Educational content by JabKasai Longevity. Editorial policy
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Both traditions work the back of the pelvis. Thai nuad kasai starts there; Karsai Nei Tsang returns to it with the client on all fours or face down.
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.
The techniques
1. Sacrum and buttocks
What the source describes.
Starting at the sit bones, the thumbs move up along the edges of the sacrum while the fingers spread out over the buttocks; the hands meet at the top of the pelvis and sweep down its outer sides.
Anatomy under the hands.
The sacrum, the sacroiliac joints on either side of it, and the gluteal muscles. The sit bones (ischial tuberosities) are the bony points you sit on.
Position.
Client on all fours or face down with a pillow under the pelvis.
How it is performed.
- Place the thumbs just inside the sit bones.
- Glide up along both edges of the sacrum to the top of the pelvis.
- Fan the hands out over the buttocks and sweep down the outside of the hips.
- Repeat a few times, pausing with small circles on tight spots.
Pressure and pace.
Moderate to firm on muscle, lighter over bone and over the sacroiliac joints.
Do not / stop if.
- pain shooting down the leg;
- pain that is worse with each repetition;
- recent fall or injury to the tailbone.
2. Forearm press along the midline
What the source describes.
The practitioner leans over the buttocks and lays the forearm along the midline between the anus and the sacrum, using body weight, for two to three minutes.
Anatomy under the hands.
The anococcygeal ligament and the tailbone (coccyx), with the sacrum above.
Position.
Client on all fours or face down.
How it is performed.
- Cover the area with a towel.
- Lay the forearm along the midline and add weight gradually.
- Hold steady contact for one to three minutes, then lift off slowly.
Pressure and pace.
Body weight is easy to overdo. Add it gradually and ask for feedback.
Do not / stop if.
- osteoporosis or a history of fractures from minor falls: body weight on bone is unsafe;
- tailbone pain or a recent tailbone injury;
- haemorrhoids or anal fissures that are painful.
3. Sciatic path
What the source describes.
Thumb pressure along the path of the sciatic nerve, with small circles on knots.
Anatomy under the hands.
The sciatic nerve leaves the pelvis under the piriformis muscle, deep in the buttock, and runs down the back of the thigh.
Position.
Client face down.
Pressure and pace.
Light. Work the muscles around the path, not the nerve itself. Pressing on a nerve can cause shooting pain, tingling or numbness.
Do not / stop if.
- pain, tingling or electric sensations running down the leg;
- a client with sciatica, back pain with leg symptoms, or new numbness: refer rather than treat.
New numbness around the genitals or buttocks, loss of bladder or bowel control, or weakness in both legs is a medical emergency (possible cauda equina syndrome). Stop and send the client to emergency care.
