Introduction
Humanity is currently confronted with a fast evolution in
living conditions of which the psycho-somatic impact on
citizens affect the equilibrium between load-related factors
and the individual’s adaptive capacity. Sustaining imbalances
in the coping process may result in gradually
increasing physical and psycho-mental strain, starting
initially with discomfort and pain, but may evolve into a
dysfunction or injury.
In order to relieve the strain symptoms, people develop
an individual strategy which is influenced by the importance
of the complaints: if obvious and serious, they consult
their ad-hoc expert for a classic treatment (physician,
psychologist, psychiatrist). In less obvious cases however,
many prefer to contact acquaintances, friends, or drugstores
for several reasons (which may be financial, a lack of
trust, and fear) and prefer alternative ways such as herbal
medicine and/or ancient massage techniques. At present,
the formal Thai Traditional Massage (TTM) has become very
popular for residents of Thailand and for visitors (tourists
and professional employees).
In Thai Traditional massage (TTM) it is believed that
health and well-being relies on the balance of life energy
throughout the body via invisible pathways. The core treatment
is built on releasing stress affecting the energy flows by
pressing and stimulating correct pressure points (blockages)
situated along the theorised energy Meridian basal lines.
These energy lines are inscribed graphically in marble tablets
which were brought to and kept in the ‘Wat Pho” temple in
Bangkok during the reign of King Rama III (1824e1851, A.D.).
In 2010, there were approximately 19,440 recognized therapists
(male, female, some of whom were blind) but the information
about a large amount of heritage-educated
‘massagers’ active in the informal sector is not available.
Official Thai Traditional Massage (TTM) education is offered
by many organizations such as schools, temples, universities,
clinics, hospitals, and private enterprises. In 2014, 108 organizations
were certified by the Ministry of Public Health to
be the training center of professional therapists in Thailand.
Conditions are 330 h training for an assistant massage therapist
and 800 h for massage therapist.
Thai Traditional Massage (TTM) gained in importance
during the last decades and has spread world-wide. In the
USA, approximately 6% of the population in 2002 used
complementary and alternative medicine to treat back pain
and sixty percent perceived it as a “great deal” of benefit
(Anup et al., 2010). The three TTM-methods are described
by Tyroler (2013).
The Sen Sib method focuses the manual treatment on
perceived blockages occurring along ten (10, ‘Sib’) basic life
energy lines originating from the center point (underneath
the abdominal surface (umbilicus), 2 fingers width deep).
Each of the essential acupressure points on the assumed
energy paths is stimulated for about 1e15 s, repeated three
times. The total treatment time is about 15e30 min.
The Ratchsamnak method, or ‘Royal style’, concerns
deep muscle massage exerting slow, increasing pressure
with fingers, thumbs, stretched arms, and elbows on taut
palpable nodules, ‘trigger points’, along the Meridian lines.
The concentration is put onto the back, inner legs, outer
legs arms, shoulders, abdomen, and the frontal and occipital
parts of the head, and includes stretching exercises of
the upper limbs. The normal therapy-time depends on the
specific symptoms and lasts about 30e60 min.
The Chaloeysak method: the ‘folk style’, includes a
progressive series of movements to loosen and stretch
muscles and joints, and includes deep muscle acupressure,
stimulating the flow at more than 200 possible points along
the main theorised energy lines with fingers, thumbs,
palms, elbows, knees and feet. The treatment is robust and
very thorough, enabling energetic and physical release at a
very deep level. The therapist varies his/her posture
frequently during treatment. Total massage time is about
30e60 min.
All methods claim to revitalize mind, body, and spirit e
and are aimed to impart a definite visceral feeling of
wellbeing. The physiological and therapeutic effects e
questionable due to a lack of scientific evidence e are
often classified as ‘placebos’ (Evans, 2006), especially
when fighting ‘pain’ and ‘discomfort-complaints’, and
therefore TTM is often considered as quackery and the
practitioners as frauds.
In comparison to other Western methods, such as the
somewhat comparable Swedish massage, TTM is a rather
metaphysical treatment concentrating on invisible energy
channels throughout the body, whereas the Swedish
method starts from Western concepts of anatomy and
physiology, also involving pressing and kneading but with
additional effleurage, friction and tapping.
In studying the effects of these traditional massage
techniques, researchers concentrated their focus on the
methods used in sports medicine: blood composition and
flow, oedema, connective tissue, muscle, and the nervous
system. However when evaluating, the ancient massage art
the need for a scientific basis became obvious (Goats,
1994). Tasaki et al. (1967) studied the influence of massage
on the skin and the intramuscular circulatory changes
in using lumbar massage; Mori et al. (2004) found a significant
difference between massage and rest in localized
muscle fatigue and VAS with effects on skin temperature
increase and improved blood flow in local regions.
Donoyama et al. (2008) studied the physical and psychological
effects of the Japanese ‘Anma’ massage in healthy
female volunteers in their fifth decade who had problems of
chronic muscle stiffness in the neck and shoulders. Two
interventions of 40-min Anma therapy followed by a 40-min
recovery lead to significantly reduced scores for VAS, lower
anxiety and an increase of immunoglobulin (S-IgA) in mucous
secretion. Moraska et al. (2008) reviewed the literature
on physiological adjustments to stress. Despite some
positive effects on diastolic blood pressure, on urinary
cortisol and catecholamines, the research data were
insufficient to make formal conclusions regarding
efficiency.
Additionally, Kenny and Marc (2011) made a randomized
review of massage efficiency including modalities such as
acupressure, lymphatic drainage, myofascial release,
reflexology, Swedish massage, sports massage and trigger
point therapies. Their key findings showed positive indications
as to efficiency in managing sub-acute/chronic
low back pain, delayed onset muscle soreness (DOMS),
anxiety, nausea, stress, and relaxation and support for the
Introduction
Humanity is currently confronted with a fast evolution in
living conditions of which the psycho-somatic impact on
citizens affect the equilibrium between load-related factors
and the individual’s adaptive capacity. Sustaining imbalances
in the coping process may result in gradually
increasing physical and psycho-mental strain, starting
initially with discomfort and pain, but may evolve into a
dysfunction or injury.
In order to relieve the strain symptoms, people develop
an individual strategy which is influenced by the importance
of the complaints: if obvious and serious, they consult
their ad-hoc expert for a classic treatment (physician,
psychologist, psychiatrist). In less obvious cases however,
many prefer to contact acquaintances, friends, or drugstores
for several reasons (which may be financial, a lack of
trust, and fear) and prefer alternative ways such as herbal
medicine and/or ancient massage techniques. At present,
the formal Thai Traditional Massage (TTM) has become very
popular for residents of Thailand and for visitors (tourists
and professional employees).
In Thai Traditional massage (TTM) it is believed that
health and well-being relies on the balance of life energy
throughout the body via invisible pathways. The core treatment
is built on releasing stress affecting the energy flows by
pressing and stimulating correct pressure points (blockages)
situated along the theorised energy Meridian basal lines.
These energy lines are inscribed graphically in marble tablets
which were brought to and kept in the ‘Wat Pho” temple in
Bangkok during the reign of King Rama III (1824e1851, A.D.).
In 2010, there were approximately 19,440 recognized therapists
(male, female, some of whom were blind) but the information
about a large amount of heritage-educated
‘massagers’ active in the informal sector is not available.
Official Thai Traditional Massage (TTM) education is offered
by many organizations such as schools, temples, universities,
clinics, hospitals, and private enterprises. In 2014, 108 organizations
were certified by the Ministry of Public Health to
be the training center of professional therapists in Thailand.
Conditions are 330 h training for an assistant massage therapist
and 800 h for massage therapist.
Thai Traditional Massage (TTM) gained in importance
during the last decades and has spread world-wide. In the
USA, approximately 6% of the population in 2002 used
complementary and alternative medicine to treat back pain
and sixty percent perceived it as a “great deal” of benefit
(Anup et al., 2010). The three TTM-methods are described
by Tyroler (2013).
The Sen Sib method focuses the manual treatment on
perceived blockages occurring along ten (10, ‘Sib’) basic life
energy lines originating from the center point (underneath
the abdominal surface (umbilicus), 2 fingers width deep).
Each of the essential acupressure points on the assumed
energy paths is stimulated for about 1e15 s, repeated three
times. The total treatment time is about 15e30 min.
The Ratchsamnak method, or ‘Royal style’, concerns
deep muscle massage exerting slow, increasing pressure
with fingers, thumbs, stretched arms, and elbows on taut
palpable nodules, ‘trigger points’, along the Meridian lines.
The concentration is put onto the back, inner legs, outer
legs arms, shoulders, abdomen, and the frontal and occipital
parts of the head, and includes stretching exercises of
the upper limbs. The normal therapy-time depends on the
specific symptoms and lasts about 30e60 min.
The Chaloeysak method: the ‘folk style’, includes a
progressive series of movements to loosen and stretch
muscles and joints, and includes deep muscle acupressure,
stimulating the flow at more than 200 possible points along
the main theorised energy lines with fingers, thumbs,
palms, elbows, knees and feet. The treatment is robust and
very thorough, enabling energetic and physical release at a
very deep level. The therapist varies his/her posture
frequently during treatment. Total massage time is about
30e60 min.
All methods claim to revitalize mind, body, and spirit e
and are aimed to impart a definite visceral feeling of
wellbeing. The physiological and therapeutic effects e
questionable due to a lack of scientific evidence e are
often classified as ‘placebos’ (Evans, 2006), especially
when fighting ‘pain’ and ‘discomfort-complaints’, and
therefore TTM is often considered as quackery and the
practitioners as frauds.
In comparison to other Western methods, such as the
somewhat comparable Swedish massage, TTM is a rather
metaphysical treatment concentrating on invisible energy
channels throughout the body, whereas the Swedish
method starts from Western concepts of anatomy and
physiology, also involving pressing and kneading but with
additional effleurage, friction and tapping.
In studying the effects of these traditional massage
techniques, researchers concentrated their focus on the
methods used in sports medicine: blood composition and
flow, oedema, connective tissue, muscle, and the nervous
system. However when evaluating, the ancient massage art
the need for a scientific basis became obvious (Goats,
1994). Tasaki et al. (1967) studied the influence of massage
on the skin and the intramuscular circulatory changes
in using lumbar massage; Mori et al. (2004) found a significant
difference between massage and rest in localized
muscle fatigue and VAS with effects on skin temperature
increase and improved blood flow in local regions.
Donoyama et al. (2008) studied the physical and psychological
effects of the Japanese ‘Anma’ massage in healthy
female volunteers in their fifth decade who had problems of
chronic muscle stiffness in the neck and shoulders. Two
interventions of 40-min Anma therapy followed by a 40-min
recovery lead to significantly reduced scores for VAS, lower
anxiety and an increase of immunoglobulin (S-IgA) in mucous
secretion. Moraska et al. (2008) reviewed the literature
on physiological adjustments to stress. Despite some
positive effects on diastolic blood pressure, on urinary
cortisol and catecholamines, the research data were
insufficient to make formal conclusions regarding
efficiency.
Additionally, Kenny and Marc (2011) made a randomized
review of massage efficiency including modalities such as
acupressure, lymphatic drainage, myofascial release,
reflexology, Swedish massage, sports massage and trigger
point therapies. Their key findings showed positive indications
as to efficiency in managing sub-acute/chronic
low back pain, delayed onset muscle soreness (DOMS),
anxiety, nausea, stress, and relaxation and support for the
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