Shiatsu with the Heart Energy (Wilfried Rappenecker)

Translation: Z.B & J.S.

The heart, “through insight and understanding,” rules the energetic and physical organism of human beings, as well as their social relationships. Its main function is the capacity for resonance. That means that the heart enables the different parts of a person to step into resonance with each other, and, through this, to form a lively organism. It enables the whole person to be in resonance and integrate with his environment.

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Resonance means reciprocal vibration. It means understanding through empathy. ”A healthy heart gives one the courage to be aware of the ‘vibrations’ of other people and situations….” (from: W. Rappenecker – Five Elements and Twelve Meridians)

The heart’s capacity for resonance lies not only in the heart centre of the chest, but also in each and every cell in the body. The whole person is able to synchronize with and understand every single part of his or her body.

Only when the heart opens up, in this sense, do we have a true understanding and experience of what is going on. But, in opening up, the heart becomes sensitive… vulnerable. Then we start to feel long-buried pain. I have never met a person who doesn’t’t carry a wound in his heart.

Out of fear of the pain they will experience when getting into contact with that wound, people hesitate to open their heart.

The heart is, however, best protected by its own balanced openness and vitality. If the heart is strong, it can remain open and aware, even in difficult situations. Saints, and people that become truly enlightened, are often described like this.

Three other energetic organs contribute to supporting the heart in the Fire element: the pericardium, the small intestine, and the triple heater. Heart is located in the centre of the Fire element while the supporting organs are placed concentrically around it. (Furthermore, the energy of every other organ can, in special cases, assume a protective function for the heart. The hara diagnosis shows which organ is playing this role in the current situation.)

The relationship of the pericardium to the heart is of special significance. The pericardium is – as in the anatomical reality – very close to the heart, so close that it experiences everything that happens to the heart. Actually, the pericardium is a part of heart, which has been trusted with special tasks – it becomes especially active in situations that would let the heart vibrate too strongly.

In such states of excitement, stimulation, or any sort of agitation, the pericardium is very active. Thus, not infrequently in hara diagnosis, heart appears to be quiet or even inactive, while pericardium seems restless or even excited – maybe with a hammering pulse. This may be the pericardium’s protective response in a temporary situation. However, sometimes over-activity of this type in the pericardium is of a chronic nature, related, for instance, to inexplicable anxiety, lasting tension, or insomnia. In this case, the tension has turned into a permanent state, and other signs of the protective mechanism in the heart or pericardium will be apparent in the body (see below: Stages of Constraint).

Small intestine, the yang-partner of the heart, “separates the pure from the impure.”That means it supports the heart in assessing the effect of external impulses on the heart and the person, discarding any irrelevant information. It is an essential function of the small intestine to help the heart interpret impressions. That implies, first and foremost, withholding from the heart anything that might toss it out of balance – “predigesting,” as it were. Extreme events, such as accidents or emotional shocks, provoke a similar extreme condition in small intestine energy.

Triple heater is the yang-partner of the pericardium, and the outermost protector of the heart. Its principal area of activity is widespread throughout the periphery of heart energy, so its protective function extends to the whole person. The strength arising from a harmonious interplay of the three burning chambers is the best guarantee of an effective inner protection of a person on every level of existence. The triple heater is especially demanded in all situations of change.

The Free Heart

Heart energy operates not only in the meridians, but in the whole body… in every cell. (This, of course, is a fact for all energetic organs.) Its centre, where it is most at home, is the thorax, or chest area. It is the space behind conception vessel 17, the Bo point for pericardium. If heart is in harmony, this area will appear open and pliant, but, at the same time, strong.

From this point, the free heart is at liberty to fill the whole thorax and thence the whole person. The primary pathways that this can take in a Shiatsu treatment are related to the anatomy: Firstly, a free sweep over the lower chest and diaphragm, then through the hara into the groin, down the legs, into the feet, and out.

Subsequently, the heart energy has no difficulty in spreading through the shoulders, into the arms and hands, and beyond the hands. If heart is free, a standing person will have his arms hanging loosely beside his body, with the upper arms in a natural position, slightly apart from the chest, as if a gentle force were preventing them from directly touching the body.

Free heart ki follows another important path… namely, through the neck, into the head, to the entrance of the sense organs (so that shen may be displayed), then beyond the head. The path through the neck is sometimes overlooked.

Stages of Constraint

Human beings, unable to trust fully in their heart’s strength, have various means of preventing it from operating freely (thereby excluding a total experience of life). All these methods involve diminishing the resonance function of the heart, so that the free course of the heart energy through the body and beyond is inhibited.

In principle, this control mechanism may be regarded as a positive manifestation of the wood element. In the delicate interplay between free and less free function, a person ensures his own unique inner balance. Such restrictions will be experienced negatively, when rigid patterns of control give rise to chronic blockages.

There are typical stages when the free flow is suppressed frequently over a longer period. This can happen anywhere in the body, so that it is always necessary to observe exactly what kind of pattern is really present in the current case.

The blockages can occur in the pathway of the heart and pericardium meridians, but also in that of the small intestine and triple heater meridians. Likewise, in particular cases, in the meridian pathway of all other organs can be affected.

Also, they can lie beyond the superficial meridians in the depth of the body, where the experienced practitioner can recognize them with the wide and relaxed view of energetic perception.

In the following passages, I shall describe the places in the human body, where the free operation of the heart energy is particularly restricted. More than this, meridian and organ energies operate not only on the physical, touchable level, but also comprehensively affect other levels of being.

With the techniques indicated in this article, localized physical blockages in concrete body zones can be treated effectively. The constraints at the more comprehensive energetic level may be reached through penetrating and empathetic meridian work, with an understanding of the person’s situation taking priority.

Shoulders, Arms and Hands

The wrists and the hands are a typical station in the periphery of the Heart’s domain. energies expressed in the hands. The wrists are a region where people can control the resonance between heart and hands.

As always, this ability to control ki movement is basically a positive function, as long as the person can let go when control is not needed for balance anymore. In the case of a chronic condition however, the therapist may find the wrists, to be very tense, tight, and hard, or conversely, weak, bloated, or tender.

Typically, “empty” areas are often found on the lower arm, close to the wrist. Also in between the metacarpals, it can be very tight with empty spots around as a result of stagnating ki.

The client may possibly experience some discomfort, such as tension and pain in the wrists, or the feeling, in certain situations, that a cold steel band is fastened round his wrists. As the connection with the hands is impaired, certain symptoms may arise, such as a tendency towards cold, damp, bluish hands and even nocturnal pains and weakness of the hand muscles (as in the so-called carpal-tunnel syndrome). Not infrequently, the terminal sections of the meridians of the third and fifth finger appear stiff and inflexible.

Shiatsu offers an ideal means of treating such blockage symptoms… namely through work on the meridians, by balancing local states of kyo and jitsu, as well as supporting distant connections.

Further up the arm, there appear frequent blockages of the fire energy in the region of heart 3, about 1.5 cm on the thumb side of the tip of the ulnar epicondyle. Here, the energy paths to liver, heart, and kidneys are likely to feel “frozen.” The region is more often than not jitsu, and may then feel tacky, dough-like, or even hard. Painful epicondylitis on the little finger side (a sort of “tennis elbow” on the little finger side) may be result of a lasting blockage in this area.

In the part of the biceps muscle close to the elbow, there is often a blockage in the flow of the pericardium energy. In the region of the armpit (heart 1) and of the upper arm near the shoulder, kyo areas often appear in the pathway of the heart and pericardium meridian.

Shiatsu to the arms and shoulders always aims at supporting the free flow of the heart energy through the shoulder into the arm, restoring freedom to the heart in this area. The successful location and treatment of obvious blockages (which may be found everywhere in the meridian pathway – not merely at the typical points, which I have described here) is an effective procedure.

An attack of angina pectoris, or a heart attack, comes with tense pains in the left shoulder, which approximately follow the heart meridian down the arm, sometimes as far as into the little finger. Then, quite often, the meridian pathway feels hard, thickened, and condensed in one or more places. These symptoms are an extreme example of a pronounced blockage of heart ki. The treatment described above is sensible, and possibly very effective, as first aid in such exceptional cases, before the arrival of the doctor, or on the way to the hospital.

The Neck

Free heart energy doesn’t’t only want to vibrate into the arms and hands; the way through the neck into the head is also important. Here, the pericardium runs in the depths of the channel between the trachea and the Carotid artery. In my opinion, the two branches of the pericardium connect before the root of the tongue, where the neck turns into the floor of the mouth. The heart meridian shows itself one more time below the floor of the mouth, in front of (anterior to) the horizontal connecting branch of pericardium.

Deeper down below the surface, however, heart energy is connecting up to the face, the openings of the sense organs, and, finally, out through the head. Also, in the front-side of the neck a person has the means to control the free vibration of his or her heart. Even more than in the path into the arms, here the vibrations are of a kind that manifest on an emotional level. Blushing in the neck in situations that trigger the heart and the pericardium is a visible manifestation of their operative effect in the front of the neck. When we have to gulp in difficult situations (also clients during a Shiatsu treatment), it is a sign that there is an upward ki movement, which is not completely free.

Symptoms of a chronic obstacle to this movement may, for instance, be the feeling of having a “frog,” or a lump, in one’s throat. Other effects can be in the form of any ailment in the organs of the neck, such as the larynx, the trachea, the oesophagus, or the carotid artery.

Shiatsu to the shoulders, head, and neck present a very effective means of reducing blockages of the heart energy on its way up to the head. The basis of the treatment consists, as always, in perceiving the energy pattern in the region, the finding of pronounced kyo and jitsu areas, and supporting the balance between them.

It is important, when working on heart and pericardium energy to perceive the pattern of their meridian pathways in the neck and to treat accordingly. For instance, in the case of the pericardium pathway near the trachea, one should not be afraid of probing deeply with a relaxed hand, if this seems to be the right treatment.

The Path into the Legs and Feet

I often feel that the heart meridian on the leg is a strong supportive column, giving the heart, which has its centre up in the thorax, a stable link with the ground below. I then ask myself whether this is a free, easy link, or where it may be inhibited. For the therapist, blockages are the most obvious areas in the meridian pathway, and treating them gives the best results and biggest effects.

The pericardium on the inner leg has its course really deep in the thigh – and it is not always easy to reach the centre of the meridian when sinking in. This area seems to me like an extension of the energy originating from the heart and pericardium in the upper hara and the thorax. Is this flow easy, powerful, and free, or blocked?

Working from this perspective, the deeppath of heart, pericardium, and small intestine right through the lower hara, into the groin and the pelvis become important. The hara, pelvis, and groin regions are areas where a person often blocks the free flow of these fire energies. And, here, a specific treatment may prove surprisingly effective. If the therapist can “see” deep connective patterns (and their interruptions) between the torso and the legs, he or she can work in a way that liberates ki.

On the path further down to the feet, typical kyo or jitsu blockages of the heart flow can be found in the region of the knees, the ankles, and the heels. In the case of pericardium energy, these are often located very high in the upper thigh, right below the groin, or in the groin itself.

In the small intestine meridian, they are more likely to be found above the knee. Both energies often share common ground well down on the lower leg, on the inside of the ankle, or in the feet. However, obstructions may show up anywhere in the pathway. It is therefore important to take a close look every time and see what is true of this particular person at this time.

The chest

It is seldom that the radiation and vibration of the heart and pericardium is completely free in the upper warmer. People have a variety of strategies to restrict the free operation of these energies to their “home base,” hoping, in this way, to live with fewer disturbances.

A human being can make his or her chest hard, inaccessible, and unassailable from the outside. That is how it may feel to the observer. The hardness can be manifested in the different layers of the pectoral wall: a hardness and tightness of the sternum; a numbness in the chest wall, the ribs, and the muscles; a congested, tight area between the shoulder blades; or even as a pronounced hump in the back at the level of the upper warmer.

Another strategy is that the heart makes itself small and weak… receding into the depths, while the arms may be drawn close to the rib cage. Or, alternatively, it will come into the open, getting active and “loud,” bursting with its own energy. Then, not infrequently, abackground void and fearful anxiety become apparent. These different strategies may also manifest in combination.

The therapist can be aware of all that – it is usually easy to see. Through deep contact, particularly in the kyo areas of the peripheral blockages described above, the therapist can come directly in touch with the person, at his very heart and soul.

Acute or chronic states of that kind may be experienced as more or less pronounced discomfort, such as tension or pain in the chest, which may also be lung-related with difficulties in breathing. He may also experience pain between the shoulder blades or in the shoulders.

According to orthodox medicine the cause for such symptoms range from functional ailments such as restricted mobility of the ribs, breathing difficulties of psychosomatic origin, or coronary neurosis, to life-threatening diseases, such as angina pectoris or heart infarction (heart attack).

Blocked heart energy, as described above, does not only cause problems in the thorax. It also may manifest on non-physical levels, as uneasiness, forgetfulness, anxiety, nervousness, jumpiness, and insomnia, for example.

Likewise, lack of sympathy and understanding, being overly closed off or overly brazen, high or low blood pressure, and sensitivity or insensitivity to cold can also be manifestations of this.

Once the patterns of heart energy are perceived, Shiatsu gives us the means for direct treatment. Possible techniques range from a very gentle touch or sustained holding of (parts of) the chest and all the standard Shiatsu techniques, all the way up to strong physical pressure. The choice of which method is correct depends on the therapist’s own judgment as to what kind of touch would set free the most possibilities. In this work, practical experience is the most useful guide.

The local shiatsu on the chest will usually be combined with the work on blockages in the periphery (neck, arms, hara or legs). This can be done even without touching the chest at all if one has the impression that the heart should not be treated directly in the thorax. In this work, the resting hand (Mother Hand) becomes of special importance. It may hold contact with the heart energy at exactly the right place in the thorax, perceiving minute changes, or rest on an important point somewhere between the Moving Hand and the thorax, thus maintaining the connection between the periphery and the chest.

In this way, the heart and the energetic changes that have been brought forward by the treatment are offered more space for resonance, and, by this, more freedom to change.


I would like to end this article with a noteon how Shiatsu works, and what it can principally achieve: Shiatsu works through touch. When we do Shiatsu we don’t add anything to the “body” we are working on… unless perhaps through empathy and understanding. No ki is introduced.

All that Shiatsu does is to set ki in motion, giving ki that is blocked the freedom to move. One can also say that ki gets released. Free ki can follow its natural impulse, the principal aim of which is adjustment and balance.

Balance is the other great achievement of Shiatsu for, with our hands (and also our minds); we can connect opposing energy qualities, previously not communicating adequately with each other.

This is possible at a local level, for instance, in the chest, or on a joint, by local adjustment of kyo and jitsu. One can also connect polar opposites far removed from each other; and through work at the level of meridian energies, this balance may also take place at a nonphysical level that reaches the whole person.

This is the great balancing power of yin and yang. When we work with the energy of the heart, we can be quite sure that this heart and this human being have sufficient strength to solve existing problems. Whether the patient is able to make use of this energy lies beyond our control. Nevertheless, we can certainly offer effective support through our work.  


© Wilfried Rappenecker, born 1950 near Köln (Germany), is director of the “Schule für Shiatsu Hamburg” (D-22769 Hamburg, Oelkersallee 33,, co-founder of the GSD und author of two books dealing with shiatsu. As physician for general medicine he mainly works with shiatsu.