Shiatsu Massage: The Basics
Shiatsu is a traditional, holistic Japanese form of bodywork that focuses on restoring balance to the natural flow of energy in the body. In Japanese, “shi” translates to finger, and “atsu” means pressure, meaning shiatsu literally translates to “finger pressure.”
“Shiatsu involves comfortable, sustained pressure to specific points on the body,” says Leisa Bellmore, MSc, ST. “It is based in part on Traditional Chinese Medicine and, in part, on anatomy and physiology.”
Some forms of Shiatsu are rooted in more Eastern tradition, while others take a more Western approach. “Zen shiatsu or Masunaga Shiatsu, take a more Eastern approach with points based on meridians,” Bellmore describes. “Namikoshi Shiatsu takes a more Western approach with points where there is greater physiological effect on the body, often following muscle lines, nerve pathways and blood vessels.”
During a shiatsu session, clients often remain fully clothed, but can also be traditionally draped. Often, sessions occur on a futon mat, tatami mat, massage table or chair. Massage therapists often use their thumbs to perform shiatsu, but the pads of the fingers and the palms can also be used.
“While shiatsu therapists work on the soft tissues of the body, there is no rubbing or kneading of muscles, no techniques such as effleurage or petrissage,” Bellmore explains. “As shiatsu involves pressure to specific points, there is no oil or lotion used.”
There is also a common misconception that shiatsu needs to be painful. The pressure used in shiatsu always depends on the client’s comfort level, and can range from extremely gentle—more touch than pressure—to quite deep, according to Bellmore. “Even very gentle pressure has a beneficial effect,” she adds.
Who is Shiatsu Massage For and What Are the Benefits?
There is no one demographic who stands to benefit more from shiatsu than any other. “My clients range in age from four to 94,” says Stan Shimizu, owner of Shiatsu Sennin-so. “From top-tier athletes to people with varying abilities, all bodies will benefit from shiatsu.”
The benefits, too, are wide-ranging. “Shiatsu is used for acute and chronic health conditions and as preventive care,” Bellmore explains. “It is very helpful for managing stress, enhancing health and well-being, and improving function.”
Bellmore’s own practice suggests to her that shiatsu has a profound effect on the nervous system. “It is very helpful for those living with neurological conditions such as migraine, Parkinson’s, Alzheimer’s, neuralgia, and those recovering from strokes,” Bellmore says. “I’ve also found it to be very helpful for mental health issues: PTSD, anxiety disorder, depression, and severe stress.”
Some recent research backs up some of what massage therapists who practice shiatsu have seen in their practices. For example, a 2022 study exploring the effect of shiatsu on children who have experienced trauma found positive effects on internal tension, sleep, social interaction, attention, verbalization of affects and verbalization of traumatic memories, as well as the perception of bodily limits.1
And in a 2023 study, researchers investigated the effects of shiatsu on the sleep quality of patients with chronic low back pain. Participants showed improved scores on the global Pittsburgh Sleep Quality Index, suggesting that shiatsu, in addition to standard therapy, may improve sleep quality.2
“Really, any client can benefit from shiatsu because the session is always tailored to suit the individual and their unique health and well-being needs,” Bellmore says.
“Overall, shiatsu creates a very relaxing parasympathetic response, the catalyst for the body to heal itself,” says Shirley Scranta, Director, International School of Shiatsu. “The effects of shiatsu can continue for hours, days, or weeks.”
For Shimizu, shiatsu allows clients to experience the benefits of massage more holistically. “Shiatsu is holistic,” he says. “The benefits of shiatsu affect the whole person: body, mind, and spirit.”
Shiatsu Risks and Contraindications
The risks and contraindications of shiatsu are similar to the risks and contraindications for any other massage technique. Massage therapists need to conduct a thorough intake that details any chronic or acute health conditions, both physical and emotional.
“Massage therapists should study shiatsu techniques in a classroom setting before offering it to clients,” Scranta says. “Additionally, massage therapists should educate clients on the technique so they have the vocabulary to discuss the technique and ask questions.”
Shimizu also stresses the importance of massage therapists seeking continuing education before offering shiatsu as a service to clients. “It is important that before the massage therapist performs shiatsu on a client they understand what they are doing,” Shimizu says. “Incorrect shiatsu treatments to pressure points may cause or create other unintended negative consequences in the body.”
Shiatsu and Career Longevity
Adding shiatsu to the techniques you offer may also prove beneficial for career longevity. The technique is completely different from Swedish massage, so gives massage therapists another way to use their bodies and helps them avoid fatigue or overworking one specific area.
“The therapist keeps their thumbs extended and uses their body to apply pressure, leaning in as they apply pressure and leaning back as they release,” Bellmore explains. “The pressure comes from the core of the body rather than just pushing with the thumbs/fingers or hands.”
Scranta acknowledges a similar benefit, though uses “hara” when referring to a person’s core. “When practicing shiatsu, massage therapists work from the hara, as a whole unit, thus creating a fluid movement,” she says. “They are flexible, using thumb, palm, knee, arm, feet for the session. A massage therapist who offers shiatsu may add longevity to their career.”
Similarly, Shimizu says: “Shiatsu methods can vary and many massage therapists find that shiatsu can be more gentle from an application standpoint.” However, as with any type of therapy a massage therapist may provide, proper body mechanics and a good self-care routine will help increase longevity and avoid injury.
Shiatsu Self-Care: A Quick Protocol for Better Sleep
If you have trouble relaxing into a good night’s sleep, Leisa Bellmore, MSc, ST, offers a quick hand self-shiatsu protocol, which in several studies has demonstrated subjective improvements in sleep.
- Begin with the four rows of three pressure points on the back of the hand, starting with the row between the thumb and forefinger and moving toward the pinkie finger.
- Apply pressure, always working toward the fingertip. Pressure should be comfortable, and can gradually increase.
- Then, move onto the next row (between the forefinger and middle finger) and continue until you’ve covered all four rows.
- From there, move to the three points on the front and back of the thumb. There are two points between the first two joints (between the metacarpal-phalangeal joint and the inter-phalangeal joint) and another on the nail bed.
- Apply pressure to the front and back of the thumb at the same time, again working toward fingertip.
- Then, apply pressure to the three points on the side of the thumb, always making sure pressure is comfortable.
- Move onto the four pressure points on each finger (two between the metacarpal-phalangeal joint and the inter-phalangeal joint, one between the two inter-phalangeal joints and one on the nail bed), working toward the fingertip and applying pressure front and back, then on sides.
- Lastly, turn your hand over and do the three pressure points on the thenar eminence and then three points down the center of the palm.
According to Bellmore, repeat each section three times, as it’s the repetition that helps to promote relaxation.
Massage Therapy Journal
Relief Within Reach: Massage & Stress
1. Zittoun C, Garbous W, Raffin H, Gusso G. "Le shiatsu: Shiatsu: A complementary medicine for the relief and verbalization of trauma." Encephale. 2022 Sep;48.
2. Kobayashi D, Takahashi O, Hayashi H, Shimbo T. "The Effect of Shiatsu Therapy on Sleep Quality in Patients With Low Back Pain: A Secondary Analysis." Holist Nurs Pract. 2023 Mar-Apr 01;37(2):71-77.