What makes Shiatsu massage unique and how it can improve your flexibility and combat stress

• Shiatsu massage may help relieve headaches, lower back pain, fatigue, and more.
• Shiatsu practitioners may use their thumbs, knees, or elbows during the massage.
• You may feel sore for 24-48 hours after your Shiatsu massage but it shouldn't persist beyond that.

Shiatsu massage is an ancient Japanese healing method. Due to its name - "shi" (finger) and "atsu" (pressure) - it's often described as a form of acupressure.

Medical term: Acupressure is a type of massage therapy that applies pressure by pressing and rubbing certain points on the body.

But Shiatsu massage involves more than just acupressure. It also includes stretches and kneading techniques to improve the range of motion in the joints.

Shiatsu is based in Traditional Chinese Medicine (TCM) and is a very different approach to bodywork from Swedish or Western massage, though both may help relax the body and mind, says Juliet Maris, LMT, an alignment therapist and yoga instructor with a private practice.

Here's what to expect during a Shiatsu massage and how it can benefit people of all ages and fitness levels.

What to expect during Shiatsu massage

A Shiatsu massage is a full-body massage, but where your practitioner starts and stops will vary.

"Different protocols are used depending on what's going on with each individual, so the order could be different," says Maris.

Shiatsu practitioners may use their thumbs, fingers, elbows, and knees to relieve clients' tension and pain points.

Depending on your physical constitution and general energy levels, Kanayama says the therapist will use various techniques including "gentle stretching, holding, pressing with palms, thumbs, fingers, elbows, and knees, and when appropriate, more dynamic rotations and stretches" to promote deep relaxation.

"Open communication between practitioner and client is helpful in this instance," she says. "There can be areas of more intensity, but in general [Shiatsu] feels more like a dance between two people. As with all massage, the client wants to be able to relax and breathe through the work."

Note: Kanayama, who refers to Shiatsu as "energy medicine," trained under her uncle, Ohashi, a Shiatsu pioneer who helped popularize the practice in the US. According to his teachings, Shiatsu's nurturing touch manipulates "Ki energy" ("Qi" in Chinese).

Shiatsu may cause soreness after the massage for some individuals, but it should subside within 24-48 hours. If the intensity of the massage reaches a point where a client is holding their breath or tensing up, Maris says that defeats the purpose. The typical Shiatsu session lasts for about 60-90 minutes.

Benefits of Shiatsu massage

One small 2015 study found Shiatsu may affect neurotransmitters in the brain, increasing serotonin and dopamine levels, which may help reduce anxiety.

The number and quality of published studies on Shiatsu massage are limited, but here are some of the benefits researchers have found so far:

• Improved bowel function
• Decreased fatigue
• Pain treatment
• Improved sleep quality
• Improved relaxation
• Decreased depression
• Headache treatment
• Improvement of chronic lower back pain

At-home Shiatsu massagers vs. professional massage

Experts generally recommend a professional massage over at-home Shiatsu massagers.

"There's a different sensitivity that a human brings to the interchange that's not present otherwise," says Maris.

However, during a pandemic and for a variety of other reasons including finances or location, scheduling an in-person session may not always be possible.

Fortunately, there are a variety of at-home massagers available to buy that focus on different body parts. These include:

• Foot massagers
• Shoulder massagers
• Back massagers
• Neck massagers
• Head massagers

The experts say professional Shiatsu massages have a key benefit over ones you can buy: A human practitioner transfers a sense of healing and energy through their presence and unique personal touch.

"Massagers do not have spirit nor emotions," says Kanayama. "Shiatsu transmits happy, healthy, and balanced energy from practitioner to receiver."

In other words, the basic vibrations and movements that a machine offers can't fully replicate the social experience and compassion conveyed through human touch, nor the expertise of a trained massage therapist.

Although an electronic massager may be more convenient and less expensive than an in-person massage, there is no dialogue with an at-home massager. Plus, research has found that human touch has comforting, stress-reducing benefits in itself.

Who should not get a Shiatsu massage

Trained practitioners can give Shiatsu massages to the majority of healthy people, however, there are a few individuals who should take special precautions.

For instance, someone who is pregnant might find it difficult to lay on their back, says Maris, but a thoughtful practitioner can make modifications with bolsters or have the client lay on their side.

Note: One small 2005 study found that Shiatsu massage may help induce labor. Therefore, those with high-risk pregnancies, a history of miscarriage, or anyone undergoing IVF should not partake.

People experiencing any of the following issues may also want to avoid Shiatsu bodywork:

• Broken bones
• Burns
• Open wound
• Rash
• Athlete's foot
• Fever
• Contagious illness, such as chickenpox or flu
• Blood cancers, such as leukemia
• Uncontrolled diabetes

Additionally, people with a limited range of motion, who recently had surgery, have poor immune systems, and cancer patients need to proceed with caution. Practitioners should apply only gentle pressure and should not touch sensitive areas, such as near the site of a tumor.

Most states require licensure for Shiatsu, but there are some exemptions, such as when the client is fully clothed and the practice is focused on energy work, using only very gentle touch similar to Reiki, another Japanese massage technique, versus intense physical bodywork. The differences between Shiatsu and Western forms of massage are less about pressure and more about technique and environment.

Insider's takeaway

Shiatsu massage is an ancient Japanese healing practice and complementary mind-body treatment based in Traditional Chinese Medicine that promotes relaxation and wellbeing.

"The idea is to bring the body back into balance. Energy is given to the kyo and the jitsu," says Maris.

Some benefits of Shiatsu may include lowered levels of anxiety, decreased pain, improved sleep, and reduced chronic pain.

People who are pregnant, severely ill, or have other symptoms of compromised health, such as a fever, should forgo Shiatsu massage.

While at-home massagers can help relieve tension, experts agree that a professional massage is a more enjoyable, thorough, and fulfilling experience. "A massage from a person always feels better than one from a machine," says Maris.