Shiatsu and Headaches (Wilfried Rappenecker)

The energetic patterns of physical and spiritual pains are basically really simple, even if you regard all the possible complexities created through the very subjective experiencing of pain. This is good for our work, as it allows the Shiatsu practitioner to let the difficult problems which our client might describe remain on the level of the subjective experiencing of the client. Like this, it becomes easier for us to look for the clear and simple pattern, which is the source of this experiencing.

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The simple, basic principle of headache is that the free connection between the head and the rest of the body is restricted. As a consequence, Ki is locked in the head. Mostly, it is an energetic fullness which creates the pain – Ki can go in but not out anymore. More rarely, a relative Ki-emptiness can also be the local pattern of a headache.

In the case of a headache the Shiatsu practitioner will thus always check where she or he can perceive an interruption in the energetic field that connects the head with the rest of the body. On this way, he will determine one of four important questions in the treating of headaches.

These questions are:

  • Which force makes Ki rise into the head and – what is important in our context – makes it get stuck there instead of letting it vibrate freely?
  • Which is the pattern of energetic stagnation that I find in the head of my client?
  • Where do I find the most pronounced (and therewith most important) patterns of interruption in the connection from the head to the torso and from the torso into the head?
  • Which areas of in the body are in a clear resonance with the headache’s pattern – and enable it thus to exist?

In the following I will consecutively discuss these four questions.

Rising up and blocking – the tendency for headaches

In most cases, the underlying force of headaches is one which lets Ki rise upwards. The rising force by itself does, however, not yet create a headache. As the prerequisite for every experiencing of pain is a stagnation of Ki, the rising of the Ki needs to go along with a ‘not letting it flow anymore’ so that a headache can evolve.

Liver and Gall Bladder are the energetic organs which produce the rising of the energy in a person and are also responsible for its control (its canalisation), thus being able to create a blockage in the case of an over-control. It is thus no wonder that most headaches have to do with the uprising and the controlling activity of Liver and Gall Bladder and that one can treat them through these organs and their meridians in Shiatsu.

Such an imbalance shows most clearly in the picture of a migraine headache: The fact that a migraine headache is a half-sided headache makes a reference to the Gall-Bladder energy, which is present on the sides of the body and the head. The nausea and vomiting is created through a rising of the Wood-energy, which practically clinches the normally downward moving energy of the Stomach with an iron fist and pulls it upwards. A person who is suffering from a migraine headache is usually under great tension which makes her or him withdraw from others, and only allows the person to do the necessary things under great strains. The source of this tension lays in too big a tension and control in the Wood element. The often present aversion for light shows that this too great tension is also present in the branches of the liver meridian that runs to the eye.

Other types of headaches, however, may present different characteristics which shows that other energetic organs are involved. Such other organs which could also be involved in the rising of the Ki and its stagnation are for example the Triple Heater-, Large Intestine-, Stomach-, or Bladder energy (see also the hints below which can be found in the “Localisation of the Pain”).

These organs will only make the Ki rise in a “Jitsu-style” and lock it in the head if they get the order to do so. They get this order from other organs which feel in distress. This may be the heart energy if the person feels wounded or in fear, or the energy of the lung if it feels like certain life-circumstances are becoming to narrow and threatening. These are just two examples out of many possibilities.

Pain (with a few exceptions) is always created to avoid a certain experience. Pain is itself avoidance. This is why the work with the meridians that carry this feeling which is being avoided (often a Kyo situation) can also be really helpful when working with headaches. The places where the specific state of such an energetic organ shows the clearest are often the key-points for an effective treatment of a tendency to get headaches.

Having determined that, the practitioner should now look even further:

This, as all life-circumstances, personality characteristics, ways of behaving, emotions, diet and external events which stimulate the uprising of the Yang-force within the Wood element, and at the same time encourage a stagnation of the Wood energy, can theoretically also trigger headaches. And any factor that may create the feeling of being helpless in the Kyo organ can give the order for headaches if there is a tendency for this.

Everything that “drives a person up the wall” (which means that guides his Ki upwards), everything that “heats him up” and simultaneously lets her or him cramp and makes her hold on may help to create and maintain a headache. For example stress, a lack of time, internal or external pressure, food that heats up (for example too much stir-fried or too salty food, vinegar, hot spices (these can, in certain cases, also help to dissolve the stagnation), a lack of fresh fruit and vegetables, stimulating beverages like coffee if the person cannot bear it at that moment because of a tense situation in life…

The more, to create a headache must be – for whatever reasons – of advantage for the “system” of this person or present some kind of solution. Otherwise, the rising Ki would go somewhere else (for example to the shoulders, the eyes or the ears) and cause problems there.

We find all the necessary information about all of this when we talk to our client. While we are talking, also her body will reveal important information and the Hara- or back-diagnosis will tell even more. Growing experience in the therapeutic work with Shiatsu lets the understanding become clearer and clearer.

With this long list of factors that may trigger headaches it becomes clear that as Shiatsu practitioners it cannot be our goal to simply help the client to get rid of his tendency for headaches. It is rather that the client needs to go into a process of learning, understanding and finding new ways with himself. With Shiatsu, we can accompany and support a person on a part of this way.

In the end, from our point of view, triggering the process of personal development may be even more important than a relief of the headaches.

Treatment of an acute headache attack

The principles described so far are especially important when working with the tendency for headaches, e.g. in the days or weeks in-between the headache attacks. The differentiated work with the energetic organs and their meridians according to the information received from the person and her body diagnosis can become the key for a change of the life situation of a person, which can make the tendency for headaches change.

In the case of an acute attack of headache the situation is different, though. The procedure described above can be of help here, too, but the global approach of meridian shiatsu will often not be specific enough, as it may not communicate directly enough with the actual place of pain and its vibrating relationship with the body. Often a more direct work with the local pattern of pain is needed for the effective treatment of an acute headache.

Prerequisite for a direct Shiatsu in this sense is the perception of the energetic patterns of stagnation or interruption at the place of the pain and its near surrounding. In the following I would like to discuss this.

When Ki separates

Ki never blocks homogeneously but always creates patterns of fullness and emptiness in its stagnation. The stuck separation in fullness and emptiness is a synonym for stagnation.

On the other hand, fullness and emptiness by itself do not mean stagnation. By playing with each other, the opposite energetic poles of Kyo and Jitsu constantly create and dissolve themselves. This dynamic is an expression of the pulse of life.

Separation, blockage and pain only evolve when the continuous creating, dissolving and referring to each other becomes stagnant. In separation, what was one before now goes separate paths. Continuous Kyo and Jitsu patterns occur because different parts in a person which actually belong together, lose a living contact. One could say that in a way, they do not want to talk to each other anymore. This is a process that the person brings forth himself actively – usually for reasons of her inner balance. The creation and maintenance of such stagnation patterns uses a lot of energy and can make you really tired.

A stagnation can dissolve any time just the way it was created. This can happen for example when the experiences of a person let a separation become unnecessary and thus allow it to dissolve.

It is also possible that the stagnation will dissolve through touch, e.g. in a Shiatsu treatment. In the direct work with the energetic patterns of stagnation the touch with the attention is at least just as important – if not even more important – as physical touch.

Touch works because it offers a different solution for a certain life constellation than the painful and separating “not-letting-go”. Through the immediate and relaxed presence of the person giving the treatment in the Kyo or in the Jitsu, the blockage patterns experience more space and through this the freedom to get into contact with each other again and to start to dissolve. This is not a hypothetical possibility but an effective method of treatment.

Listen, watch and take it into your hand

As in every pain situation that can be located in the body, also in the case of headaches it is necessary to let the person precisely describe the place of pain. If possible, the client should point it out with her finger and exactly localise the place (up to a few mm). The person should also describe the quality of pain, when and under which typical circumstances they occur, as well as all the other things in the life of the person that could be in connection with the headaches (see beginning of this article).

It is important to get these detailed descriptions even if they do not seem to be important at first. Early conclusions of what to do with the information is unnecessary and should be avoided. In the beginning we are nothing but collectors of information, which later may give us valuable hints on how to proceed in a treatment or a series of treatments. These pieces of information also create the picture we need of a person to work with him effectively.

Also, the localisation of the headache can give certain hints about which energetic organ might be specially involved in this pattern. I described the one-sided headache e.g. as being associated with the Gall Bladder before. The headache which shows in the middle under the skull and which sometimes feels like there would be great pressure or heat under the “lid” is an expression of tension in the liver. Tension headache that pulls upwards from the neck across the occiput is associated with Bladder energy.

In headaches that manifest in the forehead, especially the energies of Large Intestine and Stomach are involved, frontal cavity pain however may be associated with Gall Bladder. A feeling of pressure and heaviness in the whole head, which can feel as if a belt had been too tightly strapped around one’s head indicates a weakness of Ki in Spleen-Pancreas. The Wood element is involved in every kind of headache, however.

It is in the nature of the energetic that these associations are no complete truths. They can give valuable directions for the treatment but they can never replace the exact observation or the impressions we get through our senses while we are giving Shiatsu. Theory is always only a crutch, it can only give hints. To my experience it is the immediate perception that tells us what to do in a treatment.

It can be good to hold the head of the client in the beginning of the treatment and to look into it. What might seem like voodoo for some who experience this for the first time, is nothing more than using the abilities of the inner eye. Just like every person can look into his own body, one can also look into the body of other people and discover energetic patterns there. From a physical point of view, the body is a solid thing, but from an energetic viewpoint it is space, in which the attention can travel freely.

In the case of headaches we want to “see” the patterns at the place of pain and its surrounding. “Pattern” means that the place does not appear homogeneous to the inner eye, but that there are differences. There may be places that feel lighter or darker, there may be differences in density, heaviness, or in countless other possible qualities of subjective perception. If I wait for a little while, there will always be patterns that show up. All I have to do is to realise that they are there and accept that what I find is real. Then I can work precisely with the perceived differences (which one may classify as Kyo and Jitsu), it as if I could touch them with my hands.

The game

In my article “Working with Kyo and Jitsu” I have given a description of how to work with pure attention and physical touch. It is always about directly touching places that draw your attention and to perceive the changes that occur while you are working. You allow places of opposite qualities to get into contact with each other, you facilitate their communication. You just offer a possibility and the places are free to accept your offer or not. If they accept it, the situation may change within seconds, and you can “see” it happen.

If I look into the head in this way and touch directly, it is important that, at least for the next few moments, I forget everything I have ever heard about headaches and their energetic patterns. These moments completely belong to the observation and to the allowing myself to be caught by surprise. Every pattern one discovers is unique and has never existed before. To my experience, every pre-formed assumption about what one will probably find reduces the depth of perception and the possibility of Shiatsu drastically.

As an example, the central pattern of headache that started with an accident or injury many years ago may be found in a different place than where the actual injury was. You have to look carefully.

And, as always when dealing with energetic aspects, you will never be completely sure. Your work will always be an experiment. Occasionally asking the client for feedback brings more clarity.

In such a Shiatsu the patterns found can rapidly change. It takes a large amount of attention to follow the changes. One will be rewarded with always new discoveries and possibilities of understanding.

After the centre of the headache has changed to whatever degree before of my inner “eye”, I now take a look at the near surrounding, to what draws my attention and may be used as a communicating partner for the pattern in the centre.

The areas that I find I connect with my hands as well as with my attention. I offer spaces, I touch, I play, try out, allow movement to happen – small and hardly perceptible movements under my fingers or movements which set the whole of the head into movement. I never know what will happen next, it is always new, and I am always actively involved. This is the game, which offers the place of pain more freedom, openness. To the strength and power of this person it offers the possibility to find a new orientation.

The neck and shoulder area

The next step in the treatment could be to precisely explore the shoulders, neck and throat. This could as well be the first step of treatment after having gathered the information, as it may not feel right to work at the centre of the headache right away. Sometimes, e.g. in case of really strong pain, one might even touch the head only once and briefly during the whole treatment, as more does not seem to be right.

In other cases, after a short contact with the pain zone, one might go directly to the neck or a place that is even further away, and perhaps only come back to the head towards the end of a treatment in order to specifically treat there. Every treatment is unique and we always have many different possibilities to let them evolve.

One thing is important, though: when working with a client suffering from headache you should make sure that towards the end of the treatment you do not work – or even finish – on the head. This is because touch draws attention and Ki to the place where you touch. Thus, if you finish on the head, this may lead to an energetic fullness in the head and thus create a new headache or be an obstacle for the old one to dissolve.

How do I know which path to choose in a specific case? I have no other criteria for this to know than my feeling, which has been trained in years of practice! This is my very subjective feeling, no objective assessment. Every other person would do it in a different way than I do, and some will find my way strange, impossible or even wrong. However, no-one will be able to do it the way I do it – as I will never be able to do it the way someone else does it.

Describing Shiatsu with the shoulder-neck area at this point does not mean that this would be the next right step in the treatment of headaches. The reason lies merely in the structure of this article. For didactic reasons I chose to move from the head, i.e. the place of the pain, to the periphery of the body.

As I already mentioned above, the neck has a special meaning as the connector of head and torso. In almost every case of headache this connection is restricted (an exception could be for example headaches which occur in relation with an illness that involves fever). By taking the shoulder-neck area into my hands and looking at it with a wide and open glance, I can see the specialities of this neck. Energetic interruptions usually also show up physically, and the physical eye-catchers lead me to the underlying energetic pattern. One should not overlook the seemingly too obvious external facts, they are often the ones that lead us to the important places.

In the same way as I described for the head, I play with these patterns, once focusing completely on the neck and once connecting it with the patterns of the head, the shoulders, the torso or the arms. The area of transition from the throat to the head e.g. may appear really tense and dense, or maybe the spinous process of the second cervical vertebra feels like foreign matter cast into concrete. Or a weak, almost electrical feeling of stagnation emerges when touching the transverse process of the first cervical vertebra giving certainty to the practitioner that she has come into contact with an important point of the momentary process of the headache…

“Who’s going to do the Kyo for me today?”

The lower neck may, as a contrary, feel strikingly empty and powerless, or we can find surprisingly deep “holes” between all these tense knots of muscle in the shoulder area. Another possibility is to find this emptiness really close to the dense areas, e.g. only 2 mm beside, between these and the base of the cranium.

Such places of energetic emptiness, respectively under-activity, are sometimes quite hidden at first sight – especially on physically stronger people. With the treatment process going on, they often show up more explicitly, unmasking their “empty” nature. Being touched in the right way, the Jitsu from above e.g. can suddenly release and melt away; a hint in-between that the work being done is effective.

The same, the muscle knots that are higher on the shoulders, e.g. in the area of Triple Heater 15 or Gall Bladder 21, which are so typical for headache situations, have corresponding partners or emptiness. Maybe the treating person will find them halfway up the neck, in the emptiness of the lung zone at the front of the torso, or in the course of the upper arms – or even on the wrists or hands.

Once again, the immediate surrounding should not be overseen. A corresponding Kyo is always found in the direct neighbourhood of a Jitsu knot (sometimes so close that the tips of two fingers put one besides the other are more distanced from each other than this Kyo and this Jitsu). These close Kyos are really interesting and their connection with the Jitsu often quite effective. One starts to understand that Kyo and Jitsu are not two separated phenomena, but that they are indeed one and belong together.

Kyo and Jitsu always represent two sides of the same coin. The one cannot exist without the other. If the Ki is to be concentrated and held in the head – for what individual reason ever – the concentration of energy that is therefore needed, the Jitsu, can only be provided if a Kyo emerges at some other point. Not just one Kyo, though – there are always several antagonists emerging at different parts of the body.

It is as if the Jitsu would stand up and say: “I have to be Jitsu today – who wants to be the Kyo for me?”. Then, at many points of the body, arms of enthusiastic Kyos raise, which themselves again produce Jitsus in other areas. In that way, the healthy human and his body is a living pattern of changing fullness and emptiness. In this living transition lies health.

Alas, only when Ki as it were settles for long in this Kyo-Jitsu pattern, the headache can develop. Suffering and pain become manifest as an expression of consolidating energetic patterns (respectively patterns which are being formed over and over again at the same place).

An addition to the direct work on a Jitsu at the neck: at the moment of contact with an explicit Jitsu, we often find a reflex-like tension in the body of the Shiatsu practitioner, which most prominently shows up in the shoulder area. This may be a protective reaction or just a sign that giver and receiver constantly influence each other. The reaction can be very distinct or barely perceptible from the outside and it cannot easily be prevented. However, it should be noticed.

Every tension in the practitioner is a hindrance to the work with the Jitsu, as in the Jitsu the client can again react with resistance to the tension in the practitioner. In the case of headaches, such a communication of tension can, depending on the personalities of the therapist and the client, produce negative effects. In special cases the headache can even be intensified.

This is the reason for which I recommend to treat most Jitsus, but especially those in the shoulder-neck-area, with internal techniques as those of the Free Ki Flow. One works with the imagination that the touched spot under the thumb or finger has the freedom to vibrate of flow freely and thus get into contact with other parts of the body. With this imagination the tension within the practitioner will usually dissolve, the Jitsu will react more easily and a negative reaction will be rare.

Vibrating space

After the intense work in the closer environment of the pain it becomes necessary to let the widening glance wander over the body in order to find corresponding areas, which we can relate to the local work.

This phase of treatment is of great importance and has a double meaning. On the one hand, at distant areas of the body always lie important places of resonance, most often of contrary energetic quality as the immediate place of suffering. With those can be worked in the manner that I have already outlined.

On the other hand, a region locally treated with Shiatsu should be connected with distant areas during the phase of integration as to offer the starting local process enough space to expand on the whole human being. A change that reaches into the whole body has much deeper effect than a mere local change.

With regard to our example of headaches, basically every area of the human body can serve as such a space of resonance. As a matter of fact, every part of the body is in immediate and lively relation with the blocked area in the head and the neck. Having this in mind, work on any part of the body can have an effect on a person’s headache.

There are areas, however, which are more effective for our work than others. Just as the interruptions in the head or shoulder-neck area, the practitioner can “see” them. Physical indicators optically give a hint. What is more important, however, is the feeling that a certain area is of relevance in the actual context. Such a feeling, which always includes a certain uncertainty, as I have already mentioned, evolves through the practice of Shiatsu.

Typical and important areas of resonance related to headaches are wrists and hands, the legs – here especially the ankles and feet – as well as the situation of the thorax and the Hara on the torso, and the (lower) back.

The arms and legs

Every pain signifies the restriction of the freely vibrating space. In the case of the headache, not only the connection between head and thorax is restricted, but also the connection with other parts of the body. The way into the arms and legs often proves to be a key area for treating a headache.

On the way to the arms we already find a diversity of interruptions of the vibrating space in the shoulder area. Potentially any spot on the arms can be connected to them. They can be located on the meridian, which one is following at the moment. They can, however, also be found on another meridian or even off the meridians. They can spring to our attention at the outside (Yang side) of the arm, but as well on the inside (Yin side). Everything is possible and this is why it is significant to keep a relaxed, centred calmness during practical work, to concentrate on few things and not to fall into a meaningless peripheral activism.

Typically it is the (sometimes hidden) Kyo qualities to which the Jitsu in the pain zone, respectively other Jitsus on the neck and shoulders react by becoming softer when they are touched. There can, however, also be Jitsu spots on the arms, which block the way to more peripheral areas. When they are touched, the practitioner feels too how the atmosphere in the treated space becomes more free.

The most important spots, however, lie in the hands. The calm and profound work with the wrists and hands often uncovers a typical pattern of headaches, which is that this area has become empty and rigid, thus allowing the Jitsu-concentration and hence the pain in the head.

Especially the space in between the metacarpal bones (there especially between the second and third and the third and fourth) often appear as closely pulled together (such a pattern of tension is also found in many other states of tension in the wood-element e.g. in an acute sciatic pain). In the areas between the bones that are filled with muscles we often become aware of many Jitsu-points. To the direct touch they usually react unwillingly. When they are connected to close Kyos in the space between the metacarpal bones, between the basic joints of the fingers or in the area of the wrists or forearms they usually melt away, though.

With such a work the forearms and hands become more free again. They are better bound into the whole body and the vibrating space expands. This is only possible if the herewith-connected blockade in the head and neck releases, as most often happens. Often the treated person will confirm, upon request, that it becomes freer or just “better” in the head now.

The chest

In the same way as the movement into the arms is restricted, often is the movement into the thorax, too. The chest is the place of emotional experiencing in the human body. If we look or touch there, we can often learn something about the deeper emotional situation in which the headache emerges.

I do not at all want to say by this that headaches are of psychological cause in the first line. However, a connection to the emotional reality of the person is most often perceptible. Connection means that the emotional experience sets up an important factor in the multidimensional experience of a human. None of the many factors that are bound into this network has to be seen as the only reason for a problem. Every factor can, however, constitute an important aspect, maybe once even the key-point590, the closer observation of which can lead to a resolution of the knot.

Often it appears as if this headache should in fact prevent a deeper experience of the momentary mental subject. If we effectively work with such patterns, it can happen accordingly that our client goes through painful emotional phases. If the Shiatsu practitioner senses or suspects such a situation, it can be helpful to refer this possibility to the client, without laying too much emphasis on it, though. One should make clear that – if this is the case – it is a positive development.

In any case, it is important to closely observe the chest during treatment. It can e.g. appear overall more rigid and narrow as the expression of a tendency to keep this area well under control and allow an unwanted deeper emotional experience only after former “inspection”. In such a case of rigidity it is especially important (as always anyway) to approve the right of this pattern to be and not to try to remove it. The power of the inner system of the client is always stronger than the possibilities of the practitioner to change it against resistance. If the pattern however is perceived in a relaxed manner and approved, if space is offered to it and therewith new possibilities, changes are much more likely.

Maybe, for example, we notice an emptiness that appears helpless in the upper region of the chest, which mirrors the energetic situation of the lungs. This area is often eye-catching with headaches, with the tendency to appear as a relative energetic emptiness. Or the middle of the thorax distinctively utters itself as the expression of a depressed situation of the energetic heart.

In working directly with this expression on a physical as well as on an energetic level, also in connection to the head, we temporarily reduce the emotional need of this restricted space in the chest. The relatively cut-off area of head and neck regains its old “hinterland” in the thorax and is able to relax. The client may breathe several times deeply and report that the pain in the head diminishes.

Whether we can induce a lessening of the headache beyond this moment during the treatment depends on many factors. Crucial is whether the “internal system” of the client can admit and accept this solution, which is always followed by other, sometimes not so easily acceptable changes. Equally important is the openness of the practitioner who is observing what happens from a certain distance, approving every way the client chooses and resisting to every own impulse to push her into a certain direction.

The Hara

Headaches are to be seen, as all other painful problems involving ‘pressure’, as a phenomenon of the Middle Warmer. The energetic organs that manifest there (Wood and Earth, as well as Triple Heater) are often tense in the case of headaches. If they appear empty in the upper Hara this means that they only retracted to the deep, to stick to a decision with even greater decisiveness.

Accordingly, we will perceive the upper Hara from below the costal arch up to the diaphragm as tense. Such a tension is most often the expression of a pattern that has existed since longer already, which may resist successfully for a long time to the attempt of a quick influence by the practitioner. Moreover, often striking emotional issues mirror in this tension. Working with the density of the Middle Warmer is a subject on its own and requires a lot of patience, imagination and creativity from the side of the practitioner.

Once again, the principle is to offer space to the density by touching empty spots e.g. on the lower Hara or the legs or feet while connecting them to the jitsu in the upper Hara. The intense and clear work with Jitsu-areas that block the way to the peripheral sources of Kyo can be helpful. The meridians of the organs of the Middle Warmer can lead the way to the periphery; the disruptions of the vibrating space on this way can mark the important stages to the solution.

The lower Hara mirrors the Water-element and the lower part of the body. As I have already mentioned, people who often suffer from headaches have a tendency to rising (Liver-) Ki. This tendency makes the upper body, the shoulders and the head appear fuller, tenser, while the lower part of the body develops a perceptible relative lack of Ki. The lower Hara, as well as the legs, ankles and feet will appear rather empty, Kyo, even if they are tense.

Sometimes such a state has existed for years or even decades. The deep work with the Kyo areas of the lower Hara can remind the body of past times, also how good it feels to be more active there, to feel alive. As the Hara mirrors the in many respects the “actual” person, working with such patterns in it requires much patience, as transitions will usually evolve slowly.

The Hara will only change lastingly if the client himself undergoes an active process of change. This process requires regular physical and other exercises, the courage to take, if necessary with professional support, paths that may appear threatening at first (the tendency towards getting headaches may exactly have guarded him from doing this), and it takes time. On the other hand, the counter-weight to the raising Ki will lack and the tendency to bind Ki in the head will prevail without a more active Water, i.e. a lively lower body.

The back

A further way for the energy that is caught in the head to reconnect to the whole body lies in the back, be it that the tension in the back constitutes one of the causes for the emergence of headaches, or be it that the back gets tense as a response to the headache. This is primarily true for a tension-headache, which especially expresses itself on the rear part of the head, and to a certain degree for any other form of headache.

Shiatsu with the tension in the back will always perceive the different states of activity of the different storeys of the back and deal with them concisely. The Upper Warmer at the back e.g. may be quite tense as an expression of avoiding a certain emotional experience in the chest. Perhaps the area of the lungs is sunk in and empty, despite of all tension.

The middle back mirrors the Middle Warmer through the diagnostic zones and the Yu-points, and will usually present itself tensely and fully. In addition, the lower back – frequently in connection with the upper sacrum –will appear rather empty.

In Shiatsu, the aim is furthermore to meet the tension of the Bladder meridian in the big back muscle as well as in the surrounding connective tissue and to encourage the opposite qualities of the different storeys of the back to communicate with each other.

The legs and feet

Finally, the Shiatsu practitioner offers his client the chance to let the vibrating space expand beyond the back and torso down into the legs and feet.

The important passage into the legs is the pelvis with the aspects of the sacrum, buttocks and groins. Quite often it is especially resolving these blockades, which enables a release in the shoulder-head area.

The legs of our clients with headaches can present themselves in different ways. There are e.g. the heavy and full appearing legs that restrict the light vibration of Ki as an expression of a relative energetic weakness of the Spleen-Pancreas. Here the aim of Shiatsu can be e.g. a calm and deep stimulation in the depth to let connections emerge underneath the fullness of the legs that are actually empty.

Or the legs appear thin and empty, even though quite tense – a common pattern with chronic headaches. As well as in other areas of the body, this can be the symbolic external expression of the energetic attempt to control the own liveliness and only admit it in chosen aspects. Of course, this is a common and general human phenomenon, here however it is probably more pronounced.

Narrowness and rigidity bind a lot of Ki (the term ‘Liver-Ki-stagnation’ was also coined for this). Ki that has been bound for a long time in such narrowness possibly creates a strong upwards tendency of the energy, which again needs to be controlled with much force (hence the rigidity) so that it does not rush up and may possibly render the person unable to think and act clearly.

Such a controlled, strong upward tendency that consists over a long period of time can present itself to the observer in the form of a fuller and tighter appearing thorax and head, and under certain circumstances – not at all in every case, however – a tendency towards headaches may emerge. Lower Hara, lower back, legs and feet, however, remain behind rather thin and empty.

Is this controlled and highly tense energy released during a phase in life, so should this happen step by step (usually, the energetic system of a person does not allow anything else anyway) – too destructive can the effect of the suddenly released energy that is rushing up the body be.

As with the arms and hands, important Kyo- and Jitsu-points that communicate with eye-catching areas in the upper regions of the body, respectively which restrict their connection to the feet, can equally be found on the legs. Working with the meridians now can render the important Kyo and Jitsu interruptions visible. Not rarely though, essential spots are also found away from the theoretical course of the main meridians.

In an extreme case, the meridians of e.g. the Stomach, Triple Heater or Gall Bladder can be so tense that they can hardly be touched. If they get released, however, this can have a strong releasing effect on the upper body.

Again, as with the hands, the tension in the spaces between the metatarsal bones are often key-points for a release of tension in the head. They too like to react to Kyo-spots in the close surrounding between the metatarsals, in the area of the basic toe joints, or with Kyo zones at the ankles or calves.

The deep and calm treatment of the soles can be – especially if this region doesn’t appear really alive and rather Kyo – releasing, as they constitute one of the essential ways of connection of the body to the ground. Pain and especially headaches always signify that a person not only cuts himself internally off, but furthermore restricts the connection to his surrounding. The connection to the ground is of such great importance in the case of headaches because it represents a kind of anchor for upward rising energies.

How else we can help our clients

Shiatsu treatments are an effective possibility to treat headaches. The treatment itself never takes place in a quasi-empty space. Our client is always connected to a specific situation of her life, which can influence the effect of our treatment either in a supportive or inhibiting way.

It is hence important to get to know these contexts of life at least partially. This enables us to give advice in the dialogue with our clients. Indications concerning nutrition e.g. might be very important for our clients, as well as support in questions of how to structure the working day.

Advice and hints for the every-day life that we give may sometimes appear obvious to ourselves, for our clients however, they may be a revelation. It is also possible that they already knew everything and everything they needed was just someone they could have confidence in and who told them once again.

As a general rule, it is also important for clients who suffer from headaches to do regular exercises. These can be simple but effective Do-In exercises for the head-shoulder-neck-arm area. Usually it will make sense to extend the exercises to the whole body.

Physical exercises from the Hatha-Yoga and related systems or Feldenkrais are helpful as they promote the presence of perception of the client in her own body over medium-term. Lacking presence in the perception weakens the vibrating space, facilitates interruptions as well as the congestion of Ki in the head. Such exercises in contrary make the body more permeable for the vibrating Ki, facilitate the emergence of depth and space and hence work against the headache.

Exercises of perception (e.g. “Body travels” to the place where the pain is) create more consciousness and thus more space. Breathing exercises and –therapy have the same effect magnified by the relaxation. The new spaces that emerge here work against any pain, as pain is always limitation and narrowing down. Meditation can work into the same direction.

The self-massage of the own Hara is dead easy and has a pleasant effect, as it works against the tendency to cling in the upper stomach and the unconscious emptiness of the lower abdomen. Certain applications of Kneipp for legs and arms pull Ki there and thus work against the upward movement and the concentration in the head.

This is an arbitrary and totally incomplete list of some of the possibilities that gives our clients something to do for themselves besides the Shiatsu treatments. In any case, one should only advise exercises which one has personally got to know. One should only teach what one has practised for some time and with what one has gained the according experiences.

It is out of question that such exercises are of special importance not only to people who suffer from headaches. What one does out of personal interest and proper activity for oneself and one’s own health, will prove a lot more effective over a long term than any treatment one could possibly receive. Shiatsu treatments and our advice can be the initial point for such a development in the life of our clients.


In this article I have described the aspects which are especially important to me in my work with headache clients. Such a compilation should not be understood as a request to seize all the aspects as to treat all the typical places of resonance in the body e.g..

If one would treat all the body parts and meridians that are of theoretical importance in a case of headaches, the practitioner’s mind would lose its clarity. The information that “the system” of the client gets during treatment would be unclear and vapid, hence the effect – apart from lucky hits – rather weak.

Shiatsu, however, gains its effectiveness exactly from the restriction to an as clear as possible guiding line. When following such a line one has to make a choice of the regions that are to be treated according to one’s impression that one has gained from this client today. In the following week it may look quite differently already.

It is therefore helpful to engage into an intuitive and subjective perception of the client, if necessary to learn it with the support of experienced teachers, and to trust it. The subjects and regions become clearly visible then and it becomes easy and joyful to follow them. As I have mentioned earlier, there will always be an uncertainty whether one is on the right track or not. As we all know, one learns most from mistakes.

Have a lot of pleasure with Shiatsu!


© 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.