Watsu is a form of aquatic bodywork used for deep relaxation and passive aquatic therapy. Watsu is characterized by one-on-one sessions in which a practitioner or therapist gently cradles, moves, stretches, and massages a receiver in chest-deep warm water.
A relaxation technique is any method, process, procedure, or activity that helps a person to relax; to attain a state of increased calmness; or otherwise reduce levels of pain, anxiety, stress or anger. Relaxation techniques are often employed as one element of a wider stress management program and can decrease muscle tension, lower the blood pressure and slow heart and breath rates, among other health benefits.
Aquatic therapy refers to treatments and exercises performed in water for relaxation, fitness, physical rehabilitation, and other therapeutic benefit. Typically a qualified aquatic therapist gives constant attendance to a person receiving treatment in a heated therapy pool. Aquatic therapy techniques include Ai Chi, Aqua Running, Bad Ragaz Ring Method, Burdenko Method, Halliwick, Watsu, and other aquatic bodywork forms. Therapeutic applications include neurological disorders, spine pain, musculoskeletal pain, postoperative orthopedic rehabilitation, pediatric disabilities, and pressure ulcers.
Watsu, originally developed by Harold Dull at Harbin Hot Springs, California in the early 1980s, combines elements of muscle stretching, joint mobilization, massage, Shiatsu, and dance, performed in chest-deep warm water (around 35°C = 95°F). The receiver is continuously supported by a practitioner or therapist while being backfloated, rhythmically cradled, moved, stretched, and massaged.
Harold Dull is an American aquatic bodyworker and poet best known as the creator of Watsu, originally developed in the early 1980s at Harbin Hot Springs, California. He is also known for his poetry, as founder of the Worldwide Aquatic Bodywork Association (WABA), and as creator of Tantsu and Tantsuyoga. Watsu is a form of aquatic bodywork in which a practitioner or therapist gently cradles, moves, stretches, and massages a receiver in chest-deep warm water for deep relaxation and aquatic therapy.
Stretching is a form of physical exercise in which a specific muscle or tendon is deliberately flexed or stretched in order to improve the muscle's felt elasticity and achieve comfortable muscle tone. The result is a feeling of increased muscle control, flexibility, and range of motion. Stretching is also used therapeutically to alleviate cramps.
Joint mobilization is a manual therapy intervention, a type of passive movement of a skeletal joint. It is usually aimed at a 'target' synovial joint with the aim of achieving a therapeutic effect. When applied to the spine, it is known as spinal mobilization. These techniques are often used by chiropractors, osteopaths, occupational therapists, and physical therapists.
In the early 1980s Harold Dull adapted Zen Shiatsu for use in warm water pools at Harbin Hot Springs in northern California, with emphasis on connecting with the breathing patterns of the receiver and establishing a meditative state during sessions. Dull observed that people receiving Watsu treatments entered a deep relaxation state, with strong physical and emotional effects. In the early years, massage therapists were the main practitioners of Watsu, offering sessions as a new category of aquatic therapy called aquatic bodywork. By the late 1980s and early 1990s, physical therapists and other healthcare providers began applying Watsu to treat diverse orthopedic and neurologic conditions. While Watsu's roots in Shiatsu and the close physical contact led to some early resistance among those trained in conventional healthcare, Watsu is now practiced in spas, clinics, and hospitals, and utilized as an aquatic rehabilitation technique.
Harbin Hot Springs is a non-profit hot spring retreat and workshop center at Harbin Springs in Lake County, Northern California. Named after Matthew Harbin, a pioneer who settled in the Lake County area. It is located about two hours northeast of the San Francisco Bay Area, in the United States. The facility was partially destroyed in the Valley Fire in September 2015, and was temporarily closed; as of September 2017 it was announced the resort would reopen in early spring 2018.
Watsu is performed in one-on-one pool sessions in chest-deep warm water. During a session, a provider (practitioner or therapist) gently cradles, moves, stretches, and massages a receiver (client or patient). A typical session consists of a progression of breath coordination, movement patterns in different positions, and massage. Movement patterns including gentle cradling and rocking, more dynamic stretching and mobilization, stillness, and specific mobilization techniques focused on the needs or condition of the receiver. A session may last anywhere from a few minutes to longer than an hour. During a session, the provider continually monitors the state of the receiver, mindful of subtle changes in muscle tension and respiration, and responsive to adapt the treatment accordingly.
Before starting a pool session, the provider meets with the receiver to fill out paperwork, answer questions, review referrals and records, and discuss needs, expectations, and health condition. The receiver is fitted with floats around the upper shins or lower thighs to prevent the legs from sinking. The session starts with the receiver seated or crouched at the pool edge. The provider faces the receiver, coordinates breathing, and then gently draws the receiver into a back floating position called "first position".
In "first position", the receiver floats facing upward while the provider supports the receiver's head in the crook of one arm and maintains gentle traction of the spine from the base of the skull (occiput) to the base of the spine (sacrum). The provider gently sways from leg to leg ("horse to horse stance") or forcefully moves in deep lunges in alternating directions ("warrior to warrior stance"), producing rocking and wave patterns in the receiver. Typical Watsu moves use turbulent drag to produce traction and softly stretch the limbs and torso. Movements include slow rocking, arm and leg stretches, trunk rotations and stretches, and various oscillation and pulsing patterns. Moves are repeated on both sides for balance.
Basic Watsu moves include the following:
Other positions and techniques have been developed to produce specific effects and to address specific parts of the body. For example, a "head pull" permits gentle traction and mobilization of the neck, "seaweed position" permits mobilization and rotation of the spine and hips, and "full saddle" permits stretching and massage of the side body and limbs.
A specialized set of techniques have been developed to adapt Watsu for receivers with special needs. For clients with severe spasticity, the usual turbulent drag is not sufficient to stretch the body. Additional manual pressure is applied to sustain gentle, prolonged stretches, for example attaining trunk rotation by pressing the opposite shoulder while pulling the knees. Head pillows and other additional floats are often used for specific therapeutic techniques, similar to how rings or floats are used for the Bad Ragaz Ring Method for aquatic rehabilitation.
The Worldwide Aquatic Bodywork Association (WABA) oversees training programs for certification in Watsu and related aquatic bodywork forms (WaterDance, Healing Dance, Aquatic Integration...). WABA also maintains an official registry of certified practitioners and instructors, classes, and training institutes. Training consists of basic and advanced coursework, as well as logged practice and demonstration of mastery. Certification levels include "Provider", "Practitioner", "Therapist", "Assistant", and "Instructor".
During a Watsu session, the recipient's heart and respiration rates decrease, depth of respiration increases, muscle tone decreases, and recipients report a deep state of relaxation. Robert Scaer suggested that deep relaxation of Watsu balances the autonomic nervous system (ANS), decreasing sympathetic response and increasing parasympathetic response, with far-reaching benefits. Compressive forces of hydrostatic pressure combine with deep relaxation to enhance functioning of the lymphatic system and reduce swelling in cases of edema. For orthopedic impairments, combined effects of relaxation, warm water, and gentle movement decreases muscle spasm, provides pain relief, improves soft tissue mobility, and increases range of motion. The rhythmic rocking motions combined with repeated trunk rotation and elongation relaxes muscles and improves mobility.
Many patients and clinicians report psychological benefits for stress reduction and resolving past traumas.
Watsu is offered along with other forms for bodywork and massage at spas, recreation facilities, and retreat centers, and offered as a form of aquatic therapy at clinics, hospitals, and healthcare centers.
For healthy people, Watsu is used for relaxation, muscle stretching, and "nurturing connection".
For physical rehabilitation, Watsu is used by aquatic therapists to improve function and increase quality of life. Watsu has been applied for treatment of patients with orthopedic and neurologic impairment, in particular for limitations in range of motion from soft tissue restrictions, muscle spasm (hypertonicity), and pain. By improving soft tissue mobility and decreasing spasm, patients can respond better to functional activities. For severe cases, short periods of Watsu can be alternated with short periods of functional activities.
Watsu has been proposed as a therapy for fibromyalgia syndrome,and for rehabilitating patients after a stroke.
Little research has been done on Watsu. Various extrapolations concerning therapeutic effects have been made from research in established areas of therapy, in particular proprioceptive neuromuscular facilitation (PNF) and sensory integration.
For psychological rehabilitation, Watsu has been used to improve psychological function by calming the nervous system, enhancing relaxation, increasing body awareness and decreasing general anxiety. Watsu is sometimes recommended as an adjunct therapy to help process trauma, in conjunction with a psychotherapist.
As with all aquatic activities, Watsu has inherent risks. The Watsu provider needs to constantly observe and analyze each movement for safety, especially in case of injury or illness where movement could cause harm, e.g., osteoporosis, acute rheumatoid arthritis, and ligamentous instability. Slow and smooth movement, without sudden loading of the joints, is generally advisable. Motion sickness, with dizziness, nausea, or disorientation from excess vestibular system stimulation can occasionally result and therapists are advised to watch for signs of overstimulation.
Physical therapy (PT), also known as physiotherapy by using mechanical force and movements, manual therapy, exercise therapy, and electrotherapy, remediates impairments and promotes mobility and function. Physical therapy is used to improve a patient's quality of life through examination, diagnosis, prognosis, physical intervention, and patient education. It is performed by physical therapists.
Massage is the manipulation of soft tissues in the body. Massage techniques are commonly applied with hands, fingers, elbows, knees, forearms, feet, or a device. The purpose of massage is generally for the treatment of body stress or pain. A person who was professionally trained to give massages was traditionally known as a masseur (male) or a masseuse (female), but those titles are outmoded, and carry some negative connotations. In the United States, the title massage therapist has been recognized as a business norm for those who have been professionally trained to give massages.
Torticollis, also known as wry neck, is a dystonic condition defined by an abnormal, asymmetrical head or neck position, which may be due to a variety of causes. The term torticollis is derived from the Latin words tortus for twisted and collum for neck.
Tui na is a form of Chinese manipulative therapy often used in conjunction with acupuncture, moxibustion, fire cupping, Chinese herbalism, t'ai chi, and qigong.
The piriformis is a muscle in the gluteal region of the lower limbs. It is one of the six muscles in the lateral rotator group.
Thai massage or "Thai yoga massage" is a traditional healing system combining acupressure, Indian Ayurvedic principles, and assisted yoga postures.
Manual therapy, or manipulative therapy, is a physical treatment primarily used by physical therapists, physiotherapists to treat musculoskeletal pain and disability; it most includes kneading and manipulation of muscles, joint mobilization and joint manipulation. It's also used by occupational therapists, chiropractors, massage therapists, athletic trainers, osteopaths, and physicians
Adhesive capsulitis is a painful and disabling disorder of unclear cause in which the shoulder capsule, the connective tissue surrounding the glenohumeral joint of the shoulder, becomes inflamed and stiff, greatly restricting motion and causing chronic pain. Pain is usually constant, worse at night, and with cold weather. Certain movements or bumps can provoke episodes of tremendous pain and cramping. The condition is thought to be caused by injury or trauma to the area and may have an autoimmune component.
WaterDance or Wata is a type of aquatic therapy which was developed in Switzerland independently of Watsu. While wearing nose clips, a person is gently guided underwater, pulled, swayed, and "flown" while being regularly brought to the surface for breath.
Equine massage is the practice of massage on horses. Beginning in the early 1990s, it has been a growing field of equine therapy, utilized for both day-to-day riding and post-trauma rehabilitation. Proponents list a number of positive effects, including the improvement of movement and the reduction of pain and stress responses. Scientific study is beginning to demonstrate possible benefits, although more study is needed.
The acetabular labrum is a ring of cartilage that surrounds the acetabulum of the hip. The anterior portion is most vulnerable when the labrum tears.
Myotherapy is a form of physical therapy which focuses on the assessment, treatment and rehabilitation of musculoskeletal pain and associated pathologies. The term myotherapy was originally coined by Bonnie Prudden to describe a specific type of trigger point therapy which she developed in the 1970s based on the earlier work of Travell and Simons who researched the cause and treatment of pain arising from myofascial trigger points. While based on rational principles, there is little scientific research regarding the efficacy of this therapy, so it remains controversial within the medical and academic disciples.
Pulsing is a rhythmic, movement-based somatic therapy that can be classed as a form of post-Reichian bodywork. It uses a very gentle and nurturing approach in an attempt to increase body awareness and sensitivity.
Physical therapy for canines adapts human physical therapy techniques to increase function and mobility of joints and muscles in animals. Animal rehabilitation can reduce pain and enhance recovery from injury, surgery, degenerative diseases, age-related diseases, and obesity.
Canine massage is a branch of massage therapy that promotes health in dogs. Specifically, canine massage therapy is a form of alternative therapy the benefits of which may include relaxation, increased oxygenation, relief from pain, improved joint flexibility, as well as miscellaneous benefits to the immune system. It uses touch to maintain or improve both physical and emotional well-being.
Cat massage is a practice used by physiotherapists and pet owners to maintain healthy circulatory systems and joints in felines.
The Bad Ragaz Ring Method (BRRM) is a type of aquatic therapy used for physical rehabilitation based on proprioceptive neuromuscular facilitation (PNF). BRRM is a water-based technique in which therapist-assisted strengthening and mobilizing exercises are performed while the patient lies horizontally in the water, with support provided by rings or floats around the neck, arms, pelvis, and legs.
Ai Chi is a form of aquatic exercise used for recreation, relaxation, fitness, and physical rehabilitation. Clinical Ai Chi is distinguished as a specialized active form of aquatic therapy. In essence, Ai Chi uses breathing techniques and progressive resistance training in water to relax and strengthen the body, based on elements of qigong and Tai chi chuan.