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Visceral work on the abdomen and surrounding tissues is vitally important for the health of the whole body, its function and the emotional core.

Visceral work on the abdomen and surrounding tissues is vitally important for the health of the whole body, its function and the emotional core.

This area is richly innervated, with an abundance of Sên. (Sên are classified as pathways of movement in the body and extensions of the heart and nerve trees, e.g., lymph, vessels, nerves, tendons, neural offshoots, ligaments, etc). Its role as intelligent communicator (also known as the “gut brain”) is significant to the entire body, from sensory experience to mental health and vitality. The massage is concentrated on the organs at the belly, but these are in direct fascial continuity with, and have a close relationship to, the heart and lungs.

The Sên are also stimulated within the abdominal massage protocol and so it is important to notice that, as pathways of movement, the three brains (brain, heart and gut) are being activated and treated as one. Massage to the abdomen is wonderfully relaxing and assists the recipient in noticing themselves at a very deep level. The experience of receiving Thai abdominal massage is like traveling into the depths of one’s body. As each layer is massaged, the recipient’s interoception (sense of the internal body) is actuated and there is a feeling of sliding inwards and being fully present in oneself. This work requires the practitioner to be very sensitive, both in the physical hands-on work and in the deeper aspects that are potentially being experienced by the recipient.

Belly massage is one of the most effective treatments for many conditions, often unrelated to the gut. A client may come with limited shoulder movement or neck pain; this may not be resolved by working directly on those areas but often improves from moving the Wind and creating space in the abdomen.

The organs can become immobilized for many reasons: inflammation, food intolerances, injury, surgery, emotional conflict, lack of physical movement or self-expression, stress and environmental factors. It becomes less easy for them to slide and glide over each other, the spaces between becoming congested. This affects lymphatic drainage, blood flow and nerve conduction to and from a specific organ, which in turn influences both posture and function. Using manual therapy to create space in this area is the best way to improve and reduce the problem.

Location of the Wind Gates
Fig. 1: Location of the Wind Gates, which correspond to plexuses and give access to many Sên. Photos by Katya de Grunwald

How Do I Work on the Belly?

The simple answer is “slowly.” It is also important to have had class instruction from a teacher and to know the anatomy of the belly before working on it. More than any other area, the belly needs to be touched and cared for with sensitivity. If you imagine all the internal structures, the vital life-giving and sustaining organs that are housed within the abdomen, it is no surprise that it needs to be treated with respect. This is also where the reproductive organs can be touched on.

As you work your way slowly through the layers, I suggest you imagine exactly what your hands might be touching. While you may not have had the benefit of time in the dissection lab, there is still something very powerful about connecting your thoughts and intention with what your hands are doing and the structures they may be touching. Even if, like me, you have been fortunate enough to explore the inner spaces of the body, be aware that the viscera can be organized in surprising ways.

Some organs are not in the place you might think they will be, and there are also congenital presentations such as “situs inversus,” where the organs are mirrored to the opposite side. (This is rare, but it is possible for the recipient to have had this condition and yet to have been unaware of it their whole life. I have seen kidneys pushed up and hiding in the ribcage near the lungs.)

The arrangement of the organ layer is unique to the individual and is influenced by functional movement, posture, self-expression, breath, daily habits, and genetics. All of these factors, and many more, can affect the internal organization of any area of the body, including the viscera.

This means that the organs are not always located as they may be depicted in anatomical reference literature, so practitioners must be able to identify, through palpation, exactly what structure they are addressing. This work needs guidance from a teacher and experienced, skilled hands to ensure safety and efficacy.

The abdomen is often an area where emotions are stored, and touching this area is likely to bring strong feelings to the surface. Some clients feel self-conscious, while others are not used to having this area touched, especially in a therapeutic environment, and it might make them feel vulnerable or uneasy. If a client has had surgery here, there may be physical and emotional trauma and scar tissue, which can harden and pull internally if not cared for, having far-reaching effects. Others will find being touched in this area very soothing and nurturing. Either way, the practitioner needs to approach this work with sensitivity and provide appropriate care for each layer.

I have seen a case where a loved one’s belly presented internal bruising in a circular pattern from diaphragm to pelvis after experiencing physical trauma that she tried to emotionally process alone. The bruising baffled the doctors who saw her, but I think that (as it was not abuse) it was her gut visibly expressing pain, alerting both her and her loved ones to the fact that something was seriously amiss.

Massaging the body from the skin to the deepest layers can help to disperse pathogens that reside at the body’s core by encouraging it to process toxins more quickly through stimulating optimum function of the internal organs. Adhesions, tightness, pain, lack of movement, constipation and loose bowels can all be addressed through Thai bodywork techniques that have stood the test of time. In so doing, everything can be freed up and the client is made to feel much more comfortable, with improved posture, a feeling of space and lightness, and increased absorption of nutrients.

Herbal compress in use
Fig. 2: Herbal compresses are used as preparatory tools to open the layers of the body before spinal nerve treatment.

Indications for Abdominal Massage

This technique:

• can release deeply stored emotions and toxins

• creates space in the tissues

• moves Wind (making physiological change happen in the whole body)

• addresses hormonal and endocrine imbalances

• replenishes and nourishes the tissues

• influences alignment of the pelvis and organs in situ

• supports organ function

• increases slide and glide so that organs can function at their best

• calms and relaxes

• improves immune function

• addresses essence (vitality of the body)

• improves blood flow and quality

• releases the diaphragm and assists in improving breath

• improves tone

• reduces bloating and indigestion

• improves absorption of nutrients

• relieves pain

• improves posture

• improves pelvic health

• improves menstrual cycles

• encourages healthy emotional connection to the area

• connects heart, gut, and brain.

The practitioner might choose to work on the fifth layer for many reasons. I have listed some, but not all, of these here:

• menstrual or hormonal imbalance

• constipation, diarrhea, reflux

• pelvic misalignment

• back pain

• restricted, shallow breathing

• toxicity and stagnation

• depletion

• low energy/vitality

• poor posture

• being under par, anxious, highly strung.


• Pregnancy

• Swelling of the organs

• Crohn’s disease

• Food in stomach

• Inflammation in whole body (compresses only)

• Kidney stones (compresses, only)

Myofascial stretching
Fig. 3: Cross-directional myofascial stretching of the second layer.

Tune In to Your Listening Hands

Massaging gently and with increased sensitivity is essential around this area. Really tune in to your listening hands so that you can pick up on the subtle shifts that occur, and become intimately aware of the layers. Observe if emotions rise to the surface, detect where there are sore or tender areas, and then work appropriately with the receiver. Keep in mind the physiological and energetic effect you are producing while working around the navel and abdomen, having the intention to encourage change but never forcing it to happen. Patience is the name of the game.

For people who have a lot of energy and cannot calm down, the abdomen is a good place to start a treatment, working through the layers moving fluids and blood out to the extremities. These individuals are presenting agitated Fire element, so you are going straight to the core of the Fire that is burning in them and dispersing it. This will also help slow down the digestion of food so that nutrients can be extracted from it, rather than it moving so quickly through the body that the person becomes depleted (in one end and out the other).

Likewise, someone who is very depleted of energy will respond best to a treatment that brings everything towards the core to nourish it. This will encourage the Fire in their belly to be stimulated. The blood, lymph and fluids are moved towards the core of the body, where the organs can start to process them. In this instance, massage the abdomen at the end of the session, allowing ample time for the work (as a guide, 30–60 minutes into the treatment).

If someone is really stuck in their head, overthinking, anxious, or worried, I would start with the head and neck and work on the belly at the end, with the intention of working away from their tension to the core for processing of the stress chemicals. In working this way, the treatment starts at the biggest source of the problem and moves to the core.

Most therapists who work with herbal compresses have a passion for them, and never more so than for use on the belly, where they come into their own. The heat and medicinal herbs can do safe, soothing and deep work, which is especially useful if there is pain and tenderness that does not allow working with the hands. Some sessions could consist entirely of herbal compresses on the abdomen, and I always start abdomen work with them. I have never met a client who does not enjoy having their belly massaged with them. If you do not have compresses available, then use the technique of rubbing the area to work on the skin, with the intention of bringing blood and heat to the surface. When your hands feel warm from this work and the belly also feels warm, then the skin layer has been cared for.

It is good to palpate the area gently, checking in with the recipient and asking for feedback as you do this. Gently feel your way around, noticing heat, tenderness and soft and hard areas. I like to work the front and back of the body at the same time to warm up the whole area with touch. For this I use a technique I named “belly ball,” which cares for the skin and tissue layer, and structures in the back of the body, bringing touch input to the erector spinae muscle, kidneys, spleen and posterior visceral organs.

This article was excerpted from “Thai Massage Dissected.” Copyright © Handspring Publishing 2021; reproduced with permission.

Abdominal, massage, thai ⋆ Thai Abdominal Massage

About the Author:

Natasha de Grunwald is an international Thai massage teacher, mentor, author, and coach. She is a member of the Association of Therapy lecturers and teaches accredited professional training programs online and around the world. She founded the London Institute of Thai Yoga Massage in 2005 and in 2019 the Sacred Health Method, a revolutionary training program for advanced therapists. De Grunwald is the host of The Dissected Woman podcast. As a special offer to Massage Magazine readers, order Thai Massage Dissected direct from Handspring Publishing and save 20 percent off the list price. Order direct here  and use discount code MMTMD21. Offer expires May 31, 2022. Free shipping to US and UK addresses. 

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