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Shiatsu with the elderly

(G. Poli)



I have always considered a privilege to treat elderly people with Shiatsu.  Elderly people are very special people:  they have very often developed an inner wisdom that comes from their long life experience, from having lived at least a third of their existence;  they are often very compassionate:  they have gone through so many events, they know so much about life and how challenging it can be, that they tend not to judge other people’s behaviour but to have a deep understanding for how they live their life.  Elderly people are usually inwardly free as  they have accomplished most of their life plans and carried out most of their family or work tasks.  They have time: a great advantage nowadays.


Quite often, however, they feel uncomfortable, out of place, sometimes inadequate because the people and the environment around them have changed so much and so quickly over the last 20/30 years:  the rhythm of life has increased tremendously, values have changed, habits have changed, peoples’ attitude towards old people has also changed.  High technology has brought about a true revolution in communication:  computers, cellular phones, iPhones, i Pads, iPods, etc..  Elderly people often feel alone and separated in this reality also because they do not have the same strength and vitality of the old times.


In fact, also their bodies have a long life experience and, while their emotional, mental and spiritual qualities develop more and more, their physical part starts to have some discomfort.  From a wider perspective they are preparing for the big transition:  they are slowly slowly getting ready to go where they will not need their body any longer but where only their spirit, their essence will go .


Elderly people are very appreciative of Shiatsu. They are particularly sensitive to the contact we establish through its very special “loving touch”;  they value the fact that we are listening to them, that we have a deep consideration for their dis-eases and, if this is the case, for their suffering;  and they especially like our approaching them as human beings, as a unity of body/mind/spirit.  And they usually greatly benefit from Shiatsu sessions.


Because of who they are and how they are, we need specific strategies and tools to work with them;  furthermore, we have to have great respect, compassion, understanding and sometimes patience.



In my experience, one of the most important tools in working with elderly people is the quality of touch:  as already mentioned, they usually have long lived bodies and therefore often fragile bones and painful joints, limitation in the range of movement, sometimes hip or knee prosthesis.  We have, therefore, to use with them, more than with anybody else, a very expanded touch:  deep and soft at the same time, a touch that does not “press” but that establishes a deep contact with the energy flow of the meridians and that resonate in their whole body and in their whole energetic system.


This touch, this leaning must come from our hara, from our whole body:  it is not just our hand or our thumb touching one part of their body but it is “us”, our whole body, our whole energetic system getting in contact with their whole system.  This touch requires a predominance of the expansion phase when we lean, expansion that comes from being aligned between Heaven and Earth, from having a relaxed body, open and relaxed joints, a calm mind and an open heart.


When even this very expanded leaning can be painful or dangerous, I use Ki projection:  I intentionally channel my Ki through my hands and  get in contact with their meridians’ energy without using my body weight.



There are two other tools that I believe are very effective when working with elderly people:  i.e. modeling and mindset.


When I talk about modeling I mean that I can myself become an “energetic model” for the receiver through the way I set and use my energy in my whole system (body/mind/spirit).  If, for instance, I feel that the receiver has a need for more space in his joints, I will open and create space in my own joints (through a physical movement, or an idea, an imagine, a sound, etc.), This opening in my body will resonate in my energetic system and at the same time will create a resonance in the energetic system of the receiver:  as if I was showing him what it feels like to have relaxed joints.


Or, if the information I get from the contact is that the receiver has a need for calm, silence or peace, I will then resonate these qualities in my energetic system so that the client can receive this “offer”, this “suggestion” through the resonance between our two systems.


With mindset, I consciously use my mind, my thoughts, my intention.  We all know that “the mind leads the Ki”, and therefore what I think during the treatment, will pass through my touch;  for instance, I can offer the receiver an image or an idea of relaxation, of calm, of peace, etc., I can suggest through my touch:  “what about experiencing the pleasure of deep relaxation, of being calm and peaceful,  how does this feel to you”?


Through modeling and mindset I somehow magnify the effect of my touch, and this can be very useful when elderly people have pain, inflammation or reduced movement or when they have “forgotten” some of their life possibilities and they are not using their meridians’ functions to their full potential.



Fascia release represents another extremely effective and very helpful tool in working with elderly people.


Fascia is the general term used to designate the connective tissue.  It may also be called “collagenous network” or “connective tissue webbing” or according to Gray’s Anatomy “extracellular matrix” (Thomas W. Myers: Anatomy Trains).


The peculiarity of Fascia is that it is a single smooth sheath that spreads throughout the body in a three-dimensional web from head to foot without interruption.  It covers bones, muscles, nerves, organs, vessels down to the cellular level.


Quote from  “Energy Medicine -The Scientific Basis” by James L. Oschman:


“……….All of the great systems of the body – the circulation, the nervous system, the musculoskeletal system, the digestive track, the various organs and glands – are everywhere covered with material that is but a part of a continuous connective tissue fabric.


The connective tissues form a mechanical continuum, extending throughout the animal body, even into the innermost parts of each cell.


The connective tissues determine the overall shape of the organism as well as the detailed architecture of its parts.


All movements, of the body as a whole or of its smallest parts, is created by tensions carried through the connective tissue fabric………”


Fascia “restriction” can be  caused by all sorts of traumas and unresolved  stress.   Physical, emotional, mental and spiritual stress can bind down the fascia, resulting in a restriction of one or more of the energetic levels of the person, creating pain and malfunction throughout the system.


As a matter of fact the connective tissues are also very crucial energetically as they are deeply connected and interwoven both with our denser structures, such as bones, muscles, ligaments, organs, etc.  and with our more expanded energetic structures of the emotional, mental and spiritual levels.


Therefore, the release of fascia can be extremely effective when working with elderly people as, on the one hand, it will allow the return of their denser structures to their normal physiological adaptive range relieving pain and improving the quantity and quality of motion and function;  and, on the other hand, will allow their more expanded energetic structures (emotional, mental and spiritual level) to return to their normal vibrational potential, often facilitating the emergence of emotional patterns and belief systems that are not longer relevant to their present life and which are limiting their life potential.  In fact, what is also peculiar about fascia is its ability to “record” and “trap” in its fabric  the energy connected with emotional traumas and/or belief systems that originate from past negative experiences.


Fascia work is also so suitable for elderly people as in order to release fascia we do not lean, we just put our hands on the part of the body where fascia is restricted, we listen, tune in and follow its movement towards release.  So we can treat elderly people even in case of acute situations when leaning would not be appropriate or would be dangerous.  We can also treat delicate parts of their body,  like the neck for instance, where we can do a very deep work to help recreate the physiological space between vertebra, or relax muscles, tendons and ligaments, without moving the neck or stretching it but just holding it in our hands and following the fascia release.


I would also like to mention another two aspects that I find important when working with elderly people.  First, I find that it is much safer and more comfortable for them if we use a table.  It is easier for them to lie down and get up especially if they are in pain or if they have reduced movements. Furthermore, the fact of being treated on a futon comes from another culture and it is quite a new “idea” for old people who are used to doctors’ and physiotherapists’ tables.  Secondly, it can also be a good idea to have a routine in the session so that they know what is coming next and can relax more easily and feel more confident as “there will be no surprises”.


A further  consideration:  my Master Pauline Sasaki used to distinguish four components or phases in a Shiatsu session:  Movement, Control, Support and Maintenance.


Of courses these phases are not separate but always interconnected and none of them exists on its own.  However, we can observe a predominance of one or two over the others or create a predominance,  if we consider it useful.


Movement refers to physical movement:  when we move our receivers, we do rotations, stretches, mobilizations, etc..  When we work with elderly people,  the movement phase is usually not very present in our treatments:  we do not move them so much as it could be risky, painful or simply uncomfortable for them.


Control  refers to mindset, modeling, intention:  when, as already mentioned, we use our thoughts as a technique to make a proposal, a suggestion, an offer to our receiver’s energetic system or we use the way we set our energy to become a model for him.

This phase is instead predominant  as old people usually respond very well when we use our touch to communicate with them through a language made essentially of vibrations.


We talk about Support when we listen to and support  our receiver’s energy in what it is doing as a response to the movement and/or control phases.  With old people support  like control is also very present as we have to be very careful not to over-stimulate them, not  to give them too many inputs,  but to leave them the time and space to react.


In Maintenance we give elderly people all the space they need to integrate whatever movement or change has occurred in their body and in their whole energetic system.   We are aware that their energy has an intelligence of its own and knows how to best integrate the inputs of our work.  Maintenance is a precious phase: we are totally in the “being and not doing”: we are present, we hold the space for our receivers and we are witnesses of  their energy movement towards healing.


To conclude treating the elderly can be a fascinating and very intense work as we touch life in its most mature expression  and this represents an extremely enriching experience, another of the many gifts Shiatsu offers to us.

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