“Shiatsu was the first Japanese medical term to be entered into the Oxford English Dictionary,” says Takashi Namikoshi, proudly referring to his grandfather’s legacy. “This remains a great honour for our family.” As chair of the International Shiatsu Foundation – an organisation he set up in 2005 to promote true shiatsu practice and increase awareness of its benefits outside Japan – Namikoshi is the third generation of a family whose name is inextricably linked with the therapy. For it was his grandfather, Tokujiro Namikoshi, who’s recognised as the founder of the hands-on technique, famously treating prime ministers of Japan, Muhammad Ali and Marilyn Monroe during his lifetime.

Born in Japan in 1905, the young Tokujiro moved with his family from a mild climate on the island of Shikoku to the harsher environment of northern Hokkaido. A gruelling journey, the relocation was to impact heavily on Tokujiro’s mother who began to experience pain in her knees, the precursor to an ailment that would affect her whole body and which today would be diagnosed as rheumatism. With no doctor in the village of Rusutsu, her new mountain home, she turned to her children who took it in turns to stroke and press the painful parts of her body. But it was her third child, the seven-year-old Tokujiro, who eased her discomfort most effectively and, though ignorant of anatomy, began to recognise differences in her skin condition, heat and stiffness, as he applied pressure to different muscles using his hands and fingers.

Miracle massage
“When my grandfather first massaged his mother, he told me he used a ratio of 80 per cent rubbing to 20 per cent pressing,” explains Namikoshi. “But he quickly found that reversing the percentage gave better results. He concentrated on the places that were the stiffest and coolest and soon his mother’s condition disappeared. Today we think that he had unknowingly been pressing on both sides of the central spinal column in a way that would have stimulated adrenal function and therefore the secretion of cortisone to alleviate her rheumatism.”

News of Tokujiro’s ‘miracle cure’ spread throughout the village and the young boy continued to treat people with his hands into adulthood, slowly developing his own therapeutic system of shiatsu – literally translated as ‘finger pressure’. Since the only national certification available in Japan during the 1920s was for amma massage, originating from China, Namikoshi studied to obtain the certificate before setting up his own clinic in Hokkaido in 1925. Word-of-mouth recommendations meant there were no lack of clients seeking treatment to alleviate conditions such as stiff backs, shoulders and necks.

Due to he established another practice in Sapporo city. Eventually it became clear to the Namikoshi family that shiatsu had the potential to take root across Japan and so Tokujiro moved to Tokyo, founding the Japan Shiatsu Institute in 1940. Although shiatsu was legally approved in 1955 as a result of the institute’s work, it was done so incorrectly under the banner of amma massage. “Tokujiro and his family recognised that shiatsu was different in skill and technique from amma, with the latter based on Chinese meridian acupuncture points,” notes Namikoshi. “Unlike amma, elbows, knees and fists were never used – only the fingers and hands were sensitive enough to perform shiatsu.”

Official certification
Continuing to offer specialist education to students, the institute was renamed the Japan Shiatsu School in 1957 and officially licensed by the Ministry of Health, Labour and Welfare. Then, in 1964, the therapy was recognised to be distinct from amma massage and licensed under its own ‘amma massage shiatsu’ certification. Simultaneously, in the 1960s, Tokujiro’s son Toru had returned from medical school in the US, bringing with him a greater understanding of western medical science – in particular anatomical and physiological functions – to be integrated into the therapy.

So, what are the hallmarks of correct technique, according to the family? “Shiatsu should be performed only with fingers, palms and especially the thumbs,” says Namikoshi. “Based on modern medical science, there are 660 vital points located at muscles, nerves, blood vessels, lymphatic glands, hormonal glands and viscera, which can be stimulated by applying pressure through the hands to aid organ functionality. Elbows, knees and fists do not have the sensory nerves required to detect abnormalities in the skin, muscles or body heat and therefore cannot pinpoint where there are imbalances, misalignments or irregularities. This is why it’s dangerous to use anything other than the thumbs, fingers and palms in shiatsu therapy.”

Having trained under his grandfather and taught at Tokyo’s Japan Shiatsu College for many years, Namikoshi now runs his own clinic in the capital. Seeing on average 20 patients per day, he treats people for a range of conditions from lower back problems to migraine, shoulder stiffness to depression. Each application of shiatsu works as a diagnosis, with the practitioner using hands and fingers to assess the body’s condition, identify abnormalities, decide which vital points to apply pressure to and, finally, determine the level of pressure that should be applied during the treatment. He recommends treatment times of between 60 and 90 minutes per session, costing JPY13,000 (US$105, €94, £67) and JPY18,000 (US$145, €130, £93) respectively.

Long life
Although he’s unable to disclose the details of individual cases, Namikoshi explains that there are several physical benefits of shiatsu: “From circulatory to digestive system diseases and modern complaints such as insomnia or stress, shiatsu can help by invigorating the cells of the body and promoting natural healing. Specifically, it can revitalize the skin, soften the muscles, stimulate the circulation of body fluids, regulate neural functions, balance the endocrine system, adjust skeletal alignment and regulate the alimentary system.” While shiatsu is recognised as a preventative healthcare system in Japan, Namikoshi is soon to collaborate with a renowned hospital to procure medical evidence of its benefits. He hopes this will convince practitioners around the world that shiatsu can be integral to improving life expectancy and promoting good health.

At present, it’s only possible for Japanese nationals to study for an official licence at one of 20 recognised schools in the country, including ones for the deaf or blind. They are run independently but all teach under conditions set and guided by the regulations of the Ministry of Health. At Tokyo’s Japan Shiatsu College, for example, students take 2,145 hours of classes as part of a three-year curriculum that incorporates physiology, anatomy, pathology and shiatsu theories. On average, a course costs JPY5m (US$40,410, €36,090, £25,470) and is followed by a state exam that students must pass to practice as a shiatsu therapist in Japan.

The Tokyo-based school has an attached treatment centre that is currently run by another of Tokujiro’s grandsons.

International reach
For spa therapists interested in the correct application of the technique outside Japan, there’s a detailed guidebook available upon request from the International Shiatsu Foundation office in Tokyo. Namikoshi also believes it’s essential for spa therapists to be given the opportunity to learn from shiatsu masters who’ve been authorised by the foundation. “Elements such as positioning of the therapist, direction of movement and application of weight can only be learnt by watching demonstrations given by an experienced master,” he points out.

As one of 20 foundation directors or masters, Namikoshi attends international shiatsu conferences, giving two to three day seminars as far afield as Europe and North America. To date, spa and beauty therapists in Holland, Madrid, New York and Vancouver have attended his seminars – a mix of lectures, master classes and workshops. It’s through these international events that Namikoshi works to highlight his family’s therapeutic practice. While he’s aware that other styles have developed outside his grandfather’s teaching, he explains that it’s difficult to compare manipulative therapies without practising them personally. So, education about the true technique remains key.

Looking to the future, Namikoshi is building up affiliations with institutions such as the Dutch Shiatsu Academy in the hope that this network will become large and influential enough to pave the way for international certification. The foundation is also looking into developing a spa education programme that would enable such an international licence to be offered to outside Japan. “My dream,” he concludes, “is that we’ll be able to establish an international school or programme through which we can offer instruction and an official licence around the world.”