The Definitive Guide To Shiatsu Massage


How does Shiatsu Massage work?

The theory behind Shiatsu is that when a patient has poor physical health, their mental and emotional state can also be affected. This cycle can work any way, as all three (mental, emotional, and physical) work in harmony. Therefore, all areas must be involved to wholly heal the body.

Shiatsu therapists apply pressure to acupressure points in the body, to increase energy flow and correct imbalances. As with any massage, the pressure applied to the muscles releases toxins, relieves tension, and realigns any problem areas. It also focuses on the Qi of a patient, as the flow of Qi through meridian channels helps to heal the body.

Shiatsu Massage techniques

Shiatsu Massage has evolved since its creation, and different styles exist. These can include an extra focus on meditation, dietary guidance, water Shiatsu, Acupuncture, and breathing techniques. All Shiatsu styles use similar massage techniques, including:


Applying pressure along or against muscles releases a build-up of toxins within the body. Used in many massage techniques, pressure helps a therapist identify problem areas, and re-aligns muscles in a healthy manner. In shiatsu, pressure also removes blockages along the meridians, allowing the Qi to resume a proper flow, which benefits the entire body.


The thumbs, fingers, and heel of palms are used to repetitively knead muscles in a slow motion – similar to the motion of kneading bread. This helps to relieve any tension in the muscles and makes them more pliable. The repetitive motion also works out knots, and breaks down scar tissue.


Quick finger tapping stimulates muscles, particularly in tender areas such as the face. The same technique can be used with fists for larger areas, like the back or glutes. This helps to engage sluggish muscles and improves nerve function. It also helps a patient identify muscles that may be more dormant.

What can I expect from my first Shiatsu Massage appointment?

Knowing what to expect from your first appointment is helpful, as it does differ from other massages. Things to know before your first session include:

  • Wear loose, light clothing. This massage style doesn’t incorporate oils, and therapists don’t expect patients to remove their clothing. For the massage to be effective, light clothing is best. Undergarments such as bras may be removed from under the clothing when you arrive, as they can hinder massage strokes.
  • A 5-10 minute consultation is common when you arrive. Shiatsu focuses on healing the entire body through energy realignment as well as physical massage, so the more the therapist knows, the better. The therapist will ask you about any old or recurring injuries/problem areas, as well as areas you would like them to focus on. It’s important to let any massage therapist know of any past injuries, as they can create scar tissue build-up.
  • The therapist may also ask about your current levels of stress or energy, sleeping patterns, eating habits, and the general routine of your life. This helps them determine any patterns of imbalance, and design the most effective massage therapy for you.
  • As Shiatsu focuses on the flow of Qi throughout the whole body, areas you may not expect, such as the face, jaw, and ears, may also be incorporated into your session.
  • As talking can help to release emotions and re-align your Qi, your therapist may encourage talking during the session. It is up to you how comfortable you are doing this, or if you would prefer quiet.
  • There will be a certain level of discomfort during your session. If it is your first time, your Qi may be blocked, and your body will be holding tension. Excessive pain is not to be expected, but a high level of discomfort can occur. You always have the option to ask your therapist to pause, or use less pressure in certain areas.
  • The therapist will tell you to drink a lot of water after your appointment, and to avoid alcohol and cigarettes for a day or so. This is to ensure the toxins released from your muscles during the massage are flushed out of your system properly, and don’t build up.
  • It is normal to experience soreness, stiffness and headaches a day or two after a massage. In any massage, as blood circulation increases, nutrients are delivered to your muscles. This can cause a type of inflammation, especially if you are not used to Shiatsu. Soreness is a physical response to the inflammation this stimulation can cause. You may also experience emotional release, as Shiatsu Massage is about healing your entire body, not just the physical aspect.
  • Lastly, you can expect at least some pain alleviation after your soreness has disappeared! While some areas of tension, particularly scar tissue, can take a while to break down, regular tight muscles should feel more relaxed in the week following your massage.



  1. Carlos Sama, 2016, What is Shiatsu Massage Therapy?, Acupuncture Massage College.
  2. Cari Johnson Pelava, 2016, Shiatsu, University of Minnesota. 
  3. 2019, Styles of Shiatsu, Shiatsu Therapy Association of Australia.
  4. Michael Reed, 2020, Acupressure Massage Techniques, Acupressure.com.  
  5. Renee Skuban, 2017, The Benefits of Giving and Receiving Shiatsu Massage, Acupuncture Massage College.