We all know the inherent benefits our clients can gain from receiving an Ashiatsu barefoot massage. Yet, this modality is not always a good fit for every client. It’s important as a massage therapist to ask your clients the right health related questions, so you can determine how you may need to adjust or withhold your treatment all together.

Read on to learn about important health considerations, and the pros and cons of Ashiatsu barefoot massage from DeepFeet Bar Therapy Founder, Ruthie Hardee; her experience and expertise can help guide you in the right direction for decision making when it comes to providing Ashiatsu in a safe and ethical manner.

Ruthie Hardee:

The Deep tissue pros and cons taught to me over 3 decades ago, are still the gold standards today to the best of my knowledge. Whether you choose to shift your center of gravity forward and use your hands and elbows, or use gravity while you hold on to a bar and massage with your feet, contraindications for deep tissue work should be well respected no matter the tool you use.

The Physiology & Anatomy bench marks taught to me during massage and neuromuscular training in school, are the very layers of foundation in which the Deepfeet Bar Therapy fundamentals were developed on. I am honored that thousands of LMT’s have taken advantage of gravity and our barefoot trainings to spare their hands, wrists and backs but more importantly the intention to “do no harm”. We teach in our classrooms a plethora of barefoot practitioner guidelines prior to, during, and after each session, to ensure no injuries are sustained during a session.

While the term “deep” is in our brand name, it signifies a well-trained therapy with structure which goes beyond relaxational Swedish massage. One shouldn’t mistake the term “deep” as a rite of passage to stand on someone or push with uncontrolled pressure with recklessness. Sadly, the rise in Copycat Ashiatsu businesses bombarding social media with overnight videos showing little regard to client safety and fad trainings has us worried. It’s my duty to remind and refresh everyone of some Deepfeet facts every now and then:

  • Practitioner movements are at a very slow pace either following or going across the grain of muscles, tendons and fascia.
  • Practitioner applies precise palpatory application with gradual fluidity through layers of muscles, tendons, ligaments and connective tissue.
  • Practitioner melts into the belly of a muscle with consideration every time and only after the tissue has been warmed and hydrated.
  • Practitioner is trained to move gracefully and quietly around the table whether we are addressing fascia or range of motion.
  • Compassionate compression replaces the old cliché “Hurt So Good” as we are addressing the nervous system and not just musculature.
  • Clients should never experience pain or bruising during or after a treatment.
  • Clients should always feel warm and draped properly.
  • Clients have complete control of depth due to passive monitoring by Practitioner.
  • Clients experience recovery and repair of muscle tissue from this broad form of bodywork and incites a positive change in chronic soft tissue damage.


While experts in complementary and integrative medicine tell us gentle Swedish-style massage can help reduce anxiety and pain with cancer patients, I personally do not use my hands anymore for massage, therefore I would decline to work on anyone with active breast cancer. I’m not trained in oncology massage and even though I can give a super light and gentle Ashiatsu massage, I’m just not comfortable knowing that direct pressure on the upper back may affect surrounding lymph nodes on the other side. I have taught students for years that “what has a front door, has a back door” and you can’t be so caught up into the area your working that you forget that simple rule of thought.

I would never work on or near active sites of inflammation, metastasis or recent scarring. And I always avoid an Ashiatsu session if someone is on pain medication. Pain medications reduce sensation, so the client may not feel my depth in a sensitive area or inadvertently I may press too much, and it could cause bruising or nerve damage. People on blood-thinning medications such as warfarin, daily aspirin regimens or cortisone, are super vulnerable to bruising and bleeding, so I don’t go there either.

Other conditions that I personally avoid are as follows:

  • Advanced stages of Arteriosclerosis, (hardening of the arteries)
  • Autoimmune (Lupus, rheumatoid arthritis, scleroderma) during acute flare ups, the skin can be painful to the touch.
  • Circulatory problems – I avoid this like the plague because any kind of body-warming massage can cause blood pressure to fall.
  • Deep-vein thrombosis – massage increases the risk of a clot being released and traveling to the lungs.
  • Diabetes – (diabetic neuropathy); avoid area of recent insulin injection, massage may accelerate insulin uptake.
  • Contagious skin disorders or disease –Herpes in particular, because blister fluid could spread virus to the massage therapist. Other examples include Shingles, MRSA, Scabies
  • Low platelet count – because pressure could cause bruising or hematoma.
  • Sever Osteoporosis – because deep massage can cause bones to break.
  • Varicose veins – because they can be painful, and the protruding area of the vein should not be manipulated
  • Pregnant or trying to conceive
  • Implants within nine months –breast, pectoral, gluteal, calf
  • Acute liver kidney and urinary disorders
  • Uncontrolled high/low blood pressure or heart condition
  • Any disorder that causes loss of feeling or motor control
  • Any recent (acute) injuries, accidents, surgeries within the last 6 weeks,
  • AIDS, Hodgkin’s disease, Cancer, Leukemia,
  • Recent injection (cosmetic or steroid)
  • Spinal surgeries that involve pins, plates, rods
  • Stents, shunts, pacemakers


Don’t let this in-depth list scare you away from practicing Ashiatsu barefoot massage. There are plenty of potential clients who can truly benefit from this modality. By understanding what conditions are not conducive to this type of treatment, and asking about all possible health conditions, you can ensure your client’s safety before they ever get on the table.


Final Thought: Remember to work SLOWLY and always start with broad pressure before moving into direct pressure. My favorite saying in class is “different strokes for different folks”. Not all bodies should be treated equal when providing an Ashiatsu treatment. There are many different shapes, sizes and textures of body types out there and the more tools and knowledge you have about bodywork in general the better you can serve your clientele. What stroke may feel amazing to one client may be painful and uncomfortable to another. Even though we teach a full body protocol as a roadmap to follow, we always encourage our students to customize each treatment to suit their client’s individual needs.


benefits ashiatsu

In addition, we have always encouraged our students to make Ashiatsu their “own”,  be creative and incorporate other massage techniques you have learned into your sessions. Your foot is merely a tool just like your hand, fist, finger or forearm. You too can apply those techniques to barefoot bodywork. For example, therapists with a deep tissue or myofascial background apply those methodologies and utilize minimal lubrication for more drag while others use more lubrication and faster strokes for more of a swedish approach. Being mindful of your body mechanics is always important when exploring in any new technique. Always resort back to keeping your nose over your knee for consistent pressure and keeping your arms bent at 90 degrees while holding onto the bars. If you find your self hanging from your bars or struggling to give pressure do a body check, no pain should ever result when giving an Ashiatsu treatment.


With a solid foundation, practice and encouragement our graduates are the ones paving the way and evolving Ashiatsu. Thank you to ALL DeepFeet Ashiatsu Practitioners and Instructors for thinking “outside of the box” and continuing to grow Ashiatsu and making it a sought after innovative modality!


Ruthie Hardee Founder Ashiatsu Deepfeet bar TherapyFrom My Sole to Yours,

Ruthie Hardee, Founder

DeepFeet Bar Therapy