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What are the cautionary sites in Thai massage?

There are many cautionary sites on the body where Thai massage could damage some of the body’s delicate tissues.

Cautionary sites (or endangerment sites) are where careless Traditional Thai massage could damage some of the body’s most delicate tissues.

A practitioner can massage a cautionary site but needs to incorporate the site into a Thai massage with special care. Good education and skill can allow you to work safely in areas that would otherwise be “off-limits” to an inexperienced practitioner.

Cautionary Sites

Leg Region

Top of the Foot. Many bones are along the top of the foot, so only massage with light pressure.

Back of the Knee. The popliteal artery and vein, tibial and fibular nerve pass along the back of the knee. Avoid this area altogether, or only apply very light pressure if the recipient requires treatment at this site.

Back of the Thigh. The sciatic nerve runs from the buttocks down the back of the thigh, and deep pressure may damage this nerve.

Inner Thigh. The great saphenous vein runs superficially along the inside of the inner thigh area. Massage this area with light pressure, as recipients with poor mobility may have clots in this vein.

Groin. The femoral artery, vein, lymph nodes, and femoral nerve run past the upper leg and groin crease. Solid and prolonged pressure to this area may cause the blockage of blood in the leg.

Chest and Abdominal Regions

Abdominal Area. Exercise caution for the entire area, and do not press directly on the navel.

Abdominal Muscle Walls. Use light pressure on the abdominal muscle walls, as excessive pressure and stretching can cause a hernia.

Breast. Excessive or repeated pressure can break down breast tissue, so avoid this area unless you have therapeutic purposes.

Xiphoid Process. Direct pressure to the tip of the chest bone may break and puncture the liver.

Back and Spinal Regions

Waist. This area may need more massage but do not press on the transverse process on the lumbar vertebrae.

Floating Ribs. Avoid deep pressure on the two floating ribs as they rest on the kidneys, liver and spleen. Deep pressure can damage the internal organs.

Back Bone. Do not press on the spinous process, the middle tips of the spine, as it might break.

Back of the Neck. Do not press on the transverse process or the tips of the cervical vertebrae. And do not twist the neck unless qualified, as this movement might damage the nerve or compress the artery.

Arm and Hand Regions

Armpit. Avoid the armpit area, as deep pressure may damage the brachial artery, axillary artery and vein, cephalic vein, brachial nerve plexus and lymph nodes.

Front of the Elbow. You may massage this area lightly. Do not apply deep pressure to the elbow crease, as this is the location of the brachial artery and vein, median cubital vein and median nerve.

Back of the Elbow. The bony point of the elbow is sensitive as the ulnar and radial nerves run just beneath the skin at this point. Pressure on these nerves may damage them, and recipients may feel a sharp pain.

Wrist. Firm pressure on the inner wrist can damage the median and ulnar nerve, artery and vein.

Neck Region

Anterior Triangle. The common carotid artery, jugular veins, subclavian artery and vein, lymph nodes and vagus nerve are delicate, and massage may damage these structures.

Front of the Neck. The front of the neck contains the thyroid gland and trachea, and pressure on these points is dangerous. Altogether avoid this area.

Face and Head Regions

Eyeballs. Do not press or massage directly on the eyeballs, and be very careful if you work around them.

Front of the Ear. Avoid the area five centimetres in front of the ear as the parotid gland and the superficial temporal artery, vein, and nerve pass by this region.

Temples. Only apply light pressure to the temporal bone.

Top of the Head. If you massage a toddler, the Anterior Fontanel is soft and not fully closed until two years after birth.

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