Massage Therapy Modalities – Shiatsu

Shiatsu is a form of Japanese bodywork that uses finger pressure. Practitioners may also apply pressure with hands and elbows and may use other manual techniques such as stretching. Shiatsu focuses on the body’s meridians and on specific points along the meridians. Like other forms of Asian bodywork, Shiatsu intends to influence energy, or Chi. The experience may be relaxing or invigorating. While the roots are ancient, Shiatsu, as it is currently practiced, developed alongside (relatively) modern medicine. In Shiatsu, unlike classic Western massage, clients remain clothed.

There are similarities between Shiatsu and acupressure, but proponents maintain that they are separate forms of bodywork. Like many forms of bodywork, Shiatsu is practiced in different ways. The American Organization for Bodywork Therapies of Asia (OABTA) has composed teacher standards for six of these. According to the UK-based Shiatsu Society, there are multiple styles common in Britain. There is some overlap between those noted by OABTA and those noted by the Shiatsu Society.

Shiatsu Credentialing

A Shiatsu practitioner will generally need licensure as a massage therapist or bodywork professional. There are some exemptions. One Tree Guild has put together a list of relevant state text ( Some specifically reference Shiatsu. Others give descriptive information that may require clarification. In some instances, it is important that a person be practicing under the auspices of an established profession. Practitioners will want to make sure information is accurate and current.

Becoming a Shiatsu Bodywork Professional

Training pathways will vary considerably from one place to another and may involve more than just availability of classes. Also at issue: Will the person require licensing and, if so, what specific coursework requirements has the state set?

A person might start with a comprehensive program in Asian bodywork or a combined Eastern/ Western massage/ bodywork program. He or she might instead complete a massage therapy program at the onset and pursue advanced training in Shiatsu later. There is a good chance that the individual will get at least a little exposure to Shiatsu in the initial educational program.

The American Organization for Bodywork Therapies of Asia recognizes bodywork programs of 500 or more hours that meet specific curricular requirements. The student will have at least 100 hours of anatomy and physiology and at least 100 hours of Chinese medical theory. Chinese medical theory will include concepts such as chi, yin/ yang, the five elements, channels and effective points, and causes of imbalance. The program will include at least 160 curricular hours related to techniques and practices, at least 70 hours of clinical practice, and at least 70 hours of other practice-related competencies, including first aid, law, and ethics. Supervised clinical practice may be referred to as ‘student clinic hours’ – clients are members of the general public.

AOBTA has provided a directory of recognized programs (

There are commonalites between AOBTA-recognized programs and programs that focus primarily on Western massage. Both include anatomy and physiology. Both include legalities and ethics and other concepts necessary for safe practice. Both give practice opportunities, though there are differences in what the student will be practicing.

Some massage therapy/ bodywork programs include substantial preparation for both Eastern and Western massage. They may even note graduate eligibility for membership in the American Organization of Bodywork Therapies of Asia. As a very common Eastern modality, Shiatsu may get quite a bit of attention. Programs that offer substantial background in Eastern and Western techniques are often significantly longer than what is required for licensure.

A prospective practitioner will typically take one or more exams. In most cases where licensure is required, the individual will need to take a general massage and bodywork examination. This will most likely be the MBLEx. The exam covers only the basics of Asian bodywork: things that bodywork professionals would generally be expected to know. However, it also covers many broad concepts like anatomy, kinesiology, ethics, and professional practice.

A few states accept the National Certification Commission for Acupuncture and Oriental Medicine examination.

Some massage therapists pursue in-depth shiatsu training after credentialing. In fact, some Shiatsu training programs only admit students who already hold licensure as massage therapists. The number of training hours varies. A massage therapist may purchase a significant block of continuing education: 150 hours or so.

Styles of Shiatsu

Shiatsu is a relatively broad discipline with multiple styles of practice. The American Organization for Bodywork Therapies of Asia recognizes the following six:

  • Macrobiotic Shiatsu
  • Shiatsu Anma Therapy
  • Zen Shiatsu
  • Five Element Shiatsu
  • Integrative Eclectic Shiatsu
  • Japanese Shiatsu

Some styles represent hybrids of Shiatsu and other massage or bodywork modalities. Integrative Eclectic Shiatsu incorporates Western massage and Traditional Chinese Medicine as well as Japanese Shiatsu. Shiatsu Anma Therapy incorporates another form of Japanese bodywork, Anma.

The body of research is limited, though many report being helped. The European Shiatsu Federation has made available a cross-national study of shiatsu ( Recently published research has focused on refractory headaches ( and fibromyalgia (, among other conditions. Research into the effects of acupressure is sometimes cited as evidence for Shiatsu, though the practice is not without critics (