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.
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. [1] [2] [3] [4]
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. [2] [4]
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. [2] [3] [4]
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". [2] [3] [4]
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. [2] [3]
Basic Watsu moves include the following: [4]
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. [2] [3] [4]
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. [5]
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". [2] [3] [4] [6] [7]
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. [2] [3] [8]
Many patients and clinicians report psychological benefits for stress reduction and resolving past traumas. [2] [8]
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. [3]
For healthy people, Watsu is used for relaxation, muscle stretching, and "nurturing connection". [3]
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. [2] [9]
Watsu has been proposed as a therapy for fibromyalgia syndrome, [10] and for rehabilitating patients after a stroke. [11]
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. [2]
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. [2] [8] [3]
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. [2]
Massage is the rubbing or kneading of the body's soft tissues. 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. In European countries, a person professionally trained to give massages is traditionally known as a masseur (male) or masseuse (female). In the United States, these individuals are often referred to as "massage therapists". In some provinces of Canada, they are called "registered massage therapists."
Rolfing is a form of alternative medicine originally developed by Ida Rolf (1896–1979) as Structural Integration. Rolfing is marketed with unproven claims of various health benefits, is recognized as pseudoscience and has been characterized as quackery. It is based on Rolf's ideas about how the human body's "energy field" can benefit when aligned with the Earth's gravitational field.
Torticollis, also known as wry neck, is a painful, 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 Latin tortus 'twisted' and collum 'neck'.
Traditional Thai massage or Thai yoga massage is a traditional therapy combining acupressure, Indian Ayurvedic principles, and assisted yoga postures. In the Thai language, it is usually called nuat phaen thai or nuat phaen boran, though its formal name is nuat thai according to the Traditional Thai Medical Professions Act, BE 2556 (2013).
Manual therapy, or manipulative therapy, is a part of Physiotherapy, it is a physical treatment primarily used by physical therapists, occupational therapists to treat musculoskeletal pain and disability; it mostly includes kneading and manipulation of muscles, joint mobilization and joint manipulation. It is also used by Rolfers, massage therapists, athletic trainers, osteopaths, and physicians.
Myofascial trigger points (MTrPs), also known as trigger points, are described as hyperirritable spots in the skeletal muscle. They are associated with palpable nodules in taut bands of muscle fibers. They are a topic of ongoing controversy, as there is limited data to inform a scientific understanding of the phenomenon. Accordingly, a formal acceptance of myofascial "knots" as an identifiable source of pain is more common among bodyworkers, physical therapists, chiropractors, and osteopathic practitioners. Nonetheless, the concept of trigger points provides a framework which may be used to help address certain musculoskeletal pain.
Myofascial release is an alternative medicine therapy claimed to be useful for treating skeletal muscle immobility and pain by relaxing contracted muscles, improving blood and lymphatic circulation and stimulating the stretch reflex in muscles.
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.
The stone massage is a form of alternative medicine massage therapy and bodywork involving the placement of either heated or cooled stones to the body for the purpose of pain relief, relaxation and therapy. There are many variations and techniques used in the application of stone massage therapy, deriving from a variety of traditional practices. Stone massages are primarily used to alleviate physical pain issues, however, are also used to promote emotional and spiritual wellbeing in practice.
Anma is a practice of traditional Japanese massage; the word also refers to practitioners of that art. Modern shiatsu is largely derived from anma.
Equine massage is the practice of massage on horses. Beginning in the early 1990s, it has been a growing field of equine therapy, used 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.
The acetabular labrum is a fibrocartilaginous ring which surrounds the circumference of the acetabulum of the hip, deepening the acetabulum. The labrum is attached onto the bony rim and transverse acetabular ligament. It is triangular in cross-section.
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, pressure ulcers, and disease conditions, such as osteoporosis.
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, and miscellaneous benefits to the immune system. It uses touch to maintain or improve both physical and emotional well-being. However, an owner should consult with a veterinarian before attempting to massage their dog themselves.
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.
Harold Dull (1935—2019) was 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.
Marion Rosen was a German-American physiotherapist. She developed Rosen Method Bodywork and Rosen Method Movement. Under Rosen's guidance in 1980, the Rosen Institute (RI) was formed as the governing international organization that protects and sustains the quality and standards of Rosen Method. The Rosen Institute has affiliate training centers in 16 countries and has certified 1150 bodywork practitioners and 150 movement teachers.
Hydrogymnastics is a water-based therapeutic exercise. As its name suggests, this form of aquatic therapy or aquatic rehabilitation is performed in water, and it can take place in swimming pools at aquatic leisure centres and/or in home pools. Being a form of aquatic therapy, hydrogymnastics aims to improve the physical and psychological health and well-being of an individual. Hydrogymnastics can be performed by anyone, including youths, middle-aged people, the elderly, athletes and those with disabilities. Hydrogymnastics is often assisted by a qualified aquatic therapist and/or exercise physiologist. Although the effects of hydrogymnastics may vary between individuals belonging to different age groups and genders, hydrogymnastics mainly improves one's cardiovascular fitness, strength, balance and mobility.