Traditional Thai Massage: A case study of the assessment of musculoskeletal disorders in Chaloeysak-Wat Pho Massage Therapists
Keywords:Chaloeysak massage, physiological strain, work-related musculoskeletal disorders, WRMSD, Wat Pho Massage, Thai Massage
This study is designed to evaluate the physiological strain of Chaloeysak-Wat Pho Massage therapists. In Thailand, the ‘Chaloeysak’ or ‘Wat Pho’ Massage is a popular method especially for tourists which subsequently contributes to the employment of massage experts. The massage is built on the centuries-old cultural heritance of manual therapies in which deep muscle massage removes myofascial pain and discomfort. However, techniques used in physical rehabilitation classic medical physiotherapy such as manual traditional massage methods include risks for the biomechanical system of the therapists. At present, work-related musculoskeletal disorders (WRMSD) are a wide spread and persisting cause of health issues because of intensive and repetitive muscle work. Thirty experienced female therapists voluntarily participated in this project, each performing a 45-60 minute treatment followed by 15 minute rest. Patients were tourists who agreed to experience the advantages of a traditional Wat Pho Thai massage relaxation treatment. The study assessed the impact of the traditional therapies on the physical condition of the massagers by evaluating the total cardiovascular load, the local muscle strain and the subjective perceived problems. Compared to standard set thresholds, the results revealed for the set treatment conditions a safe physiological strain for the Chaloeysak or Wat Pho massage therapists (p < 0.05). In the actual conditions, the Chaloeysak massage therapists are safe from WRMSD risks when performing their job and the introduction of a resting period of 15 minutes after each treatment allows them to recover from the physiological strain. This rest period could be introduced into a WRMSD-prevention strategy for the Thai massage business.
Albert, W. J., Currie-Jackson, N., & Duncan, C. (2008). A survey of musculoskeletal injuries amongst Canadian massage therapists. Journal of Bodywork and Movement Therapies, 12, 86-93.
Albert, W. J., Duncan, C., Currie-Jackson, N., Gaudet, V., & Callaghan, J. P. (2006). Biomechanical assessment of massage therapists. Occupational Ergonomic, 6, 1-11.
Bevan, S., Passmore, E., & Mahdon, M. (2007) Musculoskeletal disorders and labour market participation. The Work Foundation, no 290003 – London, UK.
Bigland-Ritchie, B., Donovan, E. F., & Roussos, C. S. (1981). Conduction velocity and EMG power spectrum changes in fatigue of sustained maximal efforts. Journal of Applied Physiology, 51, 1300-1305.
Björksten, M., & Jonsson, B. (1977). Endurance limit of force in long-term intermittent static contractions. Scandinavian Journal of Work, Environment & Health, 3(1), 23-27. DOI: 10.5271/sjweh.2795
Borg, G. (2013). Psychophysical bases of perceived exertion. Medicine & Science in Sports & Exercise, 14(5), 377-381.
Bork, B. E., Cook, T. M., Rosecrance, J. C., Engelhardt, K. A., Thomason, M. E., Wauford, I. J., & Worley, R. K. (1996). Work-related musculoskeletal disorders among physical therapists. Physical Therapy & Rehabilitation Journals, 76(8): 827-835.
Bugajska, J., Makowiec-Dabrowska, T., Bortkiewicz, A., Gadzicka, E, Marszałek, A., & Lewandowski, Z. (2011). Physical capacity of occupationally active population and capability to perform physical work .International Journal of Occupational Safety and Ergonomics (JOSE), 17(2), 129-138. DOI: 10.1080/10803548.2011.11076883
Chulkov, N. (2011). Review of the medical services in the United Nations System. Joint Inspection Unit, UN. Geneva, GE, 11-00268.
Cromie, J. E., Robertson, V. J., & Best, M. O. (2000). Work-related musculoskeletal disorders in physical therapists: prevalence, severity, risks, and responses. Physical Therapy, 4, 336-351.
Deeb, J. M., Drury, C. G., & Pendergast, D. R. (1992). An exponential model of isometric muscular fatigue as a function of age and muscle groups. Ergonomics, 35(7-8), 899-918.
Enoka, R. M., Baudry, S., Rudroff, T., Farina, D., Klass, M., & Duchateau, J. (2011). Unraveling the neurophysiology of muscle fatigue. Journal of Electromyography and Kinesiology, 21(2), 208-19. DOI: 10.1016/j.jelekin.2010.10.006
Hägg, G. M., & Melin, B. (2004). Muscle fatigue. In: Merletti, R., Parker, P. J. (Eds.), Electromyography, physiology, engineering and non-invasive applications. IEEE series in Biomedical engineering, chapt. 9.3. Wiley-IEEE Press. ISBN 978-0-471-67580-8
Hignett, S., Wilson, J. R., & Morris, W. (2005). Finding ergonomic solutions – participatory approaches. Occupational Medecine, 55(3), 200-207. DOI: 10.1093/occmed/kqi084
HimaBindu, P., & Thiruppathi, A. (2014). Work related musculoskeletal discomfort among physiotherpists. International Journal of Physiotherapy. 1(4) 200-206. DOI: 10.15621/ijphy/2014/v1i4/54558
Hummel, A., Läubli, T., Pozzo, M., Schenk, P., Soillmann, S., & Klipstein, A. (2005). Relationship between perceived exertion and mean power frequency of the EMG signal from the upper trapezius muscle during isometric schoulder elevation. European Journal of Applied Physiology, 95(4), 321-326. DOI: 10.1007/s00421-005-0014-7
Ilmarinen, J. (1984). Physical load on the cardiovascular system in different work tasks. Scandinavian Journal of Work Environment & Health, 10, 403-408. DOI: 10.5271/sjweh.2303
Jang, Y., Chi, C. F., Tsauo, J. Y., & Wang, J. D. (2006). Prevalence and risk factors of work‐related musculoskeletal disorders in massage practitioners. Journal of Occupational Rehabilitation, 16(3), 425‐438. DOI: 10.1007/s10926-006-9028-1
Keyserling, W. M., & Chaffin, D. B., (1986). Occupational ergonomics--methods to evaluate physical stress on the job. Annual Review of Public Health, 7, 77-104.
Koukoulaki, Th. (2000). Social partner perspectives on preventing work-related musculoskeletal disorders: the employees’ viewpoint, Magazine of the European Agency for Safety and Health at Work, 3. ISBN 92-95007-15-8
Kroemer, K. H. E. (1989). Cumulative trauma disorders: their recognition and ergonomics measures to avoid them. Applied Ergonomics, 20(4), 274-280.
Kuorinka, I., Jonsson, B., Kilbom, A., Vinterberg, H., Biering-Sørensen, F., Andersson, G., & Jørgensen, K. (1987). Standardised Nordic questionnaires for the analysis of musculoskeletal symptoms. Applied Ergonomics, 18(3), 233-237.
Laing, A. C., Frazer, M. B., Cole, D. C., Kerr, M. S., Wells, R. P., & Norman, R. W. (2005). Study of the effectiveness of a participatory ergonomics intervention in reducing worker pain severity through physical exposure pathways. Ergonomics, 48(2), 150-170. DOI: 10.1080/00140130512331325727
Louhevaara, V., Smolander, J., Aminoff, T., & IImarinen, J. (1998). Assessing physical workload. In: Karawowski, W, & G. Salvendy (Eds), Ergonomics in manufacturing, raising productivity through workplace improvement (pp. 121-133). Dearborn, Michigan, USA: Society of Manufacturing Engineers.
McMahon, M., Stiller, K., & Trott, P. (2006). The prevalence of thumb problems in Australian physiotherapists is high: an observational study. Australian Journal of Physiotherapists, 52(4), 287‐292. http://dx.doi.org/10.1016/S0004-9514(06)70009-5
Murata, A., Uetake, A., Matsumoto, S., & Takasawa, Y. (2003). Evaluation of shoulder muscular fatigue induced during VDT tasks. International Journal of Human–Computer Interaction, 15(3), 407-417.
Nagamachi, N., & Imada, A. S. (1995). Participatory Ergonomics, Journal of Industrial Ergonomics, 15(5), Special issue. Elsevier Science International eds.
Oberg, T., Sandsjo, L., & Kadefors, R. (1994). Subjective and objective evaluation of shoulder muscle fatigue. Ergonomics 37(8), 1323-1333. DOI: 10.1080/00140139408964911
Occupational Health and Safety Council of Ontario (OHSCO). (2007). Occupational Health and Safety Council of Ontario-Musculoskeletal Disorders Prevention series Part 3A-MSD Prevention Toolbox. Retrieved from http://www.wsps.ca/WSPS/media/Site/Resources/MSD_Prevention_Toolbox_PartA_Getting_Started_English_Final.pdf?ext=.pdf
OSH. (2010). Work-related musculoskeletal disorders in the EU: Facts and Figures. European Agency for Safety and Health at Work. Luxemburg: Publications Office of the European Union, 2010, ISBN 978-92-9191-261-2; DOI: 10.2802/10952
OSHA. (2000). Ergonomics: The Study of Work, Department of Labor Occupational Safety and Health Administration, 3125 - U.S – revised. https://www.osha.gov/Publications/osha3125.pdf
Punnett, L., & Wegman, D. H. (2004). Work-related musculoskeletal disorders: the epidemiologic evidence and the debate. Journal of Electromyography and Kinesiology, 14(1), 13-23. DOI: 10.1016/j.jelekin.2003.09.015
Rambabu, T., & Suneetha, K. (2014). Prevalence of work related musculoskeletal disorders among physicians, surgeons and dentists: a comparative study. Annals of Medical and Health Sciences Research, 4(4), 578-582. DOI: 578-582; or (serial online). Retrieved from. http://www.amhsr.org/text.asp?2014/4/4/578/139327
Robergs, R. A., & Landwehr, R. (2002). The surprising history of the "Hrmax = 220-age" equations. Journal of Exercise Physiology Online, 5(2), 1-10.
Strambi, F., Montoliu, M. A., & Vanwonterghem, K. (2009). Risk assessment of biomechanical damage risks in small and medium-sized enterprises. In Quaderni di Ergonomia, Moretti & Vitali, pp. 155-165.
Tyroler, N. (2013). Acupressure and the Wat Po treatment protocols. In Haddad, B. (Ed.) Thai massage and Thai healing arts: Practice, culture and spiritualitis (pp.62-74). Silkworm Book. ISBN 9786162150715
Vanwonterghem, K. (1985). A postural load evaluation technique: based on energy expenditure, heart rate and subjective appreciation. In N. Corlett, J. Wilson, & I. Manenica (Eds) (1986). The Proceedings of the First International Occupational Ergonomics Symposium (pp.256-269). - Zadar , Croatia : Taylor and Francis.
Vanwonterghem, K. (2009). Ergonomic and human factors: Methodological consideration about evident based designs of work system. In Christopher M. Schlick (Ed.) .Industrial engineering and Ergonomics: Visions, concepts, methods and tools (pp.416-421.). Germany: Springer.
Vanwonterghem, K., & Intaranont, K. (1993). Study of the Exposure Limits in Constraining Climatic Conditions for Strenuous Tasks: an Ergonomic Approach. Luxemburg. Research Report. The European Commission. DGXII/ ¨Programme INCO-DC (ISBN 92-828-0574-3) Office for Official Publications of the European Communities.
Vanwonterghem, K., Yoopat, P., & Maes, G. (2012). Musculoskeletal disorders: a new approach. Work, 41(Suppl 1), 2293-2298. DOI: 10.3233/WOR-2012-0454-2293
Wilson, J. R. & Haines, H. M. (1997). Participatory ergonomics. In G. Salvendy (Ed.), Handbook of Human Factors and Ergonomics (pp. 490-513). USA: John Wiley and Sons.
Yoopat, P. (1999). Ergonomic study of strenuous tasks under tropical working conditions. In Yoopat, P., Glinsukon, T., Vanwonter ghem,K., Louhevaara, V., Vanoeteren, J. (Eds.), Proceedings of the First International Workshop on Health and working conditions in South East Asia “Heat Stress and Physical Workload” (pp. 34-47). Rangsit University Press, Thailand.
Yoopat, P. (2004). Reducing physiological strain in construction work in Thailand: an ergonomic method. Asia Pacific Newsletter on Occupational Safety and Health, 11(1), 15-17.
Yoopat, P., Maes, C., Poriau, S., Vanwonterghem, K. (2015). Thai traditional massage: efficiency-assessment of three traditional massage methods on office workers: an explorative study. Journal of Bodywork & Movement Therapies, 19(2), 246-252. DOI: 10.1016/j.jbmt.2014.04.006
Wilkowski, R. (2004). Relax the Thai way, Massage Today. Retrieved from. www.massagetoday.com /wilkowski/ phys./June.
Wilson, J. R. (1994). Devolving ergonomics: The key to ergonomics management programmes Ergonomics, 37, 579-594.
How to Cite
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.