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This section is a practitioner reference for the techniques used in Jab Kasai and Karsai Nei Tsang. Each page takes one stage of a session, describes what the published sources say is done, shows the anatomy on a diagram, and sets out the pressure limits, contraindications and stop rules a trained practitioner must apply.

Training reference, not a self-study course.

This page summarises how published sources describe a technique, with the anatomy and safety rules a practitioner needs. It does not replace supervised, in-person training, and it is not evidence that the technique treats any condition. In Thailand, Ministry of Public Health officials have said kasai massage is a treatment that belongs in licensed Thai traditional medicine settings, not general massage shops.

Two traditions, two descriptions

Two different sources are often mixed together under the same names. Keeping them apart avoids most of the confusion found online.

  • Thai nuad kasai. In 2012, the Thai Department of Thai Traditional and Alternative Medicine described nuad kasai as work on the back, from the spine down to the sacrum and tailbone, followed by the abdomen down to the groin lines. Its officials stated that the massage does not target the genitals and does not treat sexual dysfunction.
  • Karsai Nei Tsang. Mantak Chia's Taoist-inspired method, published in English, opens the abdomen first (Chi Nei Tsang) and then includes the groin, inner thighs, perineum and genitals. His school publishes a practitioner manual describing each technique in order.

The technique pages below follow the Karsai Nei Tsang order because it is the only one documented step by step in a public source. The Thai sequence has its own page.

Typical order of a Karsai-style session, from screening to aftercare1. Screening, consent, hygiene2. Opening the abdomen3. Deep abdomen: psoas, iliac crest4. Groin, inguinal ligament, inner thigh5. Back, sacrum, buttocks6. Perineum, pelvic floor (external)7. Scrotal work: restricted, optional8. Herbal compress, closing, aftercare
The usual order of a Karsai-style session. Stage 7 is restricted and can be left out entirely.

The techniques, stage by stage

  1. Preparation, screening and positioning: health questions, consent by body area, hygiene, gloves, oils and the three working positions.
  2. Opening the abdomen: clockwise palm circles, kneading and points around the navel.
  3. Deep abdomen: psoas and iliac crest: the deepest abdominal work, with the aortic midline kept free.
  4. Groin, inguinal ligament and inner thigh: strokes along the ligament and adductors, with the femoral triangle protected.
  5. Back, sacrum and buttocks: sacral edges, buttocks, the forearm press and the sciatic path.
  6. Perineum and pelvic floor (external): sit bones, perineal body and the anus-to-coccyx midline.
  7. Scrotal techniques: what the source describes: the most restricted stage, presented with the source's own limits.
  8. Herbal compress and closing: the Thai herbal ball, heat checks and aftercare.
  9. The Thai nuad kasai sequence: back first, then abdomen to groin, as described by Thai officials.

Rules that apply to every technique

  • Screen first. Any new lump, swelling, acute pain, fever, urinary symptom, untreated infection, hernia, recent surgery or blood clot means no session until a doctor has assessed it.
  • Consent is given area by area, before the session, and can be withdrawn at any moment with a simple stop word.
  • Pressure builds slowly and follows the client's feedback. Sharp, burning, shooting or increasing pain ends the technique.
  • Nausea, sweating, dizziness or paleness during groin or genital work signals a vasovagal reaction: stop, lay the client flat and raise the legs.
  • Never press on a pulsing mass, a bulge, a lump or a swollen area.
  • No technique is offered as a treatment for infertility, erectile dysfunction, low testosterone or prostate disease.

Training and licensing

These techniques are learned with a teacher who can watch your hands, correct pressure and check positioning. In Thailand, officials quoted in 2012 cited a minimum of 300 training hours for certified Thai massage practitioners, and in 2018 Ministry of Public Health officials said kasai massage counts as a treatment, to be provided in licensed Thai traditional medicine clinics or hospitals after an assessment, not in general health massage shops. Check the rules where you practise, and work within your own licence.

Before learning any technique, read risks and contraindications, consent, boundaries and hygiene and why Jab Kasai is not erotic massage.

Sources