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What are the five layers of the body?

The physical body consists of five layers in Traditional Thai Medicine; the skin, tissue, sen, bones and organs.

Traditional Thai Medicine holds that our being consists of five aspects: our physical body, our emotional body, our energetic body, our mental body and our spiritual body. These five aspects exist collectively as a whole and are not separate.

The physical aspect has five layers that practitioners work with using different techniques. Once practitioners are familiar with the five layers and the methods that work best with each layer, they can structure treatments to work mindfully from the superficial level to the deepest level.


The outer layer of the human body is the skin. Treatment should begin with gentle therapies for the skin layer to “say hello” to the skin by touch, rubbing, compressing or using balms. Practitioners can also use heating techniques such as friction over clothing, herbal compresses massaged onto the body, herbal balms, and balms and salves to bring warmth and circulation to the body’s surface. This friction helps practitioners get into the second layer.

Rubbing: Vigorous movement over the skin to bring heat and circulation to the area.
Vibration: Gently shaking or rolling the skin between hands.


The second layer of the body is the tissue layer, in which most massage therapies specialize. This layer includes the muscles, the fascia, and the fat. Practitioners use techniques that stretch, squeeze, rub, or deeply hold tissue for release. Thai massage techniques for the second layer have the most commonality with other massage modalities.

Squeezing/Kneading: Standard massage techniques.
Pressing/Compression: Pressing on muscles with thumbs, hands, elbows, knees, or feet.
Rolling: Using the forearm to roll over muscles or alternate squeezing fingers up the skin.
Beating: Using fists, Thai chops, and butterfly hands to loosen tissue.
Unwinding: Grabbing muscles and pulling each way.
Digging and Scooping: Using fingers to get under structures like the scapula.
Plucking: Grabbing the tissue and pulling it away from the body to release heat and tension.


The third layer of the body, the sen layer, is perhaps the most misunderstood. Sen are the biological pathways where major, minor and invisible movement occurs in the body. The biological pathways with major movement are the arteries and nerve ducts. Minor movement occurs in the branches of major arteries. The invisible movement that is too small to see is things such as the effect of hormones on the body.

Practitioners primarily work on sen by following massage lines on the legs, arms, and other body parts. Some sen, like in the Achilles tendon or the wrist, are easily accessible. Practitioners need not access these sen via any channel or muscle gap.

Other sen exist in the grooves or channels between the larger muscles. Practitioners create space for these deeper structures by working between muscles or between the muscles and bones. If practitioners have not worked on the muscles, the third layer is not accessible to the practitioner.

There should be a sense of space where these lines are. There should not be adhesions, unwanted fibres, stagnant bodily fluids, spasmed muscles pressing in on them, or joining muscle and fascial tissues where space should exist. You must clean the blockage and create space if your thumbs cannot quickly sink into these lines. Once the lines are clear, you will have direct access to nerves, tendons, ligaments, veins, and other sen.

Remember that depth is relative to where you are on the body. For instance, the location of Line 1 on the outside of the upper leg is where the body has substantial muscle, fascia and fat tissue, so there is potential for pressing your thumb a fair distance. In contrast, the lines of the dorsal foot have very little tissue around them; therefore, the distance a thumb can sink is significantly reduced. However, channels exist in both places.

There are many techniques taught for working the sen layer. Most schools prepare students to press the sen layer with various thumb techniques, including thumb over thumb, thumb on thumb or thumb walking. Straight-down thumb pressure usually works best to open and loosen the sen layer. Direct pressure touches upon many sen and gives the nerves and arteries impulses. Direct pressure also creates space when muscles or muscles and bones are tight.

The thumb-walking method is best for moving things directionally. For instance, thumb walking will push the blockage away from the injury site if a client has an injury. Another application will be if clients are exhausted or spinning with energy. Thumb walking upwards from the feet will open up that area to receive more energy, and thumb walking down will lower their energy. The third application of thumb walking is if someone has a low digestive fire, you will thumb walk towards the core to bring more energy.

Pressing/Compression: Pressing between muscles or muscles and bones with thumbs, hands, elbows, knees, or feet.
Ironing: Pushing with thumbs in channels and directly on sen.
Stripping: Same as ironing but adding a stretch to it.


The fourth layer consists of the bones and the joints. Practitioners work the bone layer by using passive motion techniques on the joints, such as traction, shaking joints, and range of motion to help maintain joint health. These techniques also help release blockages in the sen at the joints.

Practitioners need to understand the function of all major joints to know what movement each joint needs. They also need to do a range of motion more than three times. Theoretically, a joint movement needs to be moved nine times for improvements. 

Traction: Pulling the joint apart straight out and making space.
Compression: Pushing the joint together to reduce space.
Shaking/Vibrating: Gently shaking or rolling between hands.


The final layer of the body is the organs. There are two types of organs. Hollow organs like the lungs, bladder and stomach connect to the external world. Solid organs like the liver and spleen have no connection to the outer layers.

Practitioners engage in visceral massage to help improve organ function. Abdominal work will not address serious problems with the organs but instead supports the work of your primary care physician, herbalist, acupuncturist or naturopath, who can more directly address your organ health.

The final layer of the body requires specialized training. Practitioners should only attempt to work on the organ with this additional training.

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