Shiatsu and Its Overseas Diffusion

Written by : Kiyoshi Ikenaga, Shiatsmaster
Translated by : Yumi Yabuta
Edited by : Samantha Orr Levrat, Shiatsupractor


  • The Definition of Shiatsu
  • The Essence of Shiatsu
  • The History of Shiatsu (The Beginning- The Origin of Shiatsu)
  • The History of Shiatsu (The Middle - The Path to Legal Recognition)
  • The History of Shiatsu (The Latter Part - Derivative Shiatsu and Other Derivatives)
  • Shiatsu Diffusion--Conditions Overseas and Problems
  • Shiatsu World Standardized Licenses--Shiatsupractor
  • Shiatsu and Derivative Shiatsu
  • 2200-Hour Standard Curriculum for Shiatsupractor Status
  • Bibliography & References

The Definition of Shiatsu

When I practice Shiatsu abroad, the question of defining Shiatsu becomes extremely important. Japan is the place of origin of Shiatsu and most people in Japan know what Shiatsu is. Even if people do not understand the exact definition of Shiatsu, they can assume the general meaning from the Kanji (Japanese updated Chinese characters) used to describe the word. Recently, however, while Shiatsu has become known in foreign countries, the word itself does not have meaning in Latin alphabet characters. An explanation is, therefore, needed. To translate the meaning of Shiatsu in English, “SHI” is finger and “OYAYUBI” is thumb. “ATSU” is pressure, so Shiatsu literally translated means “finger pressure” or “thumb pressure”. The definition seems simple. The problem, however, is not the word. To diffuse Shiatsu, Japanese original hands-on therapy, accurately, it is very important to give instructions based upon the legal grounds of Shiatsu Therapy as recognized by Japan’s “Anma, Massage and Shiatsu practitioners, Acupuncture practitioners, and Moxibustion practitioners Act.” Shiatsu was first recognized in Japanese law in 1955, and in the text book “Theory and Practice of Shiatsu” published by the medical department of the Ministry of Welfare (Current Ministry of Health, Labor and Welfare) in December 1957, Shiatsu is defined as follows:

“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.”

The above translation of the definition of Shiatsu can be found on the CSSBC website. This being said, the following three points were set as the major premise of Shiatsu therapy:

  1. To use the bare hands. (No tools, elbows, knees, feet etc.)
  2. To press the surface of the body. (No rubbing, stroking, or pulling)
  3. To aim for the maintenance and enhancement of health or recovery of illnesses.

These three concepts are the most important when explaining Shiatsu overseas.

The Essence of Shiatsu

The characteristic of Shiatsu is to practice using only the fingers, palms and especially the thumbs, but the essence of Shiatsu is “Diagnosis and Therapy combined.” “Diagnosis and Therapy combined” is the ability of the practitioner to use his sensory organs (palms, fingers and thumbs) to detect irregularities, such as stiffness of the surface of the body, and to promptly correct or heal these problems. To acquire this amazing skill takes considerable experience. The defining difference between Shiatsu therapy and modern and Kampo medicine (also known as Traditional Chinese Medicine, such as acupuncture and moxibustion) is this “Diagnosis and Therapy combined”; the fact that Shiatsu does not always require previous diagnosis before commencing treatment. In modern medicine, the course of treatment can only be decided after a diagnosis has been made. In TCM, it is also necessary to diagnose before treating. In Shiatsu Therapy, practitioners promote the prevention and recovery of illnesses by stimulating the immune system and natural healing power that people already possess. Therefore, even without a diagnosis or with a language barrier, practitioners can, to quote Toru Namikoshi Sensei, treat patients with “thumbs and thin futon” at any time. Treating the body as a whole helps to restore the physical functions of the nervous system, circulatory system, bone structure, muscles, and internal secretion and stimulates its natural ability to heal illness. That being said, skilled practitioners can contribute considerably to regional health and medical treatment.

History of Shiatsu (The Beginning- The Origin of Shiatsu)

The first occurrences of Shiatsu began with “TEATE, which literally translated means 'hands-on' in Japanese. In today’s vocabulary it also means “treatment”. Since ancient times, humans have instinctively known that pain can be suppressed by putting a hand on the affected area. The oldest record of sickness being treated by “TEATE” is about two thousand years ago in the mythical age. Also, recorded in an old Japanese poem, is an incident in which Sukunahikonakami, the father of Japanese medicine, cured sickness with his bare hands. These types of legends, of course, are not only limited to Japan and have resulted in the development of hands-on therapies throughout the world, such as massage in Europe and Anma in China (called Tsui-na in contemporary China). After the prehistoric times, Kampo medicine, was imported from mainland China through the Korean peninsula with the transmission of Buddhism. In 984, Yasuyori Tanba wrote what is now the oldest medical book, entitled “Ishinboh”, that currently exists in Japan and Kampo medicine became the center of Japanese medicine. The position of Kampo medicine was maintained until the Meiji Revolution (1867). Kampo medicine included the hands-on therapy “Anma” in addition to its mainstream practices: acupuncture, moxibustion, and Chinese medicine. In the Edo period, great hands-on therapy practitioners (Anma practitioners), such as Ryouzan Goto and Shinsai Ota, appeared one after another. In the last years of the Edo period, Genpaku Sugita and Ryoutaku Maeno started the Western medicine prosperity of the Meiji Period by translating “Kaitaishinsho (an anatomy text from the Netherlands)”. With the influx of the newest medicine from western countries, many hands-on therapies such as massage, chiropractic, osteopathy and spongio therapy were also imported. In addition to these foreign therapies, there were more than three hundred civil treatments; these were ancient Japanese treatments imported from China: Anma, Douin, Kappo, Jyujutsu, etc. and their combined forms. In 1912, at the age of seven, the founder of Shiatsu Therapy, Tokujiro Namikoshi, moved to Rusutsu Village, Hokkaido from Kagawa prefecture, in Shikoku Island. At that time, the body of Tokujiro’s mother, Masa, was riddled with pain due to the fatigue of the trip and the extreme change in environment. In those days, medicine and doctors were hard to find. Tokujiro could not stand to watch his mother suffering and he tried to nurse her by “rubbing” and “stroking”. He noticed, however, that it was by pressing and relieving stiffness from her body with his thumbs that her condition showed the most improvement. Based on this observation, he developed a method of applying pressure that was dependent upon his mother’s temperature and stiffness. As a result, his mother made a complete recovery. Her condition is now termed “rheumatism”; her recovery was the result of “TEATE” from a child who desperately wanted to cure his mother. Based on this experience, after much trial and error and research, “Shiatsu Therapy” was defined by the Health Ministry of Japan.
In 1925, the world’s first Shiatsu treatment clinic was opened in Muroran, Hokkaido. In 1934, Tokujiro Namikoshi published the article “Shiatsu Therapy and Physiology.” In 1940, he opened Japan Shiatsu College. The word “Shiatsu” was first used in the 1920s by Tenpeki Tamai and his writing “Shiatsu Therapy” was published in 1939.

The History of Shiatsu (The Middle - The Path to Legal Recognition)

By the end of the Second World War, much of Japanese lifestyle, values, and common ideas had done a 180 degree turn, and the attitude toward civil medical treatment was no exception. The Japan Shiatsu School (now the Japan Shiatsu College) was established by Tokujiro Namikoshi in 1940. The school sent out many practitioners who were certified by the “Metropolitan Police Board Act” in 1930. In those days, most civil medical treatments (called quasi-medicine), including Shiatsu, were not licensed based on a standardized national examination. They were part of a reporting system under police jurisdiction. In 1947, soon after the war ended, the “Anma, Acupuncture, Moxibustion, Jyudo-Aliment Business Act” was enacted by the leader of the GHQ. This is now known as the “Anma, Massage and Shiatsu practitioners, Acupuncture practitioners and Moxibustion practitioners Act.” Under this law, Shiatsu and other civil medical treatments that were recognized by the reporting system were given a suspended sentence until 1955. In 1955, during the 22nd session of the Diet, the government made a partial amendment to the “Anma, Acupuncture, Moxibustion, and Jyudo-Aliment Business Act”. A public hearing, with witnesses summoned from every sector of society, was held by a committee of the House of Social Labor Councilors. In the bill, the expression of “Anma” was revised to “Anma (including Massage and Shiatsu)”. The intention of the bill was to ban civil medical treatments other than Anma, Massage, and Shiatsu. The seven main subjects for discussion at the public hearing were as follows:

  1. Relations between medicine and quasi-medicines
  2. Relations between Anma and Shiatsu
  3. Relations between Shiatsu and medicine
  4. Educational and business standards for quasi-medicines
  5. Interpretation of the eight year suspension period introduced by the “Anma, Moxibustion, Jyudo-Aliment Business Act”
  6. Change or close any quasi-medicine practices, except Shiatsu practices within three year Banning of quasi-medicines

This public hearing of amendments was extremely important in the history of Shiatsu because the bill was passed with the expression of “Anma (including Massage and Shiatsu)”. This was the first time in history that the word “Shiatsu” appeared in law. In 1957, two years after the hearing, the text book that provides the definition of Shiatsu was published by the Health Ministry of Japan. Moreover, the senseis who were the witnesses at the public hearing published many writings about Shiatsu which were widely recognized by society. That was also the period in which the Japan Shiatsu College became an authorized school by the Minister of Health. Through these processes, another amendment was made in 1964, and the name “Anma (including Massage and Shiatsu)” became the expression of “Anma, Massage and Shiatsu”. That was the point at which Shiatsu finally obtained legal recognition as a Japanese original method of medical treatment. The testimonies of witnesses from the 22nd session of Diet at the House of Social Labor Councilors in 1955 were the basis for the “Anma, Massage and Shiatsu practitioners, Acupuncture practitioners, and Moxibustion practitioners Act” that separated Shiatsu, as well as massage, from “Anma”. Over the next nine years, many amendments were made to the laws which eventually positioned Shiatsu as an independent hands-on therapy. That public hearing and the nine year movement that followed were critical in the establishment, organization, and legal recognition of Shiatsu, and most of what we recognize as Shiatsu Therapy today was established during that period. The following is a list of the Senseis who attended this public hearing as witnesses and defended their point of view:

  • Dr. Kunisaku Shimura, Director of the Japan Doctors Association.
  • Dr. Naohisa Fujii, Honorary Professor of Tokyo Medical University.
  • Dr. Kazumi Yarimotsu, Lecturer of the Former Yokohama Medical University.
  • Dr. Katsusuke Serizawa, Special Instructors Training Lecturer of Tokyo Education University.
  • Yoshikatsu Komori, President of the Japan Acupuncture Moxibustion Massage Association.
  • Hiroshi Hanada, President of the Japan Acupuncture Moxibustion Practitioners Association.
  • Mitsuo Kekino, President of the Kyoto Acupuncture Moxibustion Massage Association.
  • Shigeru Matsumoto, Director of the National Treatment Technique Cooperation.
  • Yoshizumi Utsunomiya,Chairman of the National Treatment Technique Cooperation.
  • Tokujiro Namikoshi, President of the Japan Shiatsu Association.
  • Dr. Iyuji Miki, Medical Professor of Toyo University.

On behalf of the government, the Health Ministry of Japan, the Chief of the Public Health Bureau, the Chief of the Medical Bureau, and the Chief of the Pharmaceutics Bureau were in attendance. While the testimony of each sensei was recorded word for word, the following is a selection of some of the most important comments. First, the Director of the Japan Doctors Association, Shimura Sensei, stated that he considered Anma, Massage, and Shiatsu to be the same no matter what the origin and the theory because they are all hands-on therapies; this was a common perception among doctors (and society) in those days. Next, the Honorary Professor of Tokyo Medical University, Fujii Sensei, who, as requested by the Health Ministry of Japan, spent two years (1949-50) at Tokyo Medical University researching and comparing the terms “Shiatsu”, “Anma” and “Massage” concluded that Shiatsu is a reflex experience treatment based on Western medical knowledge--like American Chiropractic, Osteopathy, Spongio Therapy, and German Natool Therapy, etc—and is therefore different from Anma which is part of Kampo medicine. Fujii Sensei wrote “Shiatsu Theory and Outline”. Serizawa Sensei, who represented Acupuncture, Moxibustion, and Anma, asserted that Shiatsu (and Massage) were forms of Anma. In 1957, however, he published “Shiatsu Theory and Practice”. In the book, he stated that Shiatsu drew on a stream of old-style Anma, but also Japanese original hands-on therapy. Namikoshi Sensei went to the US in 1953 to research many kind of hands-on therapy, including Chiropractic, in addition to Shiatsu which he originally developed. He also tried to outline “Shiatsu Therapy” to establish the Japan Shiatsu College. He attended the public hearing to represent the Shiatsu society as a President of Japan Shiatsu Association. He strongly asserted the originality of Shiatsu. His theory, along with the results of Tokyo Medical University’s research for the Health Ministry of Japan from 1949-50, would become the basis for legalization of Shiatsu. His theory also defined the today’s form of “Shiatsu Therapy”. Serizawa Sensei, who was an authority on Kampo medicine and wrote many books relating to Shiatsu, was strongly influenced by Namikoshi Sensei’s Shiatsu theory. Even years later, at the celebration party of Namikoshi Sensei’s eighty-eighth birthday, Serizawa Sensei expressed his belief that Namikoshi Sensei is the founder of Shiatsu by stating, “Japanese Shiatsu is Namikoshi Shiatsu, Namikoshi Shiatsu is Japanese Shiatsu”

The History of Shiatsu (The Latter Part - Derivative Shiatsu and Other Derivatives)

In many regions of the world, including sometimes Japan, people associate Shiatsu with Eastern medicine. However, as previously stated, Shiatsu has been established as a Japanese original hands-on therapy that is different from Anma of Kampo medicine’s hands-on therapy. The Father of Shiatsu Therapy and the founder of the Japan Shiatsu College, Tokujiro Namikoshi Sensei, declared, “My Shiatsu does not have any influence from Kampo medicine.” Also, as previously mentioned, this statement was supported by the 1949-50 research results of Tokyo Medical University lead by honorary professor Naohisa Fujii Sensei. The practice of combining Shiatsu with Kampo medicine theory is called Keiraku Shiatsu or Meridian Shiatsu. In the 1972 book “Meridian and Shiatsu Therapy” written by Tadashi Izawa, there is a quote from Katsusuke Serizawa Sensei, who was the leading expert of Kampo medicine in those days. Serizawa Sensei stated, “From what I have heard, Shiatsu Therapy is a new, modern hands-on therapy based on chiropractic and balancing hands-on therapies , and it is different from the time-honored Anma method in the region of Kampo medicine. I am sure that the meridian theory of Kampo medicine started being combined with Shiatsu therapy is a derivative Shiatsu that came about after the war.” As this quote indicates, around the 1960s, Keiraku Shiatsu, which uses mainly thumb pressure applied to the meridian points of Kampo medicine, appeared and rapidly became popular after the Carina boom of 1972, which happened with the restoration of diplomatic relations between China and Japan. Tadashi Izawa Sensei, one of the graduates of the Japan Shiatsu College and a disciple of Namikoshi Sensei, noticed that the basic pressure points of Shiatsu Therapy tend to be consistent with Keiraku (Meridian) points of Kampo medicine and compiled “Illustration of Anpuku (the time-honored Anma method) and Shiatsu Therapy” (Illustration of Anpuku was written by Shinsai Ota, Anma practitioner in 1820s). After that, Namikoshi disciples developed many original theories. For example, Iwajiro Sato Sensei wrote “Shiatsu Therapy and Sho-atsu (palm pressure) Treatment” in 1994, and Shizuto Masunaga Sensei wrote “Zen Shiatsu”, in 1974; which relates Meridians and Shiatsu. And I published the writing “Tsubo Shiatsu (in English)” in 2003; I explain Tsubo (Keiketsu/meridian points) anatomically and physiologically, distinguishing them from the meridian lines used in Kampo medicine. Currently, both overseas and in Japan, there seems to be a trend toward creating derivative forms of Shiatsu by combining Meridian theory and Qi-gong theory with Shiatsu Therapy.

Shiatsu Diffusion - Conditions Overseas and Problems

Presently, interest in Japanese Shiatsu is spreading rapidly overseas, gaining support for its safe and effective method. There are, however, some problems. The most serious problem is that educational standards are all different and sometimes stray away from the original definition of Shiatsu. When I practice Shiatsu overseas, I am often asked, “What form of Shiatsu do you teach at your college?” indicating that derivative forms of Shiatsu are mistakenly believed to be equally defined as Shiatsu Therapy. More specifically I am asked, “Do you teach Namikoshi Shiatsu or Masunaga Shiatsu?” This is a very important question as “Namikoshi Shiatsu” indicates the 2500-Hour Shiatsu Therapy course as taught at the Japan Shiatsu College and recognized by the Health Ministry of Japan for licensing as a professional practitioner. On the contrary, “Masunaga Shiatsu” (also known as “Zen-Shiatsu” overseas) was developed by a Namikoshi disciple (graduate of the Japan Shiatsu College), Masunaga Seneei. The lectures of the Ioh-kai Shiatsu Center established by Masunaga Sensei are two and half hours per week and total of thirty hours for twelve weeks. This program is not certified by the Health Ministry of Japan to become a professional practitioner. Many other short courses and programs on derivative forms of Shiatsu are available throughout the world, but not unlike Masunaga Shiatsu they do not qualify participants to write the nationally recognized exam to become professional practitioners. To become a professional practitioner in Japan, one must learn Shiatsu Therapy as defined by the Health Ministry of Japan. Regardless of which derivative form of Shiatsu one wishes to practice, one must first become a licensed practitioner (Anma, Massage and Shiatsu Practitioner). For that reason, practitioners of all forms of Shiatsu have a basic standardized knowledge level. Overseas, however, in countries where Shiatsu is not regulated by law, it is possible to introduce oneself as a professional practitioner without having studied any of the basics of Shiatsu or medical basics of anatomy and physiology; all that is required is a short course on meridian theory or another derivative of Shiatsu. As a result, the standard of all practitioners is lowered which could be a critical problem as Shiatsu therapy gradually gains worldwide recognition. To maintain the reputation of Shiatsu and its qualified practitioners, it is imperative that an international standardized license for practitioners of Shiatsu Therapy be introduced.

Shiatsu World Standardized Licenses “Shiatsupractor®”

Shiatsupractor® is the name given to the recently introduced international standardized Shiatsu license. This international standardization will not only ensure quality by setting guidelines for the practitioners of Shiatsu therapy, but also for the instructors, worldwide. In the past, in countries where Shiatsu has not been regulated by law, instructors often have not learned the medical basics, such as anatomy, physiology, pathology, which are require subjects in Japan, and those instructors often focus entirely on their knowledge of Kampo medicine. The name Shiatsupractor® was first used in British Columbia, Canada in 1990’s has since been recognized by the International Shiatsu Association as the official name for the of the international standardized Shiatsu license. Presently, at the end of 2003, in the regions of North America (United States and Canada), Europe (member nations of the EU), and Japan, the use of Shiatsupractor® is officially protected as a registered trademark. In Japan, the educational standard for Shiatsupractor® approval corresponds to that of the licenses for Anma, Massage and Shiatsu Practitioners. In other regions, if there are no regulations by public officials in the country or states, the requirements are two years and 2200 hours in North America and two-to-three years and 1600 hours in Europe.

Shiatsu and Derivative Shiatsu

1. Original Shiatsu Therapy

The Road to the Recognition of Shiatsu:

  • 1912 Tokujiro Namikoshi Sensei invented the prototype
  • 1940 Creation of the Shiatsu school that later became known as the “Japan Shiatsu College”
  • 1955 The Health Ministry of Japan officially recognizes Shiatsu, Anma, and massage in the same category
  • 1957 The Health Ministry of Japan is sued over the legal definition of Shiatsu
  • 1964 The Health Ministry of Japan reviews the regulations and acknowledges Shiatsu, massage therapy and Anma as unique and independent therapeutic methods

In conclusion, because Shiatsu Therapy as developed by Tokujiro Namikoshi Sensei has been recognized on a civil and a government level, he is known as the father of Shiatsu. And, though many of his disciples developed their own forms of Shiatsu that have become known throughout the world and thus the original Shiatsu is often called “Namikoshi Shiatsu” to distinguish it from its derivatives, history proves that “Japanese Shiatsu is Namikoshi Shiatsu.” Shiatsu is Shiatsu.

2. Derivative Shiatsu Techniques & Theories

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 sensei published the book “Tsubo Shiatsu” and finally presented the theory to the world. Ikenaga sensei studied Shiatsu directly from Namikoshi Sensei and graduated from the Japan Shiatsu College in 1986.

Keiraku (Meridian) Shiatsu:

This Shiatsu treatment is based on TCM (Traditional Chinese Medicine) theory. Tadashi Izawa sensei published his book “Meridian and Shiatsu Therapy” 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 and graduated from the Japan Shiatsu College in 1946. Later, he became an instructor at the college.

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 “Ioh-kai Shiatsu Centre”, opened by Masunaga sensei in Japan. Masunaga sensei studied Shiatsu directly from Namikoshi Sensei and graduated from the Japan Shiatsu College in 1958.

Tao Shiatsu:

Ryukyu Endo sensei introduced this form of Derivative Shiatsu. He followed Zen Shiatsu theory, but left “Ioh-kai” after Masunaga sensei died. This theory contains religious and spiritual practicum, for example reciting a Buddhist prayer before lectures. There are several one- and two-day workshops available in Tokyo and Kyoto. Endo sensei studied Shiatsu directly from Namikoshi Sensei 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.


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 “Practitioner”.

2200-Hour Standard Curriculum for Shiatsupractor Status

Reference from the minimum standard of the Canadian Shiatsu Society of British Colombia:

1. Compulsory Section - 1600 hours


Basic Shiatsu / Shiatsu Foundation - 150 hours

Theory & Practice

Advanced Shiatsu -150 hours
Treating specific pathological conditions
Derivative Shiatsu techniques & theories (optional)
Clinical experience - 500 hours

Medical Foundations

Anatomy - 300 hours
Physiology - 300 hours
Pathology - 100 hours
Kinesiology - 50 hours

Others - 50 hours

Ethics and Professionalism
First Aid and CPR
Medical Lows

2. Optional Section - 600 hours

Kampo Medicine (TCM)
Japanese Culture
Business Management