Muay Thai is usually regarded as a very hard, external style. However, especially because of its roots in heavily Buddhist Thailand, some consider it to have a spiritual aspect as well. Thai boxers typically perform some Buddhist rituals before beginning a match. Practicing Muay Thai is a vigorous workout and produces tremendous cardiovascular endurance. Muay Thai involves boxing techniques, hard kicking, and knee and elbow strikes. Low kicks to the thighs are a very distinguishing technique used frequently in Muay Thai. Stand up grappling is also used and allowed in the ring. Muay Thai practitioners develop a very high level of physical conditioning developed by its practitioners.