A man lies face down on a mat as a woman kneels on his lower half, grasping his wrists and pulling his arms behind him, causing his upper body to bend back into the “bow” pose. Not exactly what you picture when you hear the word “massage,” is it?

But in traditional Thai massage or Nuad Thai, this is just one of the many elaborate contortions that can occur—and a common one at that. A Nuad Thai practitioner will use their hands and fingers, forearms, elbows, knees, and perhaps even their feet to work the client’s body. They may also use hot and cold applications or herbal medicine. All this isn’t just to treat a few muscles, but the patient’s whole well-being.

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