When the founder of Shiatsu Therapy, Tokujiro Namikoshi-sensei, was seven years old, he completely cured his mother who suffered from rheumatism. He used only his thumbs, fingers and palms in applying pressure to her body. This was the beginning of Shiatsu in 1912. His continuing studies lead him to the establishment of an anatomical and physiological theory of Shiatsu. He further developed his theory at his school which he opened to train Shiatsu therapists. As a result of continued presentation of his work, in 1964 the Ministry of Health of the Japanese National Government recognized Shiatsu as a uniquely Japanese therapeutic treatment.
The word “Shiatsu” is thought to have been used first by Tenpeki Tamai about the year 1900. Namikoshi-sensei was influenced by this, and gave the name “Shiatsu Ryoho(Treatment)” to the therapeutic method he had invented, thus establishing modern Shiatsu therapy.

The Root of Shiatsu

The root of Shiatsu is ‘Te-ate’ (which means ‘hands-on’ in Japanese). When we feel pain, we usually place a hand on the affected area in attempt to relieve the pain.

This behavior is called ‘Te-ate’, and nowadays the word ‘Te-ate’ indicates medical treatment in general.

More than 2000 years ago in Japan’s mythological age, an old Waka (Japanese poem) talks about the first doctor in Japan, named Sukunahikona-kami, healing people with his bare hands.

There are many records throughout the world of people healing with their bare hands and over time this practice has developed to become massage in Europe, chiropractic in the USA, Anma/Tsuina in China, and Shiatsu in Japan.

History of Shiatsu

1905 Tokujiro Namikoshi-sensei was born.
1912 He healed his mother of rheumatism. (The birth of Shiatsu)
1925 The very first Shiatsu Clinic was opened in Hokkaido.
1933 A Shiatsu clinic was opened in Tokyo.
1940 A Shiatsu school that later became known as ‘The Japan Shiatsu College’ was opened.
1953 Namikoshi-sensei visited Dr. Palmer of the Palmer Chiropractic School in Iowa, U.S.A. (The first introduction of Shiatsu in the West.)
1955 The Japanese Ministry of Health and Welfare officially recognized Shiatsu, Anma, and Massage in the same category.
1957 The Japanese Ministry of Health and Welfare issued a legal definition of Shiatsu.
1957 Japan Shiatsu College became one of the schools sanctioned by the Ministry of Health.
1964 The Japanese Ministry of Health reviewed the regulations and acknowledged Shiatsu, Massage Therapy and Anma as unique and independent therapeutic methods.


Shiatsupractors perform Shiatsu by pressing with their thumbs, fingers and palms on Shiatsu points throughout the body to enhance the body’s natural healing ability and prevent the progression of disease. Shiatsu points are called “Tsubo” in Japanese and their location and the effect of Shiatsu on them is based on an understanding of modern Anatomy and Physiology. These points are effective in treating all body systems including the Integumentary, Muscular, Nervous, Circulatory, Skeletal, Endocrine, and Digestive systems. They are applicable only to Shiatsu Therapy and are not related to ancient “Chinese Meridians” for Acupuncture, Moxibustion or Anma therapy.
The Japanese expression “Shindan soku Chiryo”, means “Diagnosis and Therapy Combined” and is the essence of Shiatsu. The thumbs, fingers and palms of trained and experienced Shiatsupractors are sensitive enough to detect, on contact, irregularities in the skin, muscles or body temperature. Relating to “the Cutaneovisceral Reflexes”, in the course of practical experience, Shiatsupractors are able to locate abnormalities and ascertain their degree, as well as determining the condition of the organs. When detecting abnormalities, Shiatsupractors apply Shiatsu as a treatment at the same time. The amount of pressure and its tempo are gauged to apply the appropriate pressure for each patient – sometimes strong or soft – quick or slow. Lacking the sensitivity of the hand, knuckles, elbows, knees and feet are not used for application of pressure during treatments by Shiatsupractors. Mastering the essence of Shiatsu requires many years of practical experience and is the goal of a Shiatsupractor.


There are many Shiatsu workshops held in Japan. These workshops are mostly organized by graduate students from the Japan Shiatsu College, who learned Shiatsu directly from Tokujiro Namikoshi sensei. In some cases, the workshops become very popular not only in Japan but throughout the world. A good example is Zen-Shiatsu created by the late Shizuto Masunaga sensei. The techniques taught at these workshops, however, are not recognized as Shiatsu treatment according to government regulations. Consequently, if a person only has a certificate from attending a workshop, s/he is not eligible to take the government examination to become a professional Shiatsu practitioner. The techniques taught at these workshops are called ‘Derivative Shiatsu’ to distinguish them from the original Shiatsu taught at the school that is registered with the Ministry of Health of Japan.
The Following are Well-Known Forms of Derivative Shiatsu

Tsubo Shiatsu

Some of the accredited schools of the CSSBC teach Tsubo Shiatsu in the Advanced Shiatsu course. This course investigates Tsubo points from an anato-physiological point of view. Around 1980, Dr. Hiroshi Ishizuka M.D. (current principal of the Japan Shiatsu College) first introduced this theory in his seminars. In 2003, Kiyoshi Ikenaga senseipublished the book <<Tsubo Shiatsu>> and finally presented the theory to the world. Ikenaga sensei studied Shiatsu directly from Namikoshi Sensei, who is the founder of Shiatsu, and graduated from the Japan Shiatsu College in 1986.

Meridian Shiatsu

This Shiatsu treatment is based on TCM (Traditional Chinese Medicine) theory. Tadashi Izawa sensei published his book <> in 1964. Meridian is the joining of the points which represent the energy (ki) of the organ, body parts or body materials. In Meridian Shiatsu, practitioners press the Meridian points with their thumbs therefore some believe that this technique should be deemed as a form of Acupressure. There is no set theory with regards to the treatment. (Some use the Root-Branch Treatment theory, some just press the Meridian points which are close to the problem area). Izawa sensei studied Shiatsu directly from Namikoshi Sensei, who is the founder of Shiatsu, and graduated from the Japan Shiatsu College in 1946. Later, he became an instructor at the college.

Tao Shiatsu

Ryukyu Endo sensei introduced this form of Derivative Shiatsu. He followed Zen Shiatsu theory, but left ‘Iou-kai’ after Masunaga sensei died. This theory contains religious and spiritual practicum. There are several one- and two-day workshops available in Tokyo and Kyoto. Endo sensei studied Shiatsu directly from Namikoshi Sensei, who is the founder of Shiatsu, and graduated from the Japan Shiatsu College.

Oha Shiatsu

OHASHIATSU is a registered trademark. This technique was derived by Ohashi sensei, who did not graduate from the Japan Shiatsu College. He took a three-day Shiatsu workshop, which was held by Tokujiro Namikoshi sensei when he came to U.S.A in 1973. This derivative contains less thumb pressure application to the body and focuses more on balancing the body through the ‘Seitai’ technique. Seitai is type of stretch or manipulation done to the body to maintain the best balance of the body.

Macrobiotic Shiatsu

The Macrobiotic Diet is well known in the world right now. Michio Kushi sensei is the developer of the Macrobiotic Diet. He mainly practices complementary medicine which is based on diet, acupuncture, meditation, Shiatsu and Chinese Herbal Medicine. They teach Macrobiotic Shiatsu as part of the Macrobiotic Career Training course at the Kushi Institute (non-profit educational organization) in Vermont, U.S.A. Kushi sensei was not trained in Shiatsu therapy at the Japan Shiatsu College. Some of the accredited schools of the CSSBC teach the Macrobiotic Diet in the Nutrition course.

Zen (Ioh kai) Shiatsu

This form of Shiatsu was derived by Shizuto Masunaga sensei. Because “Zen” is a religious word, this form of treatment was not called ‘Zen Shiatsu’ in Japan. This is a part of Meridian Shiatsu, but follows a separate Meridian theory from that of TCM. In Zen Shiatsu, practitioners use their elbows, knees and bony parts of the body to apply stronger pressure to the Meridian points instead of using their thumbs, fingers or palms. For this reason, some believe that this technique should not be defined as ‘Shiatsu’. A three-month long, non-credit workshop is available at the ‘Iou-kai Shiatsu Centre’, opened by Masunaga sensei in Japan. Masunaga sensei studied Shiatsu directly from Namikoshi Sensei, who is the founder of Shiatsu, and graduated from the Japan Shiatsu College in 1958.


Shiatsu treatment technique is enhanced and learned through experience and thus different Shiatsu techniques will exist with each Shiatsu practitioner. There should, however, be a minimum of Shiatsu training and education completed in an appropriate Shiatsu training college or school. (The standards of such an institution should be the same as those set by the Ministry of Health of Japan. These standards include Basic Shiatsu training; basic medical sciences such as Anatomy, Physiology and Pathology; and clinical practicum. There should be a minimum of 2 years (2000 hours) of training. A practitioner who completes a short-term workshop should not be called a Professional Shiatsupractor.


Tokujiro Namikoshi Sensei, the Founder of Shiatsu Therapy, was born November 3rd, 1905 in Kagawa prefecture on Shikoku Island, Japan. When he was 7 years old, his family moved to Hokkaido where the weather was cold and harsh. His mother “Masa” developed rheumatoid arthritis as a result of hard physical labour and the change from a warm to a cold, damp climate. There was no doctor or medicine available due to the isolation. Tokujiro, only 7 years of age, tried to ease his mother’s pain. He discovered that she felt better when he pressed on her body with his thumbs, rather than stroking or rubbing. He concentrated his pressure on points which he found on the cervical region of her spine as well as the middle and lower back. As he applied himself, he also learned the relationship between the Adrenal glands and rheumatism. Eventually Masa’s rheumatoid arthritis was cured by Tokujiro’s treatment. She lived in good health to be 88 years of age.

From his study and practice he subsequently developed a scientific anatomical and physiological theory which explained his treatment. This unique Japanese hands-on therapy, he called “SHIATSU” (meaning thumb and finger pressure in Japanese). He then opened his Shiatsu clinic in Sapporo in 1925 and in Tokyo in 1933. In 1953, he was invited to introduce his Shiatsu at the Palmer Chiropractic School in Iowa, U.S.A. There he developed a good relationship with Dr. B.J. Palmer who was a founder of Chiropractic.

Toru Namikoshi Sensei, who is a son of Tokujiro, stayed at the Palmer Chiropractic School for 7 years to study and compare Shiatsu and Chiropractic. After he returned to Japan from the U.S., he contributed to the development of Shiatsu Therapy based on modern Anatomy and Physiology.

In 1940, Tokujiro established his school, the Japan Shiatsu College in Tokyo, and began to train Shiatsupractors / Shiatsu Practitioners. This was the first Training school in the world for Shiatsupractors / Shiatsu Practitioners. In 1955, the Japan Shiatsu College was officially licensed by the Ministry of Health in Japan. At present, the 3 year Registered Shiatsu Therapist program requires students to be in full attendance for 2500 hours. Upon successful completion of the program the students are eligible to take a government examination.

In 1955, Shiatsu Therapy was first authorized by the Ministry of Health in Japan. At that time the Ministry mistakenly assumed that Shiatsu and Western massage were partially Anma, a type of Acupressure massage from ancient China. In 1964, The Ministry of Health in Japan realized that Japanese Shiatsu and Western massage didn’t belong to Traditional Chinese Medicine and amended the law so that Anma from China, Shiatsu from Japan and Massage from the West were all realized as different and unique therapies. Finally, Shiatsu Therapy obtained legal acknowledgement as a unique therapy.

Today, the Ministry of Health in Japan authorizes Acupuncture, Moxibustion, Anma, Massage and Shiatsu as “Alternative Therapies” which it regulates under the license system. This licensing system has promoted a misunderstanding that Shiatsu belongs to traditional Chinese Medicine. This is because the Japanese Ministry of Health considers Japanese Shiatsu, Western Massage and Anma, (all hands on therapies) to be in one category, As such, they all come under one license.

Therapists are required to pass government exams. Every student in Japan who wants to become a Shiatsu Therapist or a Registered Massage Therapist must learn the Chinese Meridians to pass the examination. Students who pass are officially called an “Anma, Massage and Shiatsu Therapist”.

It is important to recognize that Shiatsu and Western massage do not belong to Traditional Chinese Medicine. Shiatsu Therapy was first authorized by the Japanese Ministry of Health in 1955. At that time, the Ministry considered Anma (a type of acupressure massage from China), Western Massage and Shiatsu all as one inclusive therapy. It was not until 1964 that Shiatsu and Western Massage were recognized by the Ministry of Health in Japan as distinctly different therapies not belonging to Traditional Chinese Medicine.

Although the word “Shiatsu” is originally Japanese, its meaning has come to be understood in English speaking counties and throughout the world.


“Shiatsu means shiatsu as originated by the founder of shiatsu, Tokujiro Namikoshi Sensei. It is the application of manual and digital pressure to the skin with the aim of preventing and curing illness by stimulating the body’s natural powers of recuperation, eliminating fatigue-producing elements, and promoting general good health.”
– from ” The Complete Book of Shiatsu Therapy” written by Toru Namikoshi

“Shiatsu technique refers to the use of fingers and the palm of one’s hands to apply pressure to particular sections on the surface of the body for the purpose of correcting the imbalances of the body, and for maintaining and promoting health. It is also a method contributing to the healing of specific illnesses.”
– from ” The Theory and Practice of shiatsu” published by the Ministry of Health in Japan, in 1957.

Indications and Contraindications

Acoording to Ministry of Helth in Japan, and the book “The Theory of Anma, Massage, and Shiatsu” published by Toyo Ryoho Gakko Kyokai Kyokasho Shippitsu Shoiinkai, in 2004, Shiatsu is an Alternative and/or Preventive Medicine.

Shiatsupractors must have knowledge of medical foundations and clinical experience in order to develop a treatment plan. The following are some examples of conditions which may be improved and/or prevented by receiving Shiatsu Therapy.


Nervous system disorder
E.g.: neuralgia, paralysis、convulsions、stroke recovery、polio、insomnia
E.g.: rheumatoid arthritis、muscle aches、muscular atrophy、myositis、tendonitis、adhesion ablation、joint deformation、recovery of broken bones、dislocations and sprains
Digestive system disorder
E.g.: gastroptosis、chronic gastritis、gastro-intestine atony、chronic enteritis、chronic constipation
Circulatory system disorder
E.g.: heart neurosis、hyperemia、congestion、anemia
Urinary organ & reproductive organ disorder
E.g.: paralysis、bladder convulsions、cystitis、mammary gland disorder
Metabolism disorder
E.g.: gout、beriberi
Fatigue recovery & Rehabilitation
*depending on the condition, it may be necessary to follow a Medical Doctor’s diagnosis and/or advice for the treatments.


Acute disorder
E.g.: acute disease with fever、acute communicable disease
Malignant tumour
E.g.: cancer、sarcoma
Acute poisoning
E.g.: snake poison、insect poison
Acute inflammation
E.g.: peritonitis、appendicitis
Bleeding disease
E.g.: hemoptysis、bloody vomit、right after cerebral hemorrage
E.g.: wounds、broken bones、right after dislocation
Serious internal organ disease
E.g.: chronic valvular disease、nephritis
Vessel disease
E.g.: aneurysm、serious arteriosclerosis
E.g.: gastric ulcer、duodenal ulcer
E.g.: pulmonary tuberculosis、back bone carie
Venereal disease、suppuration disease
E.g.: syphilis, gonorrhea