Shiatsu

Shiatsu: A Complete Guide to Japanese Finger Pressure Therapy

Last Edited: Oct 2025

What is Shiatsu?

Shiatsu translates literally to "finger pressure" in Japanese, which gives you a pretty good hint about what to expect. But it's so much more than someone pressing on you with their fingers.

Imagine lying fully clothed on a comfortable mat whilst a practitioner uses their hands, thumbs, fingers, elbows, and sometimes even their knees or feet to apply rhythmic pressure along specific pathways in your body. They'll combine this with gentle stretches and joint movements, creating an experience that feels both deeply relaxing and surprisingly energising at the same time.

Shiatsu emerged from Japan but has its roots in Traditional Chinese Medicine. It's built on the understanding that vital energy, called Qi (pronounced "chee"), flows through your body along specific pathways called meridians. When this energy flows smoothly, you feel healthy and balanced. When it gets blocked or disrupted, you experience pain, fatigue, stress, or illness.

The whole philosophy rests on the belief that your body has an extraordinary ability to heal itself when given the right support. Shiatsu practitioners see themselves as facilitators of your body's innate healing capacity rather than fixers of broken parts. They're helping restore the natural flow and balance that stress, injury, and daily life can disrupt.

Another core concept in Shiatsu is the dance between Yin and Yang energies. Yin represents the passive, receptive, cooling aspects of your being, whilst Yang represents the active, dynamic, warming qualities. We all have both, and health comes from these opposing forces working in harmony rather than one dominating the other. Too much Yang and you're wired, anxious, overheated. Too much Yin and you're lethargic, withdrawn, cold. Shiatsu aims to bring these energies into balance.

What makes Shiatsu special is the practitioner's presence and connection during treatment. They're not just mechanically applying techniques. They're tapping into their intuition and sensitivity, reading your body's energy, and responding to what they feel. Every session is personalised based on what your body needs in that moment rather than following a rigid protocol.

The Origins and Philosophy of Shiatsu

Shiatsu as we know it today was formally developed in the early 20th century, though its roots reach back centuries through traditional Japanese massage techniques called Anma. Two practitioners, Tokujiro Namikoshi and Shizuto Masunaga, were instrumental in shaping modern Shiatsu, each bringing their own approach and philosophy to the practice.

Namikoshi focused on anatomical and physiological aspects, creating a style that could be more easily understood and accepted by Western medicine. He wanted to bridge the gap between traditional Eastern healing and modern scientific understanding. His approach emphasised the physical effects of pressure and manipulation on muscles, joints, and circulation.

Masunaga, on the other hand, developed what's known as Zen Shiatsu. He incorporated a deeper understanding of meridian theory and emphasised the practitioner's intuitive connection with the client. For Masunaga, Shiatsu was as much about the energetic and emotional dimensions as the physical. His approach expanded the traditional meridian pathways and developed new diagnostic techniques that practitioners still use today.

Both lineages continue to influence modern Shiatsu practice, and many practitioners draw from both traditions. Some lean more towards the anatomical approach, others towards the energetic. The beauty is that both work, just through slightly different lenses.

The practice has evolved and adapted as it's spread around the world, but it maintains its core principles: working with your body's energy flow, respecting your innate healing capacity, and treating you as a whole person rather than a collection of symptoms.

Shiatsu Techniques and Pressure Points

Shiatsu incorporates a range of techniques that work together to stimulate energy flow and promote healing. The techniques are designed to address imbalances, release tension, and restore harmony within your body.

Palming and Thumb Pressure

Your practitioner uses their palms and thumbs to apply pressure ranging from gentle to firm on specific areas of your body. Palm pressure feels broad and comforting, whilst thumb pressure can be more focused and intense. These techniques stimulate energy flow, release muscle tension, and promote deep relaxation. The pressure isn't about forcing change but rather about encouraging your body to let go of what it's holding.

Kneading and Rolling

Kneading involves rhythmic, circular movements using the palms, fingers, and thumbs. It feels a bit like bread dough being worked, though obviously much more pleasant. This technique helps stretch and loosen tight muscles, improve circulation, and enhance flexibility. Rolling motions are also used to stimulate energy flow and release tension, creating a wavelike sensation through your tissues.

Stretching and Joint Mobilisation

Shiatsu incorporates gentle stretching and joint mobilisation techniques to improve flexibility, increase range of motion, and alleviate stiffness. These aren't aggressive stretches that push you beyond your limits. They're gentle explorations of your body's current capacity, encouraging it to open just a bit more. The aim is to restore balance and promote a sense of ease throughout your body.

Acupressure on Meridian Points

This is where Shiatsu really distinguishes itself. The practice focuses on specific pressure points along your body's meridian pathways. These meridians are energy channels through which Qi flows, connecting your organs, tissues, and systems. By applying pressure to these points, your practitioner aims to unblock and harmonise energy flow, addressing specific imbalances and promoting overall wellbeing. Some points might feel tender or sensitive, which often indicates an area that needs attention.

Rotational Movements

Rotational movements involve gentle rotations of joints like your wrists, ankles, and shoulders. This technique helps improve joint mobility, release tension, and promote relaxation. You might hear some pops or cracks, which is generally fine if it doesn't hurt. Your practitioner is helping your joints move through their full range of motion.

Commonly Targeted Pressure Points

Hara

Located around your navel area, the hara is considered your body's centre of energy in Shiatsu philosophy. Stimulating the hara helps balance and strengthen your internal organs and promote deep relaxation. Your practitioner often spends time here, both assessing your energy and helping ground you.

Tsubo Points

Tsubo points are specific acupressure points found along the meridians. These are the precise spots where Qi can become blocked or stagnant. Shiatsu practitioners apply pressure to these points to address specific symptoms and imbalances throughout your body. There are hundreds of tsubo points, and practitioners learn which ones relate to different organs, emotions, and conditions.

Back Points

Your back is crucial in Shiatsu, with various pressure points targeted along your spine to release tension, promote relaxation, and support the health of your internal organs. The points along your back, called bladder meridian points, are particularly powerful for affecting your whole system. Many people carry enormous tension in their backs, and working these points can create profound shifts.

Head and Neck Points

Shiatsu includes techniques to address tension and promote relaxation in your head, neck, and shoulders. By targeting specific points in these areas, your practitioner can alleviate headaches, neck stiffness, and stress-related symptoms. This part of the treatment often feels particularly blissful after you've been holding tension in these areas, sometimes without even realising it.

Benefits of Shiatsu

Shiatsu offers benefits that reach from your physical body through to your mental and emotional wellbeing. Research and centuries of practice have shown it can alleviate stress, relieve muscle tension, improve circulation, enhance immune function, promote relaxation, and support emotional balance.

Stress Reduction

This is perhaps what Shiatsu is most renowned for. The gentle pressure and rhythmic techniques stimulate the flow of Qi throughout your body, which helps reduce anxiety, soothe your mind, and induce a state of deep relaxation. Many people describe feeling like they're floating after a session, with their racing thoughts finally quieted. In our constantly stimulated, always-on world, this respite alone is remarkably valuable.

Pain Relief

Shiatsu can be effective for various types of pain, including muscle tension, headaches, back pain, and joint discomfort. Research has shown that Shiatsu therapy combined with standard care for lower back pain improved symptoms and quality of life immediately after treatment. By targeting specific pressure points and using techniques to release tension and promote circulation, Shiatsu helps alleviate pain and supports your body's natural pain management systems. The pain relief often lasts well beyond the session itself as your body maintains the improved energy flow.

Improved Circulation

The techniques used in Shiatsu, such as kneading and stretching, help improve both your blood and lymphatic circulation. Better blood circulation means more oxygen and nutrients reaching your tissues, promoting detoxification and supporting overall cellular health. Your lymphatic system, which doesn't have a pump like your heart, relies on movement and pressure to circulate. Shiatsu provides exactly this, helping clear metabolic waste and supporting immune function.

Enhanced Energy Flow

By unblocking and harmonising the flow of Qi, Shiatsu helps restore your vitality, boost energy levels, and promote a sense of balance and wellbeing. When Qi flows freely, your body's natural healing abilities strengthen. People often report feeling more grounded and in harmony with themselves after treatment. It's not just about feeling relaxed—you also feel more alive, more present in your body.

Muscle Relaxation and Flexibility

Athletes particularly benefit from Shiatsu techniques as they help release muscle tension, leading to improved flexibility and range of motion. This is valuable for anyone with muscle stiffness, postural imbalances, or those seeking to enhance athletic performance. The gentle stretching component addresses not just muscles but also the fascia and connective tissue that can become restricted and limit movement.

Emotional Wellbeing

Shiatsu doesn't only address physical symptoms. It supports emotional balance too. During a session, you might experience emotional release as stored emotions and tensions are freed from your body. We hold emotions in our tissues—grief in the lungs, anger in the liver, fear in the kidneys, according to traditional Chinese medicine. The combination of physical touch, pressure, and energy work can help unlock and release emotional blockages, allowing you to process and let go of unresolved feelings. Don't be surprised if you feel tearful during or after a session. That's often your body releasing what it's been holding.

Shiatsu Compared to Other Massage Modalities

Different massage modalities offer unique techniques and benefits. The choice between them depends on your individual preferences, desired outcomes, and specific needs. Here's how Shiatsu compares to other well-known practices.

Shiatsu vs Swedish Massage

These two approaches are quite distinct. Shiatsu focuses on stimulating your body's energy flow through pressure points and meridians, addressing imbalances and promoting overall wellbeing. Swedish massage primarily uses long, gliding strokes, kneading, and tapping motions to promote relaxation, improve circulation, and relieve muscle tension.

Shiatsu is typically performed clothed and without oils, whilst Swedish massage often involves oils or lotions on bare skin. The experience feels different too. Swedish massage is more passive and soothing, whilst Shiatsu can feel more active and engaging, even though you're not doing the work yourself.

Shiatsu vs Thai Massage

Both Shiatsu and Thai massage work with energy pathways and use pressure applied through the practitioner's body weight. However, they come from different traditions. Shiatsu originates from Japan and focuses on meridians and specific tsubo points, whilst Thai massage comes from Thailand and combines acupressure with extensive assisted stretching and deep tissue techniques.

Thai massage includes much more stretching and movement, sometimes putting you into yoga-like positions. Shiatsu involves some stretching but is generally more stationary, with pressure held at specific points. Both are performed clothed on floor mats, making them similar in that regard.

Shiatsu vs Deep Tissue Massage

These practices have different focuses and approaches. Shiatsu primarily works with energy flow and balancing your body's meridians through pressure points and gentle stretching. Deep tissue massage targets deeper layers of muscle and connective tissue to alleviate chronic muscle tension and address specific musculoskeletal issues.

Whilst both can provide relief from muscle tension and promote relaxation, Shiatsu's emphasis is on energy flow and holistic balance. Deep tissue massage is more focused on addressing specific areas of tightness and discomfort through sustained, deeper pressure techniques. If you have a specific injury or chronic knot, deep tissue might be more appropriate. If you're seeking overall balance and addressing the root causes of tension, Shiatsu might suit you better.

What to Expect in a Shiatsu Session

Understanding what happens during a Shiatsu session helps you feel more comfortable and prepared for your first treatment.

Initial Consultation

Your session begins with your practitioner asking about your health history, current symptoms, and any specific concerns. This conversation matters. Be honest about everything—recent injuries, chronic conditions, stress levels, sleep quality, digestive issues, emotional challenges. In Shiatsu philosophy, everything is connected, so seemingly unrelated information might be relevant.

Your practitioner might also assess your energy by observing your posture, looking at your tongue, feeling your pulse, or palpating your hara (abdomen). These diagnostic techniques help them understand your current state and what your body needs.

Clothing

Shiatsu is performed fully clothed. Wear loose, comfortable clothing that allows freedom of movement—think yoga pants or tracksuit bottoms and a comfortable shirt. Avoid tight jeans, restrictive clothing, or anything with heavy zippers or buttons that might be uncomfortable when you're lying down. Some practitioners provide loose cotton clothing if you need it.

Treatment Space

Shiatsu sessions commonly take place on a mat or futon on the floor, though some practitioners use massage tables. The treatment space should feel quiet, peaceful, and conducive to relaxation. The room might be dimly lit, and there might be soft music playing, though some practitioners work in silence to help you turn inward.

Techniques Applied

Your practitioner uses their fingers, thumbs, palms, elbows, and sometimes knees or feet to apply pressure and rhythmic movements along your body's energy pathways. The pressure varies depending on your needs and preferences, ranging from gentle to firm. They might also incorporate stretching, joint mobilisation, and gentle rotations.

The pressure should feel good, even when it's intense. There's a difference between therapeutic discomfort and pain. If something hurts in a bad way, speak up immediately.

Holistic Approach

Shiatsu addresses your entire body, not just specific symptoms or areas of discomfort. Your practitioner will typically work on different areas including your back, neck, shoulders, arms, legs, and feet. The sequence and techniques used vary depending on your practitioner's training and the specific style of Shiatsu they practice, as well as what your body needs in that moment.

Sensations and Communication

During the session, you might experience various sensations such as warmth, tingling, or a sense of deep relaxation. Some points might feel tender or sensitive—that's normal and often indicates an area that needs attention. It's important to communicate with your practitioner about any discomfort, pain, or sensitivities you feel. Open communication helps them customise the treatment to your comfort level and needs.

Session Duration

A Shiatsu session usually lasts between 60 and 90 minutes, though shorter or longer sessions may be available depending on your practitioner's offerings and your needs. The full 90 minutes allows time for a comprehensive treatment that addresses your whole body.

Post-Session Recommendations

After the session, your practitioner may offer self-care recommendations such as stretches, lifestyle modifications, or dietary suggestions to support the effects of the treatment. These recommendations are worth following—they help maintain the benefits between sessions. You might also be encouraged to drink plenty of water to help flush released toxins.

Some people experience delayed onset muscle soreness for 24 to 48 hours after the session, similar to how you might feel after a good workout. This is normal and indicates your body is responding to the treatment.

Who Can Benefit from Shiatsu?

Whether you're seeking relief from physical discomfort, stress reduction, or overall wellbeing enhancement, Shiatsu can suit people of various ages and conditions.

Shiatsu can benefit pregnant women (though certain points are avoided during pregnancy), athletes seeking to improve performance and recovery, individuals with chronic pain, and those seeking preventive care. It's particularly helpful for people dealing with stress-related conditions, musculoskeletal issues, digestive problems, headaches and migraines, sleep disturbances, and emotional imbalances.

The holistic nature of the practice means it addresses your whole being rather than just isolated symptoms. You don't need to have a specific problem to benefit from Shiatsu. Many people receive it regularly as a form of preventive care, maintaining balance before imbalances become problems.

Frequently Asked Questions

Is Shiatsu safe?

Yes, Shiatsu is generally safe when performed by a qualified practitioner. The techniques are gentle and non-invasive, working with your body's natural energy systems rather than forcing change. However, certain conditions require caution or modification.

Always inform your practitioner if you're pregnant, have recently had surgery, have osteoporosis, blood clots, severe varicose veins, cancer, or other serious medical conditions. A qualified practitioner will adjust their techniques or suggest alternative treatments if Shiatsu isn't suitable for your specific situation. They know their scope of practice and won't work outside it.

How many Shiatsu sessions will I need?

The number of sessions varies depending on your individual needs and goals. Some people experience significant benefits after just one session, particularly for stress relief and relaxation. You might walk out feeling lighter, more grounded, more yourself.

For chronic conditions or deeper healing work, you'll likely benefit from a series of sessions. Many practitioners recommend starting with four to six sessions to allow your body time to respond and rebalance. Some people continue with regular maintenance sessions every few weeks or months to support ongoing wellbeing. Your body didn't develop its patterns overnight, and it often takes time to shift them.

What should I wear to a Shiatsu session?

Wear loose, comfortable clothing that allows easy movement—tracksuit pants and a t-shirt work perfectly, or anything similar. Avoid tight jeans, restrictive clothing, or anything with heavy zippers or buttons that might be uncomfortable when lying down. You'll remain fully clothed throughout the session, so choose something you feel relaxed in. Think comfort over fashion.

Will Shiatsu hurt?

Shiatsu shouldn't be painful, though you might experience some discomfort when your practitioner works on areas of tension or blockage. The pressure applied can range from gentle to firm, and good practitioners always check in with you about your comfort level.

You might feel what's sometimes called "good pain" or "therapeutic discomfort"—a sensation that feels intense but ultimately relieving. It's like pressing on a bruise: it hurts a bit, but there's also something satisfying about it. Always communicate with your practitioner if anything feels too uncomfortable or painful in a bad way.

How much do Shiatsu sessions cost?

Shiatsu sessions typically cost between $80 and $150 in Australia, depending on the practitioner's experience, location, and session length. Initial consultations may be slightly more expensive as they include comprehensive assessment time. Your practitioner needs to understand your whole health picture before they can work with you effectively.

Some practitioners offer package deals for multiple sessions, which can reduce the per-session cost. You may be able to claim rebates through private health insurance under remedial massage or natural therapies, depending on your practitioner's qualifications and your level of cover. Always check with your insurer about specific coverage.

How do I find a qualified Shiatsu practitioner?

When looking for a Shiatsu practitioner, seek someone who's completed recognised training through a reputable Shiatsu school or organisation. In Australia, look for practitioners registered with organisations such as the Shiatsu Therapy Association of Australia or the Australian Traditional Medicine Society.

Read reviews and testimonials from previous clients to get a sense of their approach and effectiveness. Consider whether their style and philosophy resonate with you and your health goals. During an initial consultation or phone call, notice whether they listen carefully, explain their approach clearly, and create an environment where you feel comfortable asking questions.

Can I receive Shiatsu if I'm pregnant?

Yes, Shiatsu can be beneficial during pregnancy, but it requires a practitioner trained in prenatal Shiatsu techniques. Certain pressure points are avoided during pregnancy as they can potentially stimulate contractions or affect the pregnancy. A qualified prenatal Shiatsu practitioner knows how to work safely with pregnant clients, often helping with common pregnancy discomforts such as back pain, nausea, and anxiety.

Always inform your practitioner if you're pregnant—even if you think it's obvious—so they can adjust their approach appropriately. If you have a high-risk pregnancy or any complications, check with your healthcare provider before booking treatment.

What's the difference between Shiatsu and acupuncture?

Both Shiatsu and acupuncture work with the same meridian system and aim to balance Qi flow in your body. They come from the same traditional Chinese medicine framework. The main difference is in their methods: acupuncture uses fine needles inserted into specific points, whilst Shiatsu uses finger pressure, stretching, and other manual techniques.

Shiatsu is non-invasive and doesn't break the skin, making it a good option for people who are uncomfortable with needles. Both can be effective, and some people find combining them provides comprehensive benefits. They work with the same principles through different tools.

How will I feel after a Shiatsu session?

After a Shiatsu session, most people feel deeply relaxed and may experience improved energy levels, reduced tension, and a greater sense of balance. Some people feel energised and clear, whilst others feel sleepy and need to rest. Both responses are completely normal.

You might experience what's called a "healing response" in the hours or days following treatment, which can include temporary fatigue, emotional release, increased thirst, or heightened awareness of areas that need attention. These responses are normal and indicate your body is processing and rebalancing. Drink plenty of water, rest if needed, and trust the process. Your body knows what it's doing.

References and Further Reading

Professional Organisations

• Shiatsu Therapy Association of Australia (STAA)
• European Shiatsu Federation
• Shiatsu Society UK
• International Shiatsu Network
• Australian Traditional Medicine Society (ATMS)
• Complementary Medicine Australia (CMA)

Research and Scientific Foundation

• National Center for Complementary and Integrative Health (NCCIH)
• Australian Research Centre in Complementary and Integrative Medicine
• Journal of Alternative and Complementary Medicine
• Evidence-Based Complementary and Alternative Medicine
• International Journal of Therapeutic Massage and Bodywork

Educational Resources

• "Zen Shiatsu: How to Harmonise Yin and Yang for Better Health" by Shizuto Masunaga
• "The Complete Book of Shiatsu Therapy" by Toru Namikoshi
• "Shiatsu Theory and Practice" by Carola Beresford-Cooke
• "The Foundations of Shiatsu" by Chris Jarmey
• Australian Shiatsu College training materials
• Nature Care College Shiatsu programs

Related Modalities

• Acupuncture and Traditional Chinese Medicine: Works with the same meridian system as Shiatsu but uses fine needles inserted into specific points rather than manual pressure, offering a complementary approach to balancing Qi flow
• Tui Na (Chinese Therapeutic Massage): A Chinese manual therapy that combines massage, acupressure, and joint manipulation to treat both musculoskeletal conditions and internal organ imbalances
• Reflexology: Applies pressure to specific points on the feet, hands, and ears that correspond to different body organs and systems, sharing Shiatsu's principle of working with energy pathways through touch
• Craniosacral Therapy: A gentle hands-on technique that works with the subtle rhythms of cerebrospinal fluid, complementing Shiatsu's focus on energy flow by addressing the nervous system directly
   

This guide was written by the Bodhi Holistic Hub team according to their editorial policy.