Family Shiatsu Course

FAMILY SHIATSU MASSAGE

Compiled&&Edited Editedby By Compiled BenjaminEugenio EugenioJrJrLMT LMT Benjamin ChenRoaring Roaring Chen

Course Outline Module 1 - COURSE INTRODUCTION Module 2 - NECK AND BACK Module 3 - BUTTOCKS, LEGS AND FEET (PRONE) Module 4 - LEGS

AND FEET

(SUPINE)

Module 5 - ARMS (SUPINE) Module 6 - HEAD, FACE AND CHEST Module 7 - STOMACH REGION

MODULE 1 – COURSE INTRODUCTION Purpose and Scope For the student to acquire a deeper appreciation of Shiatsu, the Japanese art of healing through the use of touch. This module will provide a background on the nature and benefits of shiatsu and shall serve as a study guide on the basic operations of shiatsu and its correct application. Objectives After completing the course you should be able to:  Define shiatsu.  Learn the basic techniques.  Acquire a deeper appreciation of the human body and how it works. Time Completion of this unit should take approximately 1 ½ hour. BASICS OF SHIATSU What Is Shiatsu? Shiatsu is a “hands on” method of preventive health care and therapy that increases

vitality, relieves fatigue, and stimulates the body’s natural healing power by pressure

applied to key points of the body. Many people are anxious about the adverse effect of modern life on their health. There are no simple means to address this concern, but shiatsu offers a way to be aware of your body and to

care for it. This way, you can take your health “into your own hands.” WHY LEARN SHIATSU? Shiatsu, which literally means “finger pressure” in Japanese, has many outstanding benefits both to the giver and the receiver. To the giver, it serves as a challenge in maintaining a balanced emotional state since moods have a direct effect on the person being treated. Also, a good level of concentration and discipline is required from the giver to help ensure a successful and beneficial therapy. In all these, the therapist shall experience the joy of helping others by way of relieving them from physical and even psychological pain and stress. To the receiver the benefits are as many, they are as follows:

Shiatsu promotes mental and physical well-being. Studies have shown that one of the least recognized and yet equally important basic needs of man is the need to be touched. One classic example was an experiment made by a group of scientists many years ago to a number of babies. In that study it was found out that infants who were mechanically fed (devoid of human contact) grew up to be sickly, weak and even suicidal. On the other hand, babies who were nurtured by human beings, supplied with enough amount of cuddling and touching grew up to become healthy and strong led and have led successful lives. It helps stimulate the body’s self healing powers. Every living organism has its own

healing powers. This is especially true among human beings. However, many people get sick easily and frequently because their healing powers were deactivated or has slowed down due to stress and other factors. Shiatsu points, when properly applied, activate that healing power and make the recipient’s body strong and resistant to many diseases.

It prevents illnesses. Many health experts say that 80% of man’s illness are stress related. After a full body therapy, the recipient is relieved from stress, the circulation improves significantly, and the nutrients are distributed evenly. Thus, the fighting chance of the body against its enemies improves dramatically.

It restores balance of energy. Man is made up of three things: mind, body and spirit.

Unfortunately, life’s many challenges, wreak disharmony to these three co-equal parts. The gradual weakening of the spirit, further weakens the physical and emotional state, making it more susceptible to the slowing down of the immune system, making the body prone to sickness. Shiatsu corrects this by reintegrating the said trio and correcting the imbalance.

It is easy to learn. What used to be a tedious way to learn and apply, acupuncture &

acupressure (in fact, it has very few practitioners elsewhere)-- was made easy and affordable through Shiatsu, without the loss of its beneficial advantages. Foremost in this field is Mr. Tujokori Namikoshi, who pioneered and advocated this form of therapy in Japan, and later, the rest of the world.

Three Tenets Of Shiatsu 1. Shiatsu is suitable for everyone, from the very young to the very old. 2. Shiatsu treats the body as a whole. 3. Shiatsu is a way to give yourself a daily health check up. Basic Techniques Most of us are unaware that the human hand is actually a marvelous tool, a tool which has shaped and honed human civilization. Many skin receptors are located in the skin of the fingers, particularly in the finger tips and the palms. There are different types for sensing light touch, deep pressure, heat, cold and pain. Although you may think fingers all have the same degree of sensitivity, each has its specialty. The thumb is specially sensitive to sharpness; the index finger can detect fine differences in texture, smoothness or roughness; the middle finger can detect hardness and contour; and the ring finger is sensitive to heat.

Ways of Applying Pressure The 12 Basic Hand Movements 1. One-thumb pressure Apply pressure with the thumb of either the right or left hand. Be sure to apply pressure with the ball of the thumb and not the joint. The other four fingers are held together and placed lightly on the patient’s body for support. (Uses: in treating the left and right anterior cervical region, the back, the Namikoshi points, the arms, the palms, the legs, and the soles of the feet).

2. Two-thumb pressure The two thumbs are each open to about 30 degrees. They should barely touch. The outer sides of the tips of both thumbs are held together, and the digital balls are pressed against the skin. Pressure is applied with both thumbs simultaneously. 3. Thumb-on-thumb pressure If you are right handed your left thumb should generally be placed over your right thumb, unless instructions say otherwise. The reverse is true for left handed people. Apply pressure simultaneously with equal pressure from both thumbs. The other four fingers of each hand provide light support. This is used when strong pressure is desired. 4. Thumb-and-four fingers

The digital balls of the thumb is held opposite the digital balls of the other four fingers. The part of the patient’s body being treated is gripped between thumb and fingers. (Uses: legs, calves, and neck) 5. Two-digit pressure Thumb and index finger are held apart slightly, then they each apply equal pressure. The part of the patient’s body being treated is gripped between the digital balls of the thumb and the index finger. 6. Middle and Index Finger For stability, the tip of the middle finger is pressed on top of the fingernail of the index finger. The other fingers are held lightly closed. Pressure is applied with the tip of the index finger on the bottom. (Uses: Sides of the nose and face). 7. Three-finger pressure Three fingers are held together closely, then pressure is applied, equally by each from a single point. (Uses: most often used in self shiatsu). 8. One-palm pressure With all five fingers held together, pressure is applied with the whole palm of one hand. 9. Two-palm Pressure Each hand is held flat and the thumbs are just touching. 10. Palm on Palm Pressure With the fingers of both hands held together firmly, the left palm is held over the right, palms crossed at 90 degree angle. 11. Thenar pressure The thenar of the hand is pressed against the skin. (Uses: for the face, abdomen and the inguinal region). Degree of Pressure The degree of the pressure depends on the muscle stiffness in the area being treated. Giving abrupt, strong pressure to stiff muscles will not only be counter-productive but is also unpleasant. Strong pressure should first be preceded by gentle pressure for a short duration. With practice, you will learn to observe changes in muscle condition and adjust the degree and type of pressure accordingly.

1. Light pressure - Penetrates slightly through the skin into the connective tissues. Particularly good for the children and the elderly. 2. Standard pressure - Penetrates lightly through the skin to the surface of the muscles, producing pleasurable sensation. 3. Medium pressure - Reaches deep into the muscles, producing a sensation of pleasurable discomfort. 4. Strong pressure- Used for working deep into stiff muscles. It may produce some pain, but to the extent that your partner can tolerate it comfortably. ANATOMICAL TERMS 1. Supine position- Your partner is lying face up on his or her back. 2. Prone position-Your partner is lying face down on his or her stomach. 3. Lateral position- Your partner is lying on his or her left or right side. THE HUMAN BODY Muskuloskeletal System The musculoskeletal system is made up of the skeleton and muscles. Each skeleton helps to give the body shape and protects the internal organs. The adult skeleton has 206 bones. On the other hand, the muscles provide for movement. The major areas of the skeleton include the following: 1. The skull has a number of broad, flat bones that form a hollow shell. It houses and protects the brain. There are several small bones of the face. They give shape to the face and permit the jaw to move. 2. The spinal column houses and protects the spinal cord. 3. The thorax, or rib cage, protects the heart and lungs--vital organs of the body. 4. The pelvis, or hip bones, consists of the ilium, pubis and ischium. The iliac crests form the “wings” of the pelvis. 5. The shoulder girdle consists of the clavicle (the collarbone) and the scapulae (shoulder blades). 6. The upper extremities extend from the shoulders to the fingertips. The lower extremities extend from the hips to the toes. The Respiratory System The respiratory system consists of organs that let us breath. When airs enter the body, it does through the mouth and the nose. The Circulatory System

The circulatory system delivers oxygen and nutrients to the body’s tissues and removes waste products. The Nervous System The nervous system is composed of the brain, the spinal cord, and the nerves. It has two major functions-communication and control. The Digestive System The digestive system is composed of the alimentary tract (food passageway) and accessory organs. Its main functions are to ingest food and to get rid of waste. Digestion consists of two processes- mechanical and chemical. The Urinary System The urinary system filters and excretes waste from the body. It consists of two kidneys and two ureters, one urinary bladder, and one urethra. The Endocrine System The endocrine glands regulate the body by secreting hormones directly into the blood stream. They affect physical strength, mental ability, stature, reproduction, hair growth, voice pitch, and behavior. The Reproductive System The reproductive system of the male includes two testes, a duct system, accessory glands, and the penis. The reproductive system of the woman consists of two ovaries, two fallopian tubes, the uterus, vagina and external genitals. The Skin The skin separates the human body from the outside world. It protects the deep tissues from injury, drying out and invasion by bacteria and other foreign bodies. Reminders before the ACTUAL MASSAGE * Before beginning the session, make sure that your hands are clean and your fingernails are trimmed. * Take a few minutes to breathe deeply, calm yourself and clear your mind of distractions. * Tell your partner to relax and enjoy the session. * Finally, use the correct pressure points and procedures. Do not hurry or try to perform miracles. Patience and regularity give the best results

MODULE 2 - NECK AND BACK Purpose and Scope To familiarize the student with massage manipulation tech-niques, starting at the neck, then to the upper and lower part of the back. Objectives After completing the course you should be able to:  Perform shiatsu therapy on the neck and upper back part of your partner  Identify the critical points at the neck and spine. Known benefits Eases motion sickness, prevents prostrate trouble, bronchial asthma, hiccups, diarrhea, headaches, heartburn, insomnia; provides relief from migraine; serves as a remedy for hangovers, difficulties in waking-up, constipation; and improves skin complexion. Time Completion of this unit should take approximately 1 ½ hour As a rule, shiatsu therapy must always begin at the left side of your partner. She should lie in the right lateral position, with the right leg straight. For purposes of support, the left leg is crossed over the right one; and the left knee lie on the floor. When the therapy is completed, the treatment should be repeated in similar fashion on the other side of your partner.  Step 1 – Inner part of the neck Assume a position behind your partner’s back with your left knee on the floor and right knee raised. Put your left palm on the floor in front of your partner’s chest to support your body. Then, press your right thumb lightly against the anterior cervical (front of the neck) in the carotid sinus to ascertain pulse. While taking care that you do not strike your partner’s face, put the four fingers of your right hand to the upper part of the lateral cervical region (side of the neck) so that thumbs and hands together grip the neck lightly. Pressure, which is not strong, but gentle, is directed towards the inner part of the cervical vertebrae; and the motion is made as if with a pull in the direction of the inner side of the neck muscle. Pressure lasts for three seconds on each point. The treatment continues for all four of the anterior cervical points leading along the inner border of the neck muscle to a point just before the clavicle. Repetition: Twice.  Step 2 – Side of the Neck

With your partner remaining in the same position, place your right thumb over left at the side of your partner’s neck, the therapy begins treatment with the first point in the lateral cervical region. Each application lasts for three seconds. All four lateral cervical points, which begin right below the ear and continue down the base of the neck, are treated in the same way. Since thumb-on-thumb pressure is in the vertical direction with all of your weight directed to it, applications tend to be strong. Please note that the strength of pressure must be according to the condition of the part of your partner’s body being treated and must never be too great. Repetition: Two (2) times  Step 3 – Neck, Upper back To treat the neck, upper back area, assume the position prescribed for Step 2. Lightly supporting your partner’s forehead with the palm of the right hand, apply your left thumb, directed upward, on the medulla-oblongata region and support your partner’s right lateral cervical region with the remaining four fingers of your right hand. Pressure on one point lasts for five seconds and is directed toward the eyebrows. Repetition: Twice.  Step 4 – Back, Middle outer Assuming the position prescribed for Step 3, place your right thumb at the first the first point of the left posterior cervical region. Put your left thumb on top of your right thumb and appliy pressure with both thumbs for three seconds. The pressure should be directed towards the opposite side toward the median line of the face. Repetition: Twice.  Step 5 – Neck base, shoulder level Your partner lies in the same position. Move around to the crown of your partner’s head and, with your left knee raised and your right knee on the floor, assume a position fairly close to the patient’s head. Extending both arms fully, support your partner’s shoulder with the four fingers of each hand. With the right thumb on top of theleft thumb, using both, apply pressure to the suprascapular point. The left thumb should be on the bottom this time, because, if the right one were in that position, the little-finger of the right hand might touch your partner’s face. Pressure point on each application shoudl last for five seconds. Repetition: Twice.  Step 6 – Upper spine column With your partner remaining in the same position as in the preceding step. Move to a kneeling position where your partner’s scapulae (shoulder blades) are directly in front of you. In the five points on the interscapular region (between the scapula and spinal column) apply pressure from the upper corner to the lower corner of the scapula. Apply pressure for two or three seconds to each point. In pressing, the trunk is held perfectly straight and slightly inclined to the front. Both arms are fully

extended, and the body weight rests on the thumbs. Caution: pressure must not be applied directly to either the scapul or the spinal column. Repetition: Twice.  Step 7 – Middle and lower back In this step, your partner remains in the same position as in the preceding operation. Move to a position close to your partner’s buttocks and kneel with your left knee on the floor and your right knee raised. The first point of application in this operation is the fifth point for the operation directed to the interscapular region. The points run along the spinal column from this first point to the last, which is located at the lumbar area. For the first nine points, pressure is applied for three seconds each with both thumbs-the right under the left. On the last point, strong pressure is applied for five seconds in two applications. Repetition: Twice.  Step 8 – Closing palm points For the final step, move to a position near your partner’s buttocks. Placing the left palm on your partner’s buttocks, press the four points along the spinal column, with the palm of the right hand for three seconds on each point. Repetition None.

MODULE 3 – BUTTOCKS, LEGS AND FEET (PRONE) Purpose and Scope To facilitate the flow of blood vessels in the lower limb area of the body. Objectives After completing the course you should be able to:  Identify the location of Namikoshi points and apply appropriate pressure.  Perform shiatsu therapy to the lower body parts. Known benefits Relief from diarrhea, menstrual pain, anxiety and insomnia; increased sexual vitality, increased suppleness of the muscles, improved circulation. Time Completion of this unit should take approximately 1 ½ hour.  Step 1 – Upper Part of the Ilium (Iliac Crest) Ask your partner to lie facedown on the mat. For comfort, place a pillow on her face during the whole treatment process. This time position yourself close to your partner’s buttocks and kneel with your right knee on the floor and your left knee raised. The first point of application in this operation is at the inner part of the Iliac Crest, using thumb-on-thumb pressure; press the three points that lead upward

along the iliac crest from the sacral region. Pressure sure lasts for three seconds on each point. Repetition: Once or twice

 Step 2 – Lower Back (Sacral Region) Remaining in the same position as in Step 1 and using both thumbs with their outer edges touching each other (two-thumb pressure), press (two times) for three seconds on each point along the median line of the sacral crest. This is the region of origin of the erector spinae muscles.  Step 3 – Buttocks (Gluteal Region) Placing the thumb of the right finger on the first gluteal point located immediately to the right side of the first sacral-region, place your left thumb on top of your right thumb and press for three seconds. Pressure is directed towards the greater trochanter. You then press on points 2, 3, and 4 which are located on a downward slanting line across the gluteus maximus muscle.  Step 4 – Namikoshi Point In this position, your partner remains in the same position as in the preceding step. Kneel on both knees on the left side of your partner’s buttocks. The Namikoshi point is located on the line connecting the anterior superior iliac spine and the sacrum, about five centimeters from the anterior superior iliac spine and near the greater sciatic notch. With the right thumb underneath, strong kneading pressure is applied on this point with both thumbs for five seconds. Repetition: Once or twice  Step 5 – Upper Thigh (Posterior Femoral Region) Kneel with your right knee on the floor; left knee raised-by the side of the leg at the position of the popliteal fossa and turn to face your partner’s thighs. The first pressure point in this region is in the gluteal fold directly below the sciatic tuber. The trunk of the sciatic nerve passes through this zone. Press this point strongly three times with both thumbs, with the right thumb underneath for three seconds each. Proceed to administer three seconds of pressure three times to each of the ten points between the first point and the popliteal fossa.  Step 6 – Behind the Knee (Popliteal Fossa) Still in the position, move farther toward your partner’s feet. Using two-thumb pressure, apply three (3) seconds of pressure three times to each of the points in the politial fossa, moving from the outside inward.  Step 7 – Lower Limb (Posterior Crural Region)

Remaining in the same posture, moving still farther rearward, with the use of twothumb pressure, apply three seconds of pressure two times to the eight points starting directly below the second point in the popliteal fossa. These points lay along the triceps surea muscles. Note: pressure applications must be gauged depending on your partner’s tolerance to pain.  Step 8 – Side Part of Lower Limb Next, face your partner’s calf from the side and kneel upright on both knees, grip the calf and, applying squeezing pressure for three seconds, move downward from the gastrocnemius muscle to the Achilles’ tendon. Six applications are required to cover the distance. Repetition: Twice.  Step 9 – Achilles’ Heel (tendon) Face your partner’s ankle joint and kneel on both knees. Using both thumbs, held in such a way that their outer edges touch each other, on the calcaneal tubercle and, wrapping the other fingers around the ankle for support, lightly lift the foot upward. Holding it in this position, apply kneading pressure to the three points on the tubercle, on the side of the Achilles’ tendon. The pressure lasts for three seconds on each point. This treatment extends the Achilles’ tendon.  Step 10 – Ankle (Malleolus Region) Remaining in the same position and lowering your partner’s foot, put your right thumb on the first of the three points between the calcaneus bone and the lateral malleolus and your left thumb on the first of the three points between the medial malleolus and the calcaneus. Let the fingers of the left hand overlap with the fingers of the right hand, and place both at the bottom of the foot for support. Pressure is applied simultaneously to both sides on the three (3) points in a line moving from the malleolus toward the toes. Repetition: Once or twice  Step 11 – Foot (Plantar Region) Remaining in the same location, kneel with your left knee on the floor and the right knee raised. The four pressure points are located in a straight line down the middle of the sole, beginning immediately below the gap between the bases of the second and third toes and extending to the heel. Pressure is applied using twothumb pressure for three seconds each time (three times) on these points. The plantar arch is treated last; with the right thumb underneath, both thumbs are used to apply pressure to the point (three times) for five seconds each.

MODULE 4 – LEGS AND FEET (SUPINE)

Purpose and Scope To show the student the vital points on both legs and feet that are essential for a successful therapy. Objectives After completing the course you should be able to: Remember key shiatsu points on the lower limb.  Familiarize yourself with the healing properties of the areas being worked on. Known Benefits Relief from tiredness and weakness, dizziness, digestive ailments, menstrual problems, improved circulation and controls high blood pressure Time Completion of this unit should take approximately 1 ½ hour.  Step 1 – Hip Bone (Anterior Femoral Region) Ask your partner to lie in a supine position with her head on a pillow, and arms straight by the side. Assume a kneeling position on the left side of your partner with your left knee on the ground and the right knee raised. Press slightly, with the digital ball of your right thumb on the center of your partner’s groin--a point between the anterior superior iliac spine and the pubic bone. The tip of the thumb is pointed slightly outward and diagonally to the right. The palm of the left hand lightly supports the lower part of the anterior femoral region immediately above the knee. Pressure is applied vertically to the groin with the right palm for five seconds and is repeated two (2) times.  Step 2 – Thigh (Posterior) Next, press with both thumbs, right thumb underneath, on the ten points from immediately below the anterior superior iliac spine to a location just above the knee joint. A pressure application lasts for three seconds on each point, and the treatment is repeated once or two (2) times.  Step 3 – Thigh (Inside) (Medial Femoral Region) Remain in the same position, but turn your partners’ left knee outward and bring the left heel to the Achilles’ tendon of the left foot. With both thumbs, right thumb underneath, press on each of the points from immediately below the pubic bone to a point just above the knee joint on the central part of the medial femoral region. Apply pressure for three seconds on each point. The therapy is repeated once or two (2) times.

 Step 4 – Thigh (Side) (Lateral Femoral Region) Put back your partner’s leg close together, then kneel on the side of your partner’s thigh.With both thumbs, tips just touching, apply three seconds of pressure to a point, to the ten points along the center of the lateral femoral region from the place immediately below the greater trochanter. immediately above the knee joint. The therapy is executed once or two (2) times.  Step 5 - Knee (Patellar Region) Remaining in the same posture but in a position facing your partner’s knee, place your thumbs and fingers in such a way as to form a frame surrounding the patella. The thumbs are on the outer side of the leg, and the other fingers on the inner side. First, press for two seconds each on the three points moving from the outer side of the knee below the joint and inward. Then with the thumb of the right hand, perform the same kind of pressure treatment on the three points that are located from the outer side of the leg inward above the knee. This therapy, alternating from left to right thumbs, is repeated once or two times.  Step 6 – Lateral Leg (Lateral Crural Region) Still kneeling on both knees, move farther toward your partner’s lateral crural region. The first point in the lateral crural region is about three centimeters diagonally below the tibial tuberosity and below the lateral condyle tibia. With thumbs overlapping, right thumb on top, and with the fingers wrapped around the inner side of the leg for support, press the six points leading from this position down to the center of the lateral crural to the center of the lateral malleolus. Each application lasts for three seconds and the therapy is repeated once or two times.  Step 7 – Tarsal Joint (Tarsal Region) This time kneel on both knees facing your partner’s left foot alongside. Cupping the toes of the foot with your left hand to support it lightly, with the thumb of your right hand, press on the points located between the lateral and medial melleoli. Pressure is applied for three (3) seconds to each point, and the therapy is repeated once or two (2) times.  Step 8 – Foot Dorsal Region Still cupping your partner’s toes with your left hand, begin working on the instep, the pressure points are located on four parallel rows of four points each, beginning at the crotches of the toes and extending toward the ankle joint. Starting at point 1 between the big toe and the second toe, apply three

seconds of pressure to each of the four points in this row. Then, moving to the base of the second row, continue in the same fashion until you have applied pressure once to all sixteen points.  Step 9 – Foot Digital Region Turning to kneel on both knees so that you can face your partner’s ankle, cup her ankle with your right hand and apply pressure with the thumb and index finger of her toe. The points (three to a toe) extend from the proximal to the distal phalanx. Beginning with the big toe, press the top of her thumb and the underside with your finger, two seconds for each point, until all fifteen (15) have been treated. At the conclusion of pressure on each points, the toe is quickly pulled.  Step 10 – Toes (Toe-joint Exercise) Holding your partner’s ankle with your right hand and the toes with your left hand in a wrapping fashion, perform dorsiflexion and plantarflexion of the toes. The exercise must be fast and rhythmical.  Step 11 – Foot (Base)(Plantar Extension) Placing your left hand on the ball of the sole of the foot and extending your left elbow to the side, bend the foot in the direction of the instep. One repetition is sufficient.

 Step 12 – Leg (Leg Extension) Kneeling on both knees and facing your partner’s feet, with your left knee under your partner’s right foot as support, use both hands to grip the ankle joint above the heel and to lift the foot about twenty (2) centimeters off the floor. Then, slowly leaning your body rearward, pull the leg for about five (5) seconds. When you have pulled it sufficiently, slowly release it and return your partner’s body to its former position on the floor.

MODULE 5 – (ARMS AND HANDS) (SUPINE) Purpose and Scope This module shall cover therapy at the arms and hands of the subject while in a supine position. Objectives After completing the course you should be able to:  Check the pulse rate of your partner.

 Impove your mastery in applying appropriate pressure in the areas being worked on. Known benefits Relief from pain, numbness, chill or shaking; improved heart condition (by way of left arm treatment) Time Completion of this unit should take approximately 1 ½ hour.  Step 1- Wrist and Armpit (Axillary Region) While in a supine position, extend the left arm of your partner at shoulder level turning the palm of the hand upward. Kneel on both knees facing your partner’s left (or right) arm alongside her body. Locate the radial artery which passes through the wrist to the thumb. Then, put your joined index, middle and ring fingers of your right hand on this zone. Upon locating the pulse, pause for a second or two, and then extend your left hand towards her armpit locating the axillary artery (feel the pulse). After doing so, remove your left hand from the wrist and then put your right thumb over your left thumb in the same area. Press it for five seconds. Repetition: Twice.  Step 2- Elbow-Arm (Medial Brachial Region) Take the point in the axillary region as point 1, and, with the left thumb on top of the right thumb, press for three seconds on each of the six points leading from there toward the cubital fossa at the elbow. Applications of pressure should be made so as to pull slightly in the direction of the elbow. Repetition: Twice.  Step 3- Upper Limb (Cubital Fossa) Moving your partner’s arm, which till now has been outstretched to the side to an angle of about forty-five degrees with the body, kneel on both knees adjacent her hand. With the outer edges of the thumbs barely touching each other, press for three seconds each on the three points leading from the outer side to the inner side of your partner’s cubital fossa. This treatment is repeated once.  Step 4- Forearm (Medial Antebrachial) Remaining in the same position, following the lead of the three points in Step 3, venture to apply pressure on eight (8) points from the cubital fossa down to wrist area. That means three (3) parallel lines to work on from outside to inside. With one thumb on top of the other, apply pressure for three seconds on each point. Pressure is applied with a slight pull in the direction of the wrist.

 Step 5 – Shoulder-arm joint (Deltopectoral Groove) Your partner remains in the same position, the arm extended at forty-five degrees and the palm is turned down. Moving to a position facing your partner’s acromion, kneel on both knees and raise your hips from the floor. Place your right thumb on the first point on the deltopectral groove, near the clavicle, and wrap the remaining fingers of that hand around your partner’s shoulder for support. Then, apply pressure with your left thumb over the right thumb and the remaining four fingers of that hand in your partner’s axillary region. Repetition: Twice. Step 6 – Upper arm (Lateral Brachial Region) Kneel on both knees in front of your partner’s upper arm. With the outer edges of your thumbs barely touching each other, press with both on the six points in the lateral brachial region , leading from the deltoid muscle across the triceps brachii muscle and to the olecranon. Pressure is applied for three seconds on each point, and therapy is repeated twice. Step 7- Forearm (Lateral) (Lateral Antebrachial Region) Position yourself to the palmar side of your partner’s arm, raise her hand, and place it palm down on your left knee. Kneel on both knees, raising your hips from the floor. The first of the eight points in the lateral antebrachial region is located on the extensor digitorum communis muscle. Bending the middle finger backward causes this muscle to move in an immediately apparent way. Firm pressure on this point causes sharp pain since it forces the radial nerve against the radia. With your right thumb on the bottom, use both thumbs to press the first point and then the remaining points leading downward from this point to the wrist. Each pressure application lasts for five seconds and the therapy is repeated twice. Step 8 – Hand (Dorsal Region) Remaining in the same posture and taking your partner’s left hand with your right hand, press with your left thumb on the rows (three points) located between the proximal phalanges of the thumb and the index finger and the index finger and the middle finger. The pressure lasts for three seconds on each point. The remaining four fingers of your left hand are wrapped around your partner’s hand for support. Then take your partner’s hand in your left hand and, with your right thumb, press on the two rows of three points between the proximal phalanges of the middle and ring fingers and the ring and little fingers. Once again pressure lasts for three seconds on each point. Step 9 – Hand (Dorsal Digital Region) Returning the patient’s hand to your right hand, with the thumb and index finger of your left hand, apply pressure to the patient’s thumb, index finger, and middle finger, beginning at the points at the bases of the fingers and working down the three points on

the tops and bottoms of the thumbs and four points on the tops and bottoms of the other two fingers and then on the points on the right and left sides of the fingers. Her fingers are held between your thumb and index finger, and pressure is applied for two seconds to a point. Each finger is pulled at the conclusion of pressure application on the last point. When the middle finger has been treated, shift her hand into your own right hand and treat the remaining fingers with your left thumb and index finger. Step 10 – Palm Remaining in the same position, turn your partner’s hand palm up. Bringing the outer edges of your thumbs together on the palm, wrap the remaining fingers of both hands around her hand for support. The points for pressure application are located on the carpus, or base of the hand, in the center of the palm, and at the base of the middle finger. With both thumbs-outer edges barely touching each other, apply pressure for three seconds to each point and repeat therapy two times. Then to the second pointcenter of the palm with the left thumb on the right thumb, apply strong pressure with both for five seconds. Treatment is repeated two times. Leaning your trunk rearward, pull your partner’s arm. Step 11 – Arm (Extension) Still holding your partner’s hand at the end of the preceding operation, stand and walk behind her head to a position above her left shoulder. Gripping the arm at the wrist and keeping it well extended, lower it until it forms an angle of forty-five degrees with the floor. Holding her wrist with your right hand and with your left hand, stroke the upper arm from the armpit three times. Gripping the wrist with both hands again, lower the arm, still extended, slowly to the floor. When it is fully lowered, the arm should form an angle of 180 degrees with the body and should lie close beside the ear. Relaxing it, slowly raise the arm to the vertical position then lightly pull it once. Next, relaxing it again, allow it to fall lightly forward.

MODULE 6 - HEAD, FACE AND CHEST Purpose and Scope To help the learner identify and pressure points on the head, face and chest and its corresponding effects on his/her partner. Objectives After the course you shall be able to:  Familiarize yourself with key points that shall provide great relaxation and therapeutic relief to your partner. Known Benefits Provides relief from headaches, releases tension in chest muscles, effective against asthma, heartburn, drowsiness and nerve pain in the chest Time Completion of this unit should take approximately 1 ½ hour

Step 1 – (Median Line) Position yourself at your partner’s head and kneel on both knees. It is a good idea to place a thin towel on her head for this therapy. With both thumbs-right thumb on the bottom – press for three seconds on each of the six points leading from the hair line to the crown of the head on the median line. Repetition: Twice. Step 2 – (Temporal Region) Put your right palm lightly on your partner’s right temporal region for support. Shiatsu points for the left temporal region are arranged in six rows leading to the left from the six points on the median line. The first point for treatment on the temporal region is the final point on the median line. Using your left thumb, press each of the points in each row for three seconds. Then, place your left palm on her left temporal region for support, then perform the same therapy on the corresponding six rows of points in the right temporal region. Step 3 – (Median line and Temporal Region) First with overlapping thumbs, right thumb on the bottom, press once on each of the points on the median line, beginning with the hairline on the forehead and moving toward the crown of the head. Then, starting at the last point at the crown of the head on the median line, with thumbs the outer edges of which touch each other, simultaneously press each point in the temporal right and left rows. Moving toward the hairline on the forehead, continue until you have pressed all points once for two seconds each. Then, with overlapping thumbs, return to the first median-line point, at the hairline on the forehead, and press each with both thumbs, ending with a fivesecond pressure application on the final point on the crown of the head on the median line. Step 4 – (Frontal Region) Remaining in the same position but with your hips raised from the floor, press for three seconds on each of the three frontal points along the facial median line from the glabella, between the eyebrows, to the forehead hairline with both thumbs, with the right thumb on the bottom. Repetition: Twice. Step 5 – Nasal Region From the position in Step 4, lower your hips. With the overlapped index and middle fingers of each hand, index finger on top, press simultaneously on each of the nasal points in the rows leading from the root of the nose to the wings of the nostrils. Each pressure application lasts for three seconds. One application for each point is sufficient. In this treatment you must be careful not to press directly on the wings of the nostrils in a way that closes the nasal passage.

Step 6 – (Zygomatic, Orbital, and Temple Regions) In the same position, with the index, middle, and ring fingers of each hand, press on the two rows of three points leading to the side from the nose along the lower border of the zygomatic bone simultaneously for three seconds on each point. The therapy is executed only once. Apply pressure with a light pull towards yourself. Step 7 – (Orbital Region) To treat the orbital region and temples, rest the palm of your right hand lightly on the right side of your partner’s forehead with fingers turned inward. Then, with the thumb of your left hand, press each of the four points in the infraorbital from the inside corner to the outside corner of the eye for three seconds each. The therapy is performed only once. Step 8 – Temple (Supraorbital Region) Then press on each of the four points in the supraorbital region with the thumb of your left hand in the same way. Then, with the thumb of the left hand, press the three points leading from the outer corner of the right eye across the right temple in the direction of the ear. Pressure is applied for three seconds on each point, and therapy is performed only once. When treatment is completed on the left orbital and temple regions, the hands are changed; and therapy is performed in the same way on the right orbital and temple regions. Step 9 – (Palm Pressure on the Eyeballs) With the fingers of both hands brought tips together in the center of your partner’s face, lightly place the palms of both hands over the eyeballs and apply simultaneous pressure to both for ten seconds. Before performing this treatment, you should cover your partner’s eyes with a clean towel or other suitable cloth. Step 10 – (Intercostal Region) Remaining in the same position in which you performed therapy on the face, rest your right hand-thumb spread-on your partner’s chest near the shoulder for support. With the thumb of the left hand, treat the intercostal muscles (internal and external). Points for such treatment are located between the ribs in six rows beginning at the sternal body and moving outward to the sides. Pressure is applied with the left thumb for two seconds on each point; and therapy is performed only once. Next, placing your left hand on her upper chest for support and using the thumb of the right hand, perform the same therapy on the right intercostal muscles. Step 11 – (Xiphoid process)

In the same position, using both thumbs with the tips brought together, apply pressure for three seconds on each of the five points leading from just below the manubrium forward to the xiphoid process. Therapy is repeated two times. Pressure must be neither strong nor sudden and must not be applied directly to the xiphoid process. Step 12 – (Circular Palm Pressure on the Sternal and Pectoral Regions) Next, simultaneously with the palms of both hands, perform rotational pressure (ten times) on her pectoral region in an outward direction. Finally, returning both palms to the upper pectoral and holding them well against her body, perform a downward stroke across the pectoral region simultaneously and have your partner exhale as you do it. The therapy is performed twice. Then the palms are returned to her upper pectoral region and released.

MODULE 7 – STOMACH REGION Purpose and Scope Among the Japanese it is believed that the stomach is the center of the universe. Righly so, because its where most of the vital organs are situated. The student will learn proper shiatsu treatment on the stomach area and their corresponding benefits in this chapter. Objectives After completing the course you should be able to: Know the key points in the abdominal area that will usher in better food digestion, distribution and the elimination of wastes. Known benefits Releases tension in the abdomen, strengthens the stomach and the liver, stimulates the intestines and aids digestion, constipation, gallstone, diarrhea and acid indigestion Time Completion of this unit should take approximately 1 ½ hour. Step 1 – Palm Pressure Series Kneel on both knees facing your partner’s right lateral abdominal region. Remaining prone, your partner either places both hands on the chest or extends the right arm outward to the right side and the left arm along the left side of the body. Putting your left palm flat on your own left knee, with the right palm, investigate and proceed to press the following points in the order given: 1) upper stomach or epigastric fossa, 2) small intestine, 3) bladder, 4) cecum, 5) liver, 6) spleen, 7) descending colon, 8) sigmoid colon, and 9) rectum. Each application lasts for three seconds, and the therapy is repeated two times.

 Step 2 – Twenty Points on the Abdomen Kneel on your right knee, near your partner’s right buttock, with your hips raised. The twenty abdominal points are 1, 2, and 3 from the epigastric just above the navel; 4,5, and 6 from immediately below the navel to the bladder; 7 at the location of the cecum; 8 at the ascending colon 9, 10, and 11 at the liver; 12 at the stomach; 14, and 15 at the gallbladder; 16, 17, a the descending colon; 19 at the sigmoid colon; and 20 at the rectum. The outer edges of the thumbs are brought together, and the other fingers are spread to the sides to form a W with the thumbs. Pressure is applied in synchronization with her breathing. Each application lasts three seconds, and all 20 points are treated three times.  Step 3 – Small-intestine Region Remaining in the same position, with both thumbs held so that their outer edges touch each other, apply three-second pressure on each of the eight points of the small intestine. The pressure applications start from a place diagonally to the right (partner’s right) and above the navel and are treated in a clockwise, circular order. Therapy is repeated two times.  Step 4 – Region of the Sigmoid Colon Remaining in the same position as the preceding operation, rest your left palm lightly on her anterior superior iliac spine for support. With the digital ball of your right thumb, moving in small stages from point 1, press for three seconds on each of the four points for the sigmoid colon. Therapy is repeated two times.  Step 5 – Rippling Palm Pressure Returning to a kneeling position, on both knees, facing your partner’s abdomen, place both of your palms together on her left lateral abdominal region, fingers pointed straight forward and hand centered on the navel. Simultaneously, with the four fingers of both hands, pull the area of the sigmoid colon and push the area of the ascending colon with the carpi of both hands. Repeat this rippling pulling and pushing action five times.  Step 6 – Circular Palm Pressure and Vibrational Palm Pressure Raising your hips, though otherwise remaining in the same position as in the preceding operation, place both of your palms on the center of her abdomen. Press your hands firmly against her body in a way that exerts mild, penetrating

suction, exert circular palm pressure in the clockwise direction ten times. Then administer ten seconds of vibrational pressure with both palms.  Step 7 – Anterior Superior Iliac Spine With the right knee on the floor and left knee raised, kneel at the right side of her right thigh and raise your hips. With the digital balls of your thumbs on her right and and left anterior superior iliac spine, alternately with the left then the right palm, apply vertically directed pressure. Application on one side lasts for one second, and the series is repeated rhythmically ten times.  Step 8 – Upward-kneading of the Abdominal Region Remaining in the same position and holding the fingers of both of your hands together with palms upward, slide both hands under the patient’sbody until the tips of your fingers reach points directly below the navel and to the sides of the third lumbar vertebra. Then, using the digital balls of your fingers, apply an upward kneading motion. During this operation, the backs of the hands remain on the floor and do not move. The four fingers should make use of the lever principle. The therapy is repeated two times. To avoid interfering with your work, she must bend both arms upward at the elbows.  Step 9 – Lateral Abdominal Region Remaining in the same posture, place both of your palms on the lateral abdominal regions of your partner’s body. The four fingers of each hand are held together, and their tips are pointed downward. Pull your hands simultaneously upward, pressing both lateral abdominal regions. This is repeated three times at a fast fast speed. When your hands are raised from her abdomen, the palms must face each other.  Step 10 – Palm Pressure on the Stomach Region Remaining in the same position, stroke your partner’s abdomen from the epigastric fossa downward rapidly and smoothly ten times, alternating with first the left and then the right palm.  Step 11 – Vibrational Pressure on the Abdomen Then place the fingers of your right palm pointed toward the epigastric fossa over her navel. Put your left palm on your right hand, at ninety-degree angles, and apply ten seconds of vibrational pressure.

REFERENCES 1. Medical First Responder Course, USAID/OFDA-LAC 2. Toru Namikoshi , The Compete Book of Shiatsu Therapy and the Shiatsu Way to Health 3. Toru Namikoshi, Shiatsu Your Way to Health