Shiatsu指圧指圧（しあつ）

Accounts of shiatsu discuss sustained pressure, posture, breathing and waiting for the recipient’s response. These do not promise a fixed intensity or bodily response.

Namikoshi and Masunaga traditions differ in educational background and descriptive language. Anatomical accounts and meridian concepts should each be introduced in their own context.

Some people prefer quiet, others verbal check-ins. Rather than deciding the right pressure for someone, a session can make room for them to change their preference.

From the 1970s shiatsu spread through Japanese teachers and practitioners who had studied in Japan. In the United States Wataru Ohashi taught 'Ohashiatsu'; in Europe Masunaga's students taught Zen shiatsu, and the Shiatsu Society UK (1981) and the European Shiatsu Federation (1994) set professional standards. In Austria and Switzerland it is an officially recognised complementary therapy.

In Japan shiatsu is part of the national licence of Anma-Massage-Shiatsu Practitioner, classed as a medically related practice requiring three or more years of vocational school and a national examination. At the same time 'shiatsu-style' treatments are offered in unlicensed relaxation shops, and licensed practitioners' associations campaign for the distinction to be kept.

Clinical studies report short-term benefits for chronic low back pain, shoulder stiffness, insomnia and anxiety, and better-quality research is called for in the UK and Europe. Contraindications are those of pressure therapies generally: osteoporosis, acute inflammation, tumour sites, and strong pressure on certain points in pregnancy.

Shiatsu lives today in three settings: treatment rooms run by licensed practitioners in Japan, complementary practice abroad, and the schools that train both. Technically, beyond Namikoshi's whole-body basic points and Masunaga's meridians and kyo/jitsu diagnosis, applications have widened to seated shiatsu, side-lying shiatsu for pregnancy, and light-pressure shiatsu in palliative care.

A session runs 40 to 90 minutes. The receiver lies in light clothing on a futon; the practitioner kneels and places sustained pressures of a few seconds each across the whole body with thumbs, palms and elbows. Stretches and joint rotations are included, but pressure remains the protagonist.

Quiet, clothed and needing neither tools nor oil, shiatsu enters hospitals, care homes and offices with ease, and holds a distinctive place among the world's bodywork as a technique born in Japan.