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What do Shiatsu Practitioners Treat?

by Nicola Pooley(more info)

listed in shiatsu, originally published in issue 24 - January 1998


Shiatsu is currently gaining popularity in the field of bodywork. It is based on the same theory of Oriental Medicine as Acupuncture but uses pressure, stretches and touch to harmonise the energy in the channels. The channels each relate to different types of energy within the body. For example the Kidney channel relates to the kidneys, the back, the bones, the person’s constitution and is represented by the element Water. In Oriental Theory there are five Elements: Fire, Earth, Metal, Water and Wood.

Shiatsu is usually found to be deeply relaxing and invigorating for the mind and body. The process of moving the energy and working on the body together is generally enjoyable. Blockages and areas of stagnant energy are released. Depleted areas are allowed to fill with energy. This year shiatsu was named as one of the eight therapies that were in the Lennoye Report on non-conventional medicine. This report was accepted by the European Union and should allow access to further research funding for non-conventional medicines.

Setting Up Research

The research group of the Shiatsu Society was set up during a memorable teleconference in September 1995. We all agreed how important it was for the Shiatsu Society to enter the research field and apply for the First Rung Award being offered by The Research Council for Complementary Medicine. There had already been a couple of studies on the perceived effectiveness of shiatsu and Thalamic pain and shiatsu. We agreed the Society should conduct a survey on what type of clients and what conditions present for shiatsu across all the practitioners in the Society and how this could lead to a more specific effectiveness study. I’ll never forget the silence as we asked ‘who’ was going to do it. The sun was shining as I heard myself agree to do it.

Philip Harris from the University of Wales Institute, Cardiff agreed to be my supervisor. Our first job was to create the protocol and apply for the grant. The research would be in two parts. The preliminary stage would ask open-ended questions on what conditions clients presented with to 10 practitioners. The second stage would be a nationwide questionnaire. After being accepted for the grant we started work. The aim of the preliminary stage was to get a picture of which illness conditions were presenting for shiatsu treatments. We asked the usual demographic questions: age, gender, ethnic group, employment status and so forth. The two main questions were open-ended. What reasons, if any, did this client give for presenting for shiatsu treatment?

What were the main symptoms described by the client on this occasion?

The Preliminary Stage

When the questionnaire was prepared we asked 10 volunteers to complete them over a ten week period. The ten practitioners filled in questionnaires on 345 clients. These forms were sorted manually (and it is manual work to sort all that paper!).

The Second Stage

The second stage was a snapshot of shiatsu nationwide. All the Shiatsu Society’s registered practitioners were sent a short questionnaire about themselves and three shortened client questionnaires. Our target was to get a response rate of 75% of Shiatsu Society practitioners. My postman often asked when it would be over as he brought me all the replies.

We achieved a response of 83% (329 practitioners). Some of the practitioners were on holiday or ill so that 73% of the Society’s registered practitioners filled in client questionnaires. We then had 792 client questionnaires. This time the data was analysed on computer.

The Results:

The Practitioners

The results from the nationwide survey show the practitioners were a mature group with ages ranging from 26 to 69 years with an average of 43 years. Shiatsu teachers often say doing shiatsu is also beneficial and perhaps the 69 year old is showing us that. Unsurprisingly 73% of the practitioners who responded were female and most practitioners were in the South East of England. 14% of the practitioners indicated that they spent some time working within the National Health Service which also indicates the rise in popularity of shiatsu.

The clients

The nationwide survey showed that most clients were women (72%) and the ages were spread through a whole range with more in the 35–44 year old range reflecting the usual pattern of clients seeking complementary medicine. The preliminary stage also showed that 94% of the clients were white. This figure is probably lower than usual because one of the ten practitioners worked in a drug project. Just under half the clients were in full time employment.

The medical diagnoses given by shiatsu clients when they first came for shiatsu are illustrated in the box. Musculoskeletal problems including arthritis came out on top. Psychological problems such as depression, stress and anxiety were the next most common reason for presenting for shiatsu. Myalgic encephalomyelitis (ME) formed a large part of the general category.

The current symptoms reported by clients at the time of the questionnaire reflected the same pattern of musculo-skeletal and psychological problems. These are shown in  the box (bottom right). These categories were examined for differences between men and women. Apart from the obvious difference of ‘menstrual/menopausal/hormonal problems’, it was interesting to see that men came with significantly more breathing problems. In Oriental theory that could reflect on men having more difficulties with grief.


It should be no great surprise for Shiatsu clients or practitioners that the results of both stages show musculoskeletal and psychological problems were the most common conditions presenting for shiatsu treatments. The most frequent musculoskeletal problems were neck/shoulder problems, lower back problems and arthritis. Depression was the main psychological problem followed by stress and anxiety. Other conditions commonly reported were ME, irritable bowel syndrome, hypertension and asthma.
We are now looking forward to a new study on shiatsu and a musculoskeletal problem such as neck or lower back ache or a psychological problem such as stress or anxiety.
A case study on stress

Erica is a vivacious actress. The most striking thing about her is her attractive appearance and lack of grounding. When she first came for Shiatsu in November ‘96, she was complaining of stress in her work and emotional life. She had “terrifying panic attacks”. She couldn’t sleep and often went all night without sleeping. She had pains running down her back and in her left cheek and jaw. Soon after Erica came for shiatsu her doctor signed her off work and prescribed her Lustral, an anti-depressant.

She was exhibiting a distortion in her fire and earth energy. The shiatsu treatments gave her a sense of warmth in her arms reflecting the fire energy and she also learnt to be more grounded.

At the end of January, Erica reached a turning point. The treatments were enabling fire energy to fill the empty space in her heart. During one treatment she was able to acknowledge her ex-partner. By the end of that treatment she had no physical pain.

By May she was cutting down on her Lustral and was considering going back to work as the panic attacks came less frequently. Shiatsu worked well for Erica. The bodywork aspect gave her the nurturing she craved for; her Earth energy and the energy work helped her stabilise her sense of self via the heart and heart protector (fire) channels.

A case study on
lower backache

Richard is a hard working father of two teenage children. He is also a keen runner and believes in keeping himself going. He came with a lower backache and general stiffness especially in the knees. He used to be a builder and now manages a small building firm.

The shiatsu treatments focused mainly on his water energy and how it relates to the bones. The treatments enabled the energy to fill the spaces between the bones, particularly in the spine and at the back of the knees. Richard gradually got more flexibility in his spine. This in turn let him relax the muscles in his back. This manifested energeti- cally as stagnant energy which was emotional as well as physical.

This dispersed gradually as the back got stronger.

Shiatsu suited Richard well as the bodywork suited his concept of keeping fit and was a vehicle for the energetic changes which took place on an emotional level.


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About Nicola Pooley

Nicola Pooley is the principal of the Shiatsu College in Bristol, 46 Station Rd., BS7 9LB and Philip Harris is a lecturer at the University of Wales Institute, Cardiff in the Faculty of Community Health Sciences, Western Avenue, Cardiff CF5 2YB.

A full copy of the report to the Research Council for Complementary Medicine and the Shiatsu Society can be obtained from the Shiatsu Society at: The Shiatsu Society, The Interchange Studios, Dalby St, London NW5 3NQ3

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