Introduction
Ashiatsu, also known as back walking massage, is an ancient massage therapy that has been gaining recognition in the modern spa and wellness industry. This technique, which involves the therapist using their feet to apply deep pressure to the client's body, is said to be one of the deepest and most luxurious massages available. While Ashiatsu offers several benefits, it is essential to understand the potential risks associated with this unique practice.
What is Ashiatsu Massage?
Ashiatsu (pronounced awe-shee-at-sue) is a unique massage technique where specially educated massage therapists use their feet to apply deep pressure to your body. It’s often called a barefoot massage. The term "Ashiatsu" comes from the Japanese words "ashi" (foot) and "atsu" (pressure). The methods employed allow the deep tissues, joints, and muscles to be massaged while easing the nervous system. This technique feels like a mesmerizing massage with deep, broad, pressured strokes and no pain. It’s often called a barefoot massage.
Historical Roots
Just like other massage techniques, back walking massage has more than 3000 years of history. Many different branches of barefoot massage have originated from East Asia. Ashiatsu massage is a fusion of oriental philosophy, religion, culture, and tradition. It relates to a study of Zen and Chi. For example, India, Japan, Thailand, China, and the Philippines all have similar massage techniques. The only difference is some are practiced on a floor mat, others may require balancing props, ceiling bars, bamboo rods, or other equipment.
Modern Popularity
The practice first gained popularity in the West in 1999, largely due to Ruthie Hardee’s efforts. Her version known as Ashiatsu Oriental Bar Therapy has become widely adopted across the United States.
Benefits of Ashiatsu Massage
Ashiatsu massage offers several potential benefits, making it a popular choice for those seeking deep tissue relief and relaxation.
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Reduces Chronic Pain and Aches
Ashiatsu massage is a deep tissue compression massage through the use of the therapist’s feet. This technique manipulates the deeper layers of soft tissue to help loosen the tissues, which helps in chronic pain reduction. This massage’s compressive stokes help flush out the inflammation that causes pain. Adhesions and tight connective tissues create much of our discomfort, which is why our therapists focused on reducing these pressures during an Ashiatsu session.
Leaves Little to No Discomfort
While Ashiatsu massage is similar to deep tissue massage, there is one major difference: Ashiatsu massage has little residual soreness while the treatment is being performed. The application of the foot allows for a more generalized dispersed pressure that is both deep and relaxing with little to no discomfort. Many clients report that they prefer deep pressure from the foot vs the sensations they experience from thumbs or elbows in traditional massage. Because muscle tissue is manipulated is a more broad to general fashion post muscle soreness after an Ashiatsu massage is mild.
Increases Flexibility and Circulation
Want the benefits of a long stretching or yoga session without all the hard work? Our massage therapists, specially educated in this technique, can help you out. The feet play a significant role in Ashiatsu massage; not only do they allow the therapist to pinpoint deep tissues, but the use of feet also allows therapists to use gravity to their advantage. The long gravity-assisted stokes can broaden and lengthen the muscle fibers in the body, creating more flexibility. Tissues of the body are also often stretched in two different ways during the massage, helping scar tissues and adhesions recover, increasing circulation and flexibility. Runners often find the Ashiatsu method helpful for stabilizing and keeping the knees and hips flexible.
Provides the Deepest Tissue Therapy
When you receive a typical deep tissue massage, a therapist will use thumbs, elbows, hands, and other body parts to reach deep tissues. Ashiatsu techniques allow our massage therapists to get the same level, and more, of deepness with just the use of their feet. The secret is their use of gravity. This also allows the therapist to retain that deep pressure longer than in standard deep tissue massages. With the longer and deeper strokes come long-lasting effects on your body. Even after the massage is over, your body will continue to increase the circulation of the blood and lymphatic systems. With these effects still taking place, many clients admit to feeling just as relaxed hours after the massage is over. Since the deepest tissues have been manipulated and the body is effectively recovering, the overall effects last longer than a traditional deep tissue.
Decreases Stress and Tension
Massage therapies of all kinds can help the body let go of the stress it is holding. However, no other massage application has been proven to enhance the state of nirvana and the level of calm as Ashiatsu. These massage techniques reduce levels of cortisol, the body’s primary stress hormone. Positive effects of lowered heart rate, decreased tension, and overall mental health have all been connected with Ashiatsu massages.
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Improves Posture
Consistent sessions can help realign the spine and correct postural imbalances. This aspect is particularly beneficial for individuals who experience chronic back pain due to poor posture or spinal issues.
Other Potential Benefits
Thai massage has many health benefits, from lowering stress to relieving muscular tension.
While people may find benefits in Thai massages, it is important to note that many of the following reported benefits of Thai massage have little or no rigorous scientific backing.
Lowers Stress
While Thai massages may be more physically involved than some other forms, it is possible they still may provide stress relief, although research in this area is lacking.
For example, a limited, older 2015 study found that Thai massage significantly reduces levels of a certain stress marker present in the saliva, called sAA. The researchers concluded that Thai massage is more effective at reducing stress in healthy people than simply resting.
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Larger, higher-quality studies are necessary to fully assess the efficacy of Thai massage for stress relief.
Boosts Energy
Research has shown that Thai massage can increase people’s physical energy levels. One 2018 randomized trial examined the effects of Thai and Swedish massages in people who were experiencing fatigue.
The results revealed that Thai massage increased energy and mental stimulation, while Swedish massage was more likely to improve relaxation and sleep.
Relieves Headaches
Court-type is a specific form of Thai massage that involves applying pressure to specific energy channels.
One 2015 study found that court-type Thai massage is an effective treatment for chronic tension headaches. However, further studies have not confirmed these findings.
Stimulates Circulation
Thai massage may promote the circulation of both blood through gentle stretches and muscular manipulations. A 2020 study examined the benefits of Thai foot massage in people with peripheral neuropathy, a common complication of diabetes. Researchers found that traditional Thai massage improved blood flow in the skin and increased the range of motion of the ankle joint. An older study from 2017 reported similar findings in the legs.
Improves Range of Motion
Thai massage incorporates yoga-like stretches to reduce stress and improve circulation. Advocates claim that this gradual, gentle stretching will enhance the person’s flexibility over time, allowing a greater range of motion.
A 2017 study found that Thai massage was as effective as joint mobilization therapy in the short-term relief of nonspecific lower back pain.
Benefits for Athletes
Athletes are prone to fatigue, muscle and joint pain, and injury during their training. That is why many athletes work with specialized sports massage therapists.
A 2024 study found that Thai massage can help specific muscular fatigue recovery following exercise. Other research also suggests Thai massage may help relieve localized muscular pains and improve joint mobilization. These three factors may be of notable benefit to athletes.
However, it is important to note that these studies do not represent conclusive evidence for the benefit of Thai massage in sports recovery.
Risks and Considerations
While Ashiatsu holds numerous benefits, it is equally important to be aware of potential risks.
Risk of Injury
Walking on the back exerts forces on the bones, joints, and soft tissues. Improper stepping on the back would possibly cause nerves and spine injuries. Improper application of pressure can lead to bruising, muscle damage, or exacerbation of pre-existing conditions. It is crucial to ensure that practitioners are certified and experienced to minimize the risk of injury.
Not Suitable for All Conditions
Ashiatsu may not be suitable for individuals with certain medical conditions.
People with cervical spondylosis should not get back walking massage; a wrongful operation may impinge the spinal cord, which will aggravate the damage to the cervical spine. People with osteoporosis, varicose veins, high blood pressure, heart disease, coronary artery disease and certain cardiovascular conditions should avoid this type of massage. Additionally, people who have cancer, are pregnant or are recovering from surgery should not undergo a Thai massage.
Discomfort During the Session
For some individuals, the deep pressure applied during an Ashiatsu session can be uncomfortable or even painful.
Ashiatsu and Low Back Pain (LBP)
Low‐back pain (LBP) is one of the most common and costly musculoskeletal problems in modern society.
The global point prevalence of LBP is estimated to be 12%. According to the 2010 Global Burden of Disease Study, it is estimated that LBP is among the top 10 diseases and injuries that account for the highest number of disability‐adjusted life years (DALYs) worldwide. Although LBP is a benign and self‐limiting condition, many patients look for some type of therapy to relieve their symptoms and improve their function. For this reason, it is possible to list more than 50 potential therapies promising to relieve the pain, lessen the suffering and eliminate this problem. However, there is sound evidence for only a minority of these therapies.
Research Findings on Massage for LBP
Massage was found to be better than inactive controls for pain ((SMD ‐1.24, 95% CI ‐1.85 to ‐0.64; participants = 51; studies = 1)) in the short‐term, but not for function ((SMD ‐0.50, 95% CI ‐1.06 to 0.06; participants = 51; studies = 1)).
For sub‐acute and chronic LBP, massage was better than inactive controls for pain ((SMD ‐0.75, 95% CI ‐0.90 to ‐0.60; participants = 761; studies = 7)) and function (SMD ‐0.72, 95% CI ‐1.05 to ‐0.39; 725 participants; 6 studies; ) in the short‐term, but not in the long‐term; however, when compared to active controls, massage was better for pain, both in the short ((SMD ‐0.37, 95% CI ‐0.62 to ‐0.13; participants = 964; studies = 12)) and long‐term follow-up ((SMD ‐0.40, 95% CI ‐0.80 to ‐0.01; participants = 757; studies = 5)), but no differences were found for function (both in the short and long‐term).
Limitations of Research
We have very little confidence that massage is an effective treatment for LBP. Acute, sub‐acute and chronic LBP had improvements in pain outcomes with massage only in the short‐term follow‐up. Functional improvement was observed in participants with sub‐acute and chronic LBP when compared with inactive controls, but only for the short‐term follow‐up.
The quality of the evidence for all comparisons was graded "low " or "very low" which means that we have very little confidence in these results.
How Massage Therapy Helps Improve Posture
A massage therapist will begin by assessing your current body positioning to determine what needs to be addressed (hunched back or jutting neck, twisted knees or hips, etc.). Swedish, sports, or deep tissue massage techniques are most commonly used to deal with misaligned posture. Your therapist can also teach you stretches and techniques to improve your posture over time.
Benefits of Massage Therapy
The positive effects of massage therapy on your posture can often be felt immediately after the session, and affect your entire body.
Muscles Are Relaxed
Massage works to help your muscles relax and loosen up. Therapists use long strokes and deep, firm pressure to get rid of adhesions or knots. Then you can more easily move your body into alignment.
Joints Are More Flexible
Massage also helps increase flexibility in your joints, which can tighten up and lock into the wrong positions over time. For example, your neck joints may be so tense from hunching that it can be painful to tuck your chin. But massage loosens everything up so you can pull it back into line.
Pressure Points Are Relieved
Poor posture can put unnecessary and intense pressure on various parts of your body. Massage therapy loosens everything up and helps take the pressure off those pain points, like a hip or knee that you’ve been favouring because your other one is too tight or locked up.
Other Ways to Treat or Improve Posture
Massage is amazing and helps to relieve poor posture, but there are other things you can do in between sessions to improve and maintain proper posture and reduce future pain.
Avoid Sitting for Extended Periods
If you habitually sit for long periods of time while working, set a timer to remind yourself to get up and walk around at least once an hour. And don’t spend more time sitting than you need to - when work is over, get up and do something active every day, if you can.
Lean Back Slightly When Seated
If you have to sit, try to lean backwards slightly while doing so. Having a more open angle at your hip joint decreases pressure on the discs in your spine, compressing them less and reducing back pain.
Keep a Straight Back When Walking or Standing
Try not to hunch or lean while you’re standing or walking. Squeezing the muscles in your butt (the glutes) helps keep your pelvis level at your hip joints, preventing it from angling and causing you pain.
Spend Less Time on Your Smartphone
Smartphones are definitely bad for our posture. We spend too much time with our heads bent down or shoulders hunched forward, looking at our tiny screens, which leads to misalignment and pain in the back, neck, and shoulders and can also impede our breathing.
Stop Looking Down
Looking down at your phone drastically increases the amount of force being exerted on your neck by your head, which leads to pain and poor posture. If you must use your phone, try not to look down while doing it - place it on a higher surface or use a stand and look at it straight on.
Exercise and Stretch Frequently
A sedentary lifestyle is a major risk factor for poor posture. Spending all your time in a desk chair or curled up on a sofa will naturally degrade your body’s alignment and cause you to stiffen up and get sore, even if you feel relaxed. Keep your body loose and maintain good range of motion through regular exercise (at least 30 minutes a day, five days a week is recommended) that includes stretching.