by David L. Roylance

What Good is History to a Massage Therapist, Anyways?, MASSAGE Magazine

In my last article, I shared how Thai massage was thought, by some, to be just a fad. Thai massage is a popular spa/massage treatment in Thailand and in the West, but in actuality, it is an integral part of the traditional medical system of Thailand.

Therapists are flocking to learn this traditional massage technique and clients are actively requesting the service. SpaFinder Inc. recently ranked Thai massage as number two in the Top 10 Spa Trends for 2011 Global Spa Trends. A team of experts in the field conducted the study with data from more than 9,000 spas and salons across the globe.

Thai massage’s rich past and present day practices are part of a traditional medical system from Thailand. Practiced as a major branch of medicine in Thailand, the ancient treatment includes elements that date back thousands of years that were brought together by Thai people in a unique synthesis.
I’ve always felt it is important for therapists to understand the history of any massage technique one provides to clients. History is a way to better understand what we do today.

Clients have continuously increasing expectations of what they receive in a massage treatment from their therapist. It’s important to be prepared and ready for the challenges one would face. In my opinion, a therapist with increased knowledge of a modality’s history will have a stronger connection to the past and be able to offer a better treatment to clients.

Due to several factors, the history of Thai massage is not always straightforward to understand and can create a challenge for anyone looking for even the most basic understanding of this modality’s history. There are several websites, books and other publications that mostly contradict one another when it comes to explaining traditional Thai massage. As a beginner learning this technique, sorting this out can be more than a chore.

To understand the history of Thai massage and more about the various traditions in Thailand, I recently sat down with Dr. C. Pierce Salguero, who has a doctorate degree in medical history from Johns Hopkins University School of Medicine. He lived in Thailand for four years learning and then teaching at one of the most prestigious Thai massage schools in all of Thailand, Thai Massage School Shivagakomarpaj (“The Old Medicine Hospital”).

Today, he is a Thai massage instructor, author and researcher, a college professor and the director of research at my organization, the Thai Institute of Healing Arts in Arlington, Virginia. He is considered by many to be the foremost researcher in the field, having published five books and having taught Thai massage and traditional medicine to hundreds of students since 1997. His book A Thai Herbal is still the only guide to Thai herbalism ever written in the English language, and his Encyclopedia of Thai Massage is the top-selling publication on that topic on

The following is an excerpt from Salguero’s upcoming second edition of the Encyclopedia of Thai Massage, a book in which I was invited to participate as a contributor. Salguero writes:

The history of Thai massage, like that of traditional Thai medicine, is complicated by the fact that few historical sources remain from prior to the 1800s. Due both to willful destruction by invading armies and the damaging effects of the tropical climate on perishable materials, Thai medical texts from the premodern period are virtually non-existent. Nevertheless, from a close examination of the modern practice of Thai massage we can determine that it combines at least five important layers of historical influence.

Layer 1: Buddhism
Many Thai medical texts incorporate doctrines about the body, disease and healing from Theravada Buddhist texts that date to the last few centuries BC. In the modern practice of Thai massage, influential Buddhist ideas include a concern with ethics, an emphasis on compassion, the practitioner’s attention to breath and body sensations, and the celebration of the role of Jivaka Komarabhacca as the forefather of the art form. These are all discussed further later in this chapter.

Layer 2: Ayurveda
Closely related to Buddhism, Ayurvedic medical ideas traveled alongside the religion as it spread from India to all parts of Asia. Traditional Thai medical texts frequently contain references to principles such as the doshas and the Four Elements (Earth, Water, Fire and Air). Discussed in more detail later in this book, the idea of the body being animated and mobilized by lom (which I am translating as “energy,” but which literally means “air”) also draws from a traditional Indian model of the body.

Layer 3: Yoga
The form of yoga most familiar to Western students is hatha yoga, an energy-based physical and spiritual practice originating in India. Now found in many Western health clubs and private studios, this system of postures and breathing exercises was formalized in the first half of the second millennium AD, primarily as a spiritual practice. A similar system of individual postures exists in Thailand that is called luesii dat ton (“self-stretching exercises of the rishis”). Yoga seems to have exerted a profound influence on Thai medical arts, particularly in the realm of Thai massage. (The connections between Thai massage postures and yoga postures are explored in detail in Chapter 4 of this book.) While there is no system of chakras in Thai massage, several of the Thai energy lines, or sen, have clear parallels with the nadi channels from the Indian yogic tradition.

Layer 4: Chinese and other external cultural influences
In some of my other books, I have explored in detail other cultural influences on Thai medicine ranging from Chinese medicine to Khmer magical practices. In terms of Thai massage, the most significant of these is the influence of Chinese medicine. Many Thai massage schools today teach modified forms of foot reflexology, tuina abdominal massage, and other Chinese bodywork practices. While some of these are relatively late introductions to the Thai sphere, Chinese communities have been flourishing in Southeast Asia for many centuries and have introduced many aspects of Chinese culture to Thailand. Some of the similarities between the Thai sen and the Chinese meridians as well as some acupressure techniques may be due to this prolonged cultural contact and exchange.

Layer 5: Indigenous Thai medicine
This is by far the most pervasive layer of cultural influence in Thai healing practices of all sorts, and Thai massage is no exception. The practice of Thai Massage as we know it today clearly incorporates a wide variety of indigenous Thai healing arts—from a practice of walking on the back known as yam kaeng, to bone-setting (an indigenous form of chiropractics), to tok sen (tapping specific points on the body with a wooden mallet). Of course, it is also through the indigenous culture that all external influences have been received and interpreted.

While there have been many foreign inputs, the Thai healing arts are distinctly Thai and a unique part of Thailand’s cultural heritage. If these five layers of cultural influence form the building blocks of Thai massage therapy, different schools and teachers all over the country have put them together in highly individualized ways. Some teachers emphasize one “layer” over the other, omitting or including aspects as they see fit. In actuality, each practitioner draws from the available menu of options to create his/her own unique style of Thai massage.

Outside of the major cities, Thai massage tends to be non-scholarly and to rely on informal methods of education. Local practices tend to vary considerably from village to village, and are offered by healers who are more akin to shamans, astrologers or magicians than to learned physicians. Their medical knowledge is handed down largely orally or through secret manuscripts passed from teacher to pupil, and is usually not shared with outsiders—especially not with Westerners.

If you choose to study Thai massage, it’s important to find a teacher that has deep cultural knowledge directly from Thailand. Look for schools and teachers that are close to the Thai community. If the Thai massage program you review is deeply into Indian, Chinese or other disciplines, realize that these traditions are often substitutes added in when teachers do not have direct knowledge of Thai traditions. It’s important that students find a program that is teaching only Thai knowledge to assist in gaining a full appreciation for how what they are learning is rooted in a traditional medical system that can be practiced today to help modern society.

In Thailand, the Thai Massage School Shivagakomarpaj is a learning institution that was founded nearly 50 years ago. The “Old Medicine Hospital” has been teaching westerners Thai massage for several decades. Among countless schools that dot the landscape in Thailand, they have established a well-known and prestigious reputation.

In my next article, I will provide you more details on learning at this traditional school. I will share cultural details to help even the beginning massage student enjoy the journey of learning in a foreign land.

David L. Roylance is the executive director of Touch of Asia in Sterling, Virginia, and the Thai Institute of Healing Arts in Arlington, Virginia. He lives in Thailand for more than three months each year. He has been living and working among the Thais in the U.S. and in Thailand since 2001. Roylance currently provides in-depth training classes and seminars. For more information, visit