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Do Thai Massage Therapists Need To Know Anatomy?

Thai Massage therapy and anatomy

Do Thai Massage Therapists need to know anatomy? What kind of a strange question is this?

Isn’t it obvious that the answer should be “yes”? Or so would be the response of any western massage therapist. But the answer is not so simple, as you will see.

The observations in this article are based on the way how Thai Massage has been traditionally practiced and taught in Thailand, and how it is applied in the western world.

My personal experience in Thailand

I have lived in Thailand, the homeland of Thai Massage, for two decades.

When I started out with my career 20 years ago, I studied in quite a few Thai Massage schools, and not one of them mentioned anatomy.

I also know many native Thai Massage therapists, and the vast majority of them have practically zero knowledge of anatomy.

What’s the reason for this?

The answer is not so simple. There are several levels of how Thai Massage is being practiced. Most Thai and western massage therapists know Thai Massage as a system of stretching and pressure points.

Relatively few know that Thai Massage is part of a rather sophisticated system of traditional Thai medical knowledge. There are several reasons why very few therapists are familiar with it.

The complete study of traditional Thai medicine takes years to learn, a lot of dedication and financial investment

Such traditional Thai doctors do know about anatomy among many other subjects. However the average Thai Massage therapist in Thailand does not learn nor use anatomy.

Why is that? There are several reasons.

One is that typically Thai Massage therapists in Thailand come from a socio-economic background which makes it difficult or impossible for them to invest the time and money to access more advanced education.

Many practice Thai Massage because it it possible to become reasonably proficient in a few weeks, it is an easy job to get into, and it is better paid than most basic jobs in Thailand.

The other reason is that Thai Massage by itself, without training in Thai natural medicine, is traditionally taught without anatomical knowledge.

However, this does not mean that the Thai Massage is of inferior quality. There are countless excellent therapists who work primarily via experience and intuition, and who are highly skilled.

The reason for this is that Thai Massage is using a different approach to therapy than western massage. It uses energy lines as a map to the body, unlike western massage styles which are using anatomy as a map to the body.

Now let’s shift to the western Thai Massage therapists

Why don’t they learn the more profound aspects of Thai natural medicine in the Thai Massage schools?

Thai Herbal Ball Therapy
Thai Herbal Ball Therapy

One reason is the language barrier. The traditional Thai medical knowledge is only taught in the Thai language and therefore excludes almost all Westerners.

The second reason is that the Thais are not promoting this knowledge to Westerners. They see it as something to be preserved and guarded, not as something to be shared with the world.

Thais often look at the multitude of foreigners who come to Thailand to study Thai Massage as curiosity seekers and cash cows.

Consequently a high percentage of Thai Massage schools are set up as massage factories that churn out students as fast as possible for as much money as they can get..

The third reason is that most westerners spend only a few weeks in Thailand. This is enough for a basic hands-on Thai Massage education. However the Thai natural medicine training takes years, not weeks, and is therefore not within their time frame.

A fourth reason is that although many massage shops in Thailand offer classes, the teachers themselves have not been trained in more advanced Thai traditional medical knowledge, and therefore they cannot teach it.

A fifth reason is that it is entirely possible to become an excellent Thai Massage therapist without being trained in the entire traditional medical system of Thailand.

Western students have one advantage over their Thai counterparts. They can access anatomical knowledge more easily on their own. Also many of them have studied other styles of massage or yoga which include anatomical knowledge.

So here are some facts: In Thailand, most Thai or western therapists learn very little, if anything, about anatomy. Only in recent years some of the bigger Thai Massage schools have started to include anatomy training in their classes since there was a demand by their western students.

The Thai government has been raising educational standards for the Thais in recent years. But this does not apply to Western massage students since they do not fall under any licensing rules in Thailand.

Traditional Thai Massage education generally never included any anatomical knowledge, unless the therapist also studied the entire system of traditional Thai medicine. The reason is that Thai Massage works with energy lines instead of anatomy. 

This is gradually changing for western students who are used to the anatomical model and often incorporate it with the energy line model. Nowadays there are even some Thai Massage school for Thai students that are starting to introduce anatomical knowledge.

Where Thai Massage goes under the radar

There is a level of Thai Massage and Thai medical knowledge that is rarely seen by most westerners.

On one end of the spectrum there are those who have actually undergone years of training and who are highly educated. But in general you won’t find them teaching Thai Massage to foreigners in massage factories.

At the other end of the spectrum there are often very simple, but highly intuitive and shamanic practitioners who generally do not speak any English. They mostly live in areas where they don’t come in contact with foreigners, and they are not seeking such contact either.

Their knowledge does not come from formal education and sophisticated training, but from apprenticing, good intuition and lots of experience.

Anatomy in Thai Massage:
East and West are not on the same wavelength

When Thai Massage is taught in Western schools, anatomy is generally part of the curriculum. Now the question still remains: Is it necessary for Thai Massage therapists to know anatomy?

My personal opinion is that it is definitely an advantage. But I also have to say that I have received countless wonderful Thai Massage sessions here in Thailand from therapists who had absolutely no anatomical knowledge.

With practice, Thai Massage therapists can develop intuition and a sense of touch that can make them highly skilled without anatomical knowledge by working within the energy line model.

Thai Massage and western massage are based on two different models:

  • Thai Massage does not use anatomy and physiology as the main basis of the therapy. Instead it uses the concept of energy lines.
  • Western massage uses anatomy and physiology as the main basis of the therapy.

If you were to say that anatomy is lacking in the eastern system, then you could argue that energy lines are lacking in western massage. The fact is that they are two different ways of working with the body.

Thai Massage, anatomy and energy

image of Thai Massage energy lines
Thai Massage Energy Lines

Energy lines are not part of western anatomical training, but are an entirely different area of knowledge.

If I were to generalize a bit, I would say that Thai Massage, at its popular level, does not include anatomical knowledge, but instead relies on feeling, experience, intuition and an understanding of energy lines.

Western massage often goes to the other extreme. Massage schools require the students to study anatomy in such depth where it is often not applicable to actual massage practice anymore. 

A lot of it is forgotten by the students after they pass their exams, unless they are real anatomy aficionados.  And at the same time western massage is very much lacking an understanding of the energetic components of the body.

It is definitely possible to perform an excellent Thai Massage without any anatomical knowledge, but therapists who are trained in the more profound traditional Thai medicine can take it to an even higher level.

Traditional and less traditional Thai Massage

Since Western Thai Massage therapists have very limited access to traditional Thai medicine, some blend elements of yoga or traditional Chinese medical knowledge, which is much more available and accessible than the Thai version, with their practice.

While this might diverge from the strictly traditional Thai version of  Thai Massage, it can be just as effective.

There are two camps among western Thai Massage therapists: Those who place a high value on the traditional model, and those who place less emphasis on tradition and blend Thai Massage with other styles and other knowledge to make it effective in the most practical and most easily accessible way.


So do Thai Massage therapists need to know anatomy? It is possible to be an excellent Thai Massage therapist without any anatomical knowledge. That’s how it has been practiced in Thailand for centuries.

In the environment of the western world, it is more realistic to have anatomical knowledge. First it is required for obtaining a massage licence, and second it is pretty much expected that a therapist has anatomical knowledge.

However if the anatomy replaces the energy line concept, then Thai Massage loses its essence, its soul, and its real power.

Therefore it is much better if both systems of knowledge are learned by the therapist.

For the actual practice of Thai Massage the energy line system is the more important concept, but for therapists living and practicing in the western world, it can and should be supplemented by anatomical knowledge as well.

The two systems or approaches are not in opposite camps, but can make a good combination.

You can learn the entire system of Thai Massage through Thai Healing Massage Academy’s Complete Thai Massage online training course:

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image of Shama Kern

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

28 thoughts on “Do Thai Massage Therapists Need To Know Anatomy?”

  1. Shama,
    I’d say this is a very insightful article. I have a lot to say on this topic myself and recently, when I did an Advanced Therapeutic Thai Massage training with Dr. Pierce Salguero at the Thai Institute, we discussed, at length, this very topic.
    You always add very valuable perspective to the subject of Thai Massage, since you seem to have the “inside scoop from the street – in Thailand” as well as the sincere desire and ability to articulate some of the deeper aspects which will only appeal to the more serious seekers and students.
    I love it. Keep up the good work.

  2. Thank you very much Deon, I really value your input. You are right, the fact that I live in Thailand helps me see a different angle on Thai Massage which is not apparent in the West. So I have one foot in the western massage world, my cultural background, and the other foot in the eastern Thai Massage scene. This is my “niche”:)

  3. Hi Shama,

    As usual, a great topic for discussion and as usual from you, a well balanced and very informative overview. Thank you.

    I myself think there is still a lot to be said and explored in the area of intuitive and shamanistic practice within Thai massage.

    I remember I once went spirit dancing with Pichest, who is a highly intuitive and shamanistic healer/teacher, and after hours of dancing, noticed how the spirit energy present in the dance had dramatically altered my way of seeing other people’s physical bodies. In one instance, I was actually able to see the metaphysical form of a hex, which had been placed on the chest of one of the dancers in the symbolic shape of a pale green octopus, and which had been causing this person a prolongued bout of chest weakness and bronchitis.

    In that instant I understood how unimportant anatomy was as a physical reference point or location of illness. I didn’t need to know what muscle, bone or organ to examine, as the cause of this man’s sickness was blindingly obvious: it was a slimy green octopus on his chest!

    I also immediately understood how redundant it would have been to treat this person for his bronchitis in the way we are usually taught to treat bronchitis. It was later I learnt that to treat this person for his bronchitis, I needed to symbolically chop off the legs of the octopus and to send the energy of the entity lying behind the hex to a particular place far away.

    Just think for a moment how that would be regarded as a treatment for bronchitis in the west! But yet this is one of the ways it is treated by the wonderfully intuitive and shamanistic healers, like Pichest, who have taught hundreds of us Thai massage in and around Chiang Mai.

    I also remember going to class at Chaiyuth’s one day and he had just finished giving someone a massage treatment. The person was repeatedly asking Chaiyuth: ‘…and where was it you touched me me whan you did that exercise on me…’ The client was repeatedly pointing to specific locations on his body hoping for a series of anatomical answers from Chaiyuth, but Chaiyuth answered him in the same way he always answered this western question. He said: ‘I touched you where you needed touching’. It was the perfect answer.

    I have only had glimpses of this high level of ‘seeing’ in my own Thai massage career, but my teachers and masters are at this level all the time (or they can access this level of seeing at will). When you understand and indeed see this with your own eyes, then you know why anatomy and physiology can be so unimportant.

    In many ways we westerners use anatomy and physiology (and technique based on anatomy and physiolgy) as a substitute for the ability to ‘see’ and treat that comes from years of spiritual self-development and shamanistic training and practice.

    Where Chaiyuth would once place his finger on a point on our body which needed healing, we now place an anatomical map of the body and try to find that exact same point for ourselves.

    But you can’t use science to replicate magic. You can’t use book knowledge to replicate intuition. Yes, you can use them as learning aids and guides, but in the end to become Pichest or Chaiyuth, you have to become Pichest or Chaiyuth.

    And the good news is, you can!

    • Hi Robert,

      As usual, a really insightful response from you which is an entire article in itself! I love to hear about experiences like you described.

      It might appear to many that your story is way out there and extreme. But I feel that the way how western massage therapy is often being pushed towards scientific validation, strictly anatomical approaches to massage therapy, and double-blind, test-tube verified, science-approved ways to look at healing, is just as extreme.

      Therefore your experience here in Thailand provides a great balance to the western approach. There are many things in life that defy our normal sensory perception and scientific models.

      For example, a few days ago I went to a local temple and watched a Thai “yogi” meditate for 40 minutes in a vat of boiling oil. Seems to be impossible, but I was right there and caught it all on video, which I will post on youtube as soon as I have the video produced.

      Our minds will try to block access to many aspects of life and healing which are not within our experience. If we manage to keep our minds open anyway, there are a lot of magical and mysterious things going on. I have seen my share of them, like you.

      I agree with you, if we can really “see”, anatomy is not a necessary skill in massage therapy. In the absence of “seeing”, it is the next best skill to have. But at this point it cannot just be called ‘massage therapy’ anymore – it has moved into the realm of shamanic practices.This can be a little difficult to swallow for western therapists who have been educated in a scientific way.

      I know both of the teachers you talked about, Pichet and Chaiuth. I have studied with both of them and I have had similar experiences with them like you. So I know that what you are talking about is true.

      Thanks again for your insights!

  4. Hey Shama,

    It was nice to chat with you in Chiang Mai last week. I did not make it to Luesii Sombet but hope you did. Glad to see your writing about our chat. : )


    • Hi David,

      yes, our chat was definitely my inspiration for this article. I did make it to Luesii Sombet, the Thai “yogi” who meditates in boiling oil, and I recorded it all on video. I will post it soon.

  5. I’ve read through..It is really working since I really would like to know more about Thai Massage….Really like it..will go through again for the next article….

  6. Its great to hear some stories of other people who have studied under Pichet. After being with him for a while we had a new member join us. The woman asked how one could ever become like him. The intuitive answer that came out from us was that one could never become like him by studying under him. He is like he is because he chose to leave the conventional massage fraternity and totally do his own thing. He only does what comes from within and doesn’t care about anything else. He has no master because he became his own.

    For most of us mortals, some knowledge of anatomy will probably help us a great deal. We will also study under others long enough so that with enough experience we will develop our own style and a sometimes our intuition will provide some valuable guidance.

    • I totally agree with you Graham. One can never become just like Pichet. And why would we want that anyway! Like you pointed out he became that way by carving out his own path. What we can learn from him is to carve out our own path as well.

      That’s what happened with me. I got a lot of ideas and inspiration from Pichet, but in the end I developed my own style which is as unique as Pichet’s, but has little to do with his methods. I can’t be like him and he can’t be like me, and that’s exactly how it’s supposed to be:)

      For my purposes, intuition is more important than anatomy if I had to choose one of them, but I think the two are a great combination.

  7. Hi Shama,
    Thanks for sharing this article.
    I totally agree with the fact that quality of touch is extremely important.
    You can have a great education on the anatomy of the body and still give very unpleasant mechanical massages.
    I think it’s helpful to have some knowledge of anatomy but it’s VERY important to develop a loving touch, learn to feel that energy we share. Connecting with the person we are touching is crucial to turn a massage into an awesome massage!!


    I have been a therapist at top five-star resorts in Thailand (both ChiangMai and now Koh Samui) since 17 years. Just for your info, most resort spas have training programs, as do each Thai province’s Ministry of Health Department, to educate and teach and help improve skills and offerings of Thai Therapists around the Kingdom. Each year the programs and courses are better and better and very informative which also include from Anatomy to Physiology to Kinesiology to Reiki to Meditation, in addition to Swedish, Chi Nei Tsang, Indian Head Massage, Thai Massage and Thai Herbal Massage (Luk PraKob).

    Hope your courses are always updated and that you are always learning yourself. One things that cannot be teached are the gentle, caregiving kind ways of the Thai people. And therapists who are the good ones usually have some special kinds of ‘seeing’. Thenk you.

    • Thank you for your insightful and detailed comment. Just like you, I have worked in major spas, and the better ones clearly offer a higher level of training and education.

      As I mentioned in my article, the Thai government has made efforts to improve massage education and standards. This is mostly only available to Thais since the programs are generally not available in English. I hope that more and more Thais are taking advantage of this training.

      I was lucky enough to have studied extensively with one of those shamanic Thai Massage teachers who can ‘see’ the anatomy with his inner eye. A lot of this knowledge is incorporated in my video training courses.

      And yes, there is a sweetness which is part of the Thai nature which is a big reason why I have been here for so many years, and why I am married to a Thai woman.

  9. Well Shama, this one topic is a very interesting one, because my darling wife Banana and I we where just talking about this a few days ago, you see Banana did study anatomy and it was at great length, while studying massage in Bangkok, most morning sessions where all about anatomy and the afternoon session they would study a few techniques, she also learned some 108 Rusie-Dutton moves, not just the Yoga ones but the healing ones, also she studied about Thai Med, and the use of different herbs for medicinal healing, and she does agree that all Thai therapist should have a good basic knowledge of anatomy, that it would help them understand how fragile people can become with age, if they don’t know how to re-activate their human growth hormones by practicing certain exercises and slow the aging process, even Westerners are not aware of these techniques, that is why we have so many people with hip problems, Banana says that as a teacher that it is very important for her to include some anatomy teaching, when you say that a lot of the medical Thai knowledge and practice is to be kept here she agrees with you, she mentioned to me that at one point at Wat-Pho in Bangkok, they had revealed some medical secrets and they where scripted on the walls, and they where ordered to cover them with cement, so yes the Secret is very much alive in Thailand, I have to agree that anatomy to certified therapist should be mandatory, I personally think that knowing how everything is connected and works can only help you with the energy process, so the answer here on Samui is yes for anatomy, great article one more time Shama

    • That’s really great to hear that Banana had such a thorough training. The more I hear about you two in Samui, the more I get the impression that you started a first class operation there with your Thai Massage center.

  10. I think that’s good,all massage types can’t deal with anatomy,this creates a difference in the healing arts so people can differentiate their backgrounds.
    I first learnt Swedish massage where the anatomical structure is included as a subject but this just helps to direct the students on where to apply the different pressures,know bone sites and muscle sites but you can easily forget this except when you have a good medical background. But this a good topic with good questions about anatomy and a certain extent it has to be your instincts and general knowledge to guide us when practicing massage

    • Thanks for your contribution. I totally agree with your statement that “to a certain extent it has to be your instincts and general knowledge to guide us when practicing massage”.

  11. I have a story to tell, my own experience. my grand mother had 11 kids (she was expert of making kids, many times we had laugh telling this). she never been in school, she never read, because she don’t know how to read. she lived 95 years. she had about 50 grand kids. for 10 her grand kids, she was the one paediatric doctor, without any c-sections, perfect births, even me. but she had great knowledge of Ayurvedic medicine, she loved to treat people, lots of people in our village, came to get treatment from her, and ask questions, I’m the one her first grand son. I’m not saying my grand mother as an example. but seen how much, she love to take care people, when people thank her, she happy, she never ask money. she had such a healing hands.

  12. I born in Srilanka, I was there till 21 years. My whole life surround with Ayurvedic medicine, because of my lovely grand mother…… Shama I have to say thank you, know you person, I involve with your teaching, When I study with you, year 2000 , I felt that time you’ll go far, Because, you were so dedicated .but I never realized you going to live in Thailand this much longer. When I had difficulty with my thumbs, I put side my thai massage life, with sadness. But you gave me back, that life again…You’re great teacher, you’re great reseacher. thanks my friend

  13. Dear Shama,

    The article about Thai massage without anatomy is very interesting. Quite honestly, the review of anatomy we got in massage school was very basic, and I can feel more than the study of anatomy taught me. I always end my massages with some basic yogic stretches not so different from the stretches you showed in your free class. I do intend to invest in the longer class you have online, though I do not see my practice leaving the table. I think a massage therapist improves his or her practice with a wide variety of tools and experiences and mostly intuition. Massage, to me, is an art, not a science.

    • Hi Lani, quite a few of the students of Thai Healing Massage Academy practice Thai Massage on a table or integrate it into their existing modalities. I agree with your statement that a wide variety of tools is a big advantage. Like you, I am a big believer in massage being more art than science.

  14. shama-thanks for sharing your understanding. I have recently written a book, MELDING EASTERN AND WESTERN BODYWORK, available at amazon that you might be interested in because it comports with what you are teaching even though I am using the Chinese meridians instead of the sen lines. I learned this mostly intuitively working with eyes closed and without formal instruction or the benefit of a master like chaiyuth or pichest. you could also put in INTEGRATIVE BODYWORK WITH RALPH at youtube where several classes I gave are available if you are curious.

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