Marma knowledge occupies an unusually direct bridge between Ayurvedic medicine and Kerala's martial art, kalaripayattu, whose practitioners study the marma points as thoroughly for their vulnerability in combat as marma therapists study them for their therapeutic use, a shared body of anatomical knowledge applied to two purposes that in most other traditions worldwide remain more separated, striking and healing developed within a single continuous discipline rather than as unrelated fields. Kalaripayattu masters, the gurukkal, have traditionally combined instruction in the martial art itself with training in marma chikitsa, marma healing, a combination reflecting the broader South Indian understanding that a martial teacher bears responsibility for treating the injuries the training itself may cause, and this dual competence remains a recognised, respected specialisation within traditional kalari lineages in Kerala today.
Marma therapy as a distinct therapeutic modality has, alongside abhyanga and other elements of classical Ayurveda, spread into the wider international wellness and complementary medicine world in recent decades, though practitioners trained within authentic Kerala lineages, whether through Ayurvedic medical training or through the kalaripayattu martial tradition, generally regard the deep anatomical and diagnostic knowledge classical marma study requires as considerably harder to transmit accurately outside its originating context than the massage technique alone.