healing claims or a specific diagnosis. I am only suggesting some common sense observations and the use of some additional skills.

Suggesting to a client to switch their wallet from the back pocket to the front pocket is not illegal in any country.
Stating that their wallet placement is the definitive cause of their problem might be illegal. So you need to use good judgment in how you present your observations.

Suggesting to a client to move their computer monitor up to eye level to relieve neck strain is not illegal anywhere.
Presenting your findings as a spinal analysis and diagnosis might be illegal. So again it is a matter of the correct presentation.

What if clients don’t follow your suggestions?

This is another objection: “Why bother with such suggestions? Most clients won’t follow them anyway.”

There are two responses here.

  • Not all clients are receptive to suggestions. Some just want to lie down and get a massage, and nothing else. That’s fine, and in such cases you shouldn’t offer any suggestions. This is another area where discretion is needed.
  • Some clients are receptive to any help or suggestions you might have – especially if they have serious issues and have run out of most options. They might follow your suggestions or not. This should not be your concern.

    However there will be those few clients who really take it to heart and work with you closely. They will be grateful, they will improve, they will greatly appreciate you, and for those few it is all worth it.

Case studies

Besides Thai Massage, I have studied several other modalities like EFT, medical Qigong, energy work, yoga, visualization techniques, communication skills, anatomy, and Shiatsu.

All of them have helped me tremendously in my Thai Massage practice, and I have built some of the most compatible elements into my Thai Massage online training courses.

Before you think “Wait a moment, how am I going to learn all these styles“, the good news is that you don’t have to. You won’t have to study them all since a lot of what I have learned from them is now beautifully integrated with my refined Thai Massage therapy system, taking Thai Massage to a higher level.

CLICK HERE to check out Thai Healing Massage Academy’s extensive range of Thai Massage online training courses.

Sometimes when I worked on clients with autoimmune diseases which couldn’t be helped by conventional medicine, like Parkinsons or Multiple Sklerosis, I have had good success in improving these conditions by using such extended Thai Massage skills. 

Some clients or conditions don’t respond well to just massage therapy. However if you add another component into the session, they might suddenly respond much better.

For example I have often successfully used visualization techniques to rescue a stuck Thai Massage session that didn’t seem to go anywhere with a particular problem.

The complaining princess

I vividly remember the time when I was working in a very high end destination spa. One client, a wealthy but sickly princess, got massage every day, but she didn’t like any of it and complained to and about every therapist who worked on her.

Consequently nobody wanted to work on her. Finally management asked me to give it a try with her. I started with a Thai Massage session, and true to form, she didn’t like it and started to complain.

Then I switched gears and, while doing very gentle massage work, started to talk her through a guided visualization process which helped her to feel a healing sensation in her body and mind. Lo and behold, she loved it, had no complaints, and commented that this was a good and effective session.

Clearly this falls into the category of what I call the Thai Massage “Plus” system. There are examples of how to use visualization as part of Thai Massage in some of Thai Healing Massage Academy’s online training courses.

Benefits of Going “Plus” with Thai Massage

In my experience, by pointing out possible causes and possible remedies, along with suggestions, clients develop more confidence in your ability to help them.

Good communication skills can be to be essential in your Thai Massage practice and in building relationships with your clients. This can also result in much more repeat business and customer referrals.

CLICK HERE to learn about the 5 elements which make Thai Massage therapy successful.

Personally I have found much inspiration and satisfaction from expanding the definition of my Thai Massage work. I have been able to help my clients more, I have built up a very loyal client base, and I have seen impressive recoveries and improvements from many conditions.

This is not a black and white area. It’s not that you are either a Thai Massage mechanic or a Thai Massage virtuoso with amazing unique skills. There are all kinds of shades in between.

It is important to know that there is a range of possibilities and, if it fits you, you might want to expand your definition of massage a little more and take it to a higher level.

You might find that it breathes new life into your career, inspires you more, gives you better results with your clients, and provides more income as well.

Thai Healing Massage Academy offers many online training courses for working on specific conditions with the higher level educational and skill levels of the Thai Massage “Plus” system.
CLICK HERE to view our complete course library.

The author, Shama Kern

The author, Shama Kern, is the founder and director of Thai Healing Massage Academy. He is the creator of 20 online training courses and has been practicing and teaching Thai Massage for 18 years.

5 thoughts on “How To Get Better Therapeutic Results With Thai Massage”

  1. hello
    I am a advanced certified thai therapist from montreal. Actually my intention is driven towards intuition away from programmed flow.

    I mainly work with individuals with low back/ shoulder neck stiffness and pain…classic! I feel I am using same approaches and need to renew.

    Are you offering material that can nourished my desire to help healing process with thai massage for advanced therapist?

    • Hi Diane, it seems that we are kindred spirits. This is very much what our training courses are all about. I moved away from programmed sequences a long time ago and have used an intuitive approach for working on specific problems. As a result we have created highly specialized courses for working on specific issues. For example we have a Thai Back Massage course which is more in depth than any Thai Massage training you could find. It contains dozens of techniques. Many of them are quite unique and will guaranteed be new to you.

      We also have a Thai Shoulder therapy course which is much more advanced than what is taught in Thai Massage schools. It also contains the largest amount of shoulder techniques which you can find anywhere, over 80 of them to be specific.

      At the same time the training is based on working intuitively, not mechanically. You will also find that we use a much more flowing style which includes rocking elements which are normally not used in Thai Massage. They are highly effective and are easier both on the client and on the therapist.

      We have 21 online training courses altogether. You can find them all, including the two courses mentioned above, on this page:

      If you have further questions, you can reach me directly at

      Best wishes,
      Shama Kern
      Director, Thai Healing Massage Academy


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