What are the cautionary sites for Thai massage?

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


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.

Leg Region

Top of the Foot
There are many bones along the top of the foot, so only massage with light pressure.
Back of the Knee
The popliteal artery and vein, tibial nerve 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.
The femoral artery and vein, lymph nodes, and femoral nerve run past the upper leg and groin area crease. Strong and prolonged pressure to this area may cause the blockage of blood to the leg.

Chest and Abdomen 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.
Excessive or repeated pressure can break down breast tissue, so avoid this area except for therapeutic purposes.
Xiphoid Process
Direct pressure to the tip of the chest bone may break and puncture the liver.

Back and Spinal Regions

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.
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, the tips of the cervical vertebrae. And do not twist the neck unless you are qualified, as this movement might damage the nerve or compress the artery.

Arm and Hand Regions

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
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. You may massage this area lightly.
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.
Strong pressure on the inner wrist can damage the median nerve and the 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 Region

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.
Only apply light pressure to the temporal bone.
Top of the Head
If you are massaging a toddler, be aware that the Anterior Fontanel is soft and not fully closed until two years after birth.

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