Current legal position

Shiatsu is not currently recognised in the Czech Republic as a separate regulated profession or as a healthcare method. It is practised outside the statutory healthcare system and is not reimbursed from public health insurance as Shiatsu. Some health insurers may offer preventive contributions for qualifying massage or regeneration services, but this does not constitute recognition or reimbursement of Shiatsu itself.

Czech legislation does not define Shiatsu, protect the title “Shiatsu practitioner”, or prescribe a Shiatsu-specific  qualification. A  person  may  therefore  use  that  professional  description  without  holding  a qualification  recognised  by  the  Czech  state.  This  creates  a fundamental  distinction  between  legal permission to provide a service and professionally verified competence in Shiatsu.

Historical development

The close connection between Shiatsu and the massage profession has historical roots. According to the institutional records of a pioneering Czech Shiatsu school, an MŠMT (MEYS) accredited retraining course in Shiatsu massage was obtained in 1998. Shiatsu and several other complementary bodywork methods were then treated as  advanced  specialisations  built  upon  the  baseline  qualification  in  sports  and reconditioning massage. This enabled schools to combine substantial Shiatsu training with an officially recognised massage qualification that gave graduates a clear legal basis for professional practice.

The Czech qualification landscape subsequently changed with the introduction of the National Register of Qualifications under Act No. 179/2006 Coll. The professional qualification Reconditioning and Sports Masseur (69-037-M) became valid on 30 June 2009, at qualification level 4. Shiatsu was not incorporated as a separate qualification in the new system. The accessible evidence therefore supports describing 2009 as the point at which the earlier accreditation route was replaced by the new national qualification framework.

Different routes into professional practice

Because  Shiatsu  has  no  dedicated  Czech  qualification,  schools  and  practitioners  have  developed different responses to the current framework. Some schools continue to include, facilitate or recommend the regulated massage qualification. Their graduates may then apply for the regulated trade licence “Massage,   Reconditioning   and   Regeneration   Services”,   which   requires   recognised   professional competence and covers massage and regeneration services for healthy persons outside healthcare.

Other schools treat their Shiatsu education as a complete professional training in its own right and refer to the European Skills, Competences, Qualifications and Occupations classification (ESCO), which lists “shiatsu  practitioner”  as  a  distinct  occupation  mapped  to  ISCO-08  group  3255.  ESCO  is  valuable evidence  that  Shiatsu   is   recognised  in  the   European   labour-market  classification  as  a  distinct occupation. However, ESCO is not a licence to practise, does not create a regulated profession in Czech law and does not assign an EQF level to the occupation.

Where practitioners do not hold the regulated massage qualification, they may register activities under the Czech free-trade framework, depending on how the service is described and actually delivered. Possible  registrations  may  include  personal services and  personal  hygiene,  education and training, consultancy, or  broader  unclassified  service  activities.  Ministry  of  Industry  and  Trade  guidance for craniosacral practices identifies free-trade activity 78, “Provision of personal services and personal hygiene”, as a possible route for that comparable field. There is, however, no equivalent official Shiatsu-specific guidance, so no single free-trade category can be presented as the formally approved route for Shiatsu.

The central challenge

These different pathways should not be interpreted as evidence that one school or group of practitioners is inherently more professional than another. They are understandable responses to a fragmented legal environment. Nevertheless, the consequences are significant: people with very different levels of training may legally offer Shiatsu; graduates with comparable Shiatsu competence may enter practice under different  trade  regimes;  and  neither  clients  nor  public  authorities  have  a  single  state-recognised benchmark against which Shiatsu competence can be assessed.

The regulated massage route provides a recognised baseline qualification, but it does not verify the full body  of  knowledge  and  practical  competencies  required  for  professional  Shiatsu.  Conversely, registration under a free trade may allow a practitioner to operate legally without demonstrating any Shiatsu-specific education. ESCO recognises the occupational identity of the Shiatsu practitioner, but it cannot substitute for a Czech qualification standard.

Professional self-regulation

Professional standards are therefore maintained primarily through voluntary self-regulation. The Czech Shiatsu Association (ČAS) sets educational and competency requirements for its professional members, maintains a register of qualified practitioners and applies a Code of Ethics. Applicants for professional membership as Shiatsu practitioners must demonstrate compliance with the requirements of the ESF Shiatsu Practitioner Profile. ČAS thereby applies standards aligned with those adopted by the European Shiatsu Federation.

The need for a national Shiatsu qualification

ČAS considers the establishment of a nationally recognised Shiatsu qualification within the National Register of Qualifications to be a strategic priority. The purpose is not to discredit existing schools or replace their educational programmes. It is to create a common, transparent competency standard through which graduates from different educational pathways can demonstrate equivalent professional competence.

A  dedicated  qualification  would  recognise  that  Shiatsu  is  more  than  a  supplementary   massage technique. It would define the specific knowledge, practical skills, ethical responsibilities, boundaries of practice and safety requirements expected of a professional Shiatsu practitioner. It would provide legal clarity for schools and graduates, improve transparency for clients and  public authorities, support cooperation across the profession and give Shiatsu the professional and educational weight that its scope of practice deserves.

The Czech Shiatsu community has maintained professional education and ethical standards despite the absence of a dedicated legal framework. The next constructive step is to translate these established professional standards into a qualification recognised by the Czech state and connected appropriately to the European occupational context.

 Sources and verification notes

Source	Relevance
Czech Trade Licensing Act No. 455/1991 Coll., Annex 2	Current qualification requirements for theregulated trade “ Massage, Reconditioning and Regeneration Services”.
Government Regulation No. 278/2008 Coll.	Defines the scope of that regulated trade assports, reconditioning and regeneration massage performed on healthy persons without inducing a therapeutic process.
National Register of Qualifications (NSK), qualification 69-037-M	Reconditioning and Sports Masseur/Masseuse;  qualification level 4; first valid from 30 June 2009.
Ministry of Industry and Trade guidance of 24 January 2024	For craniosacral practices, identifies free trade activity 78, “Provision of personal services andpersonal hygiene”, as a possible route depending on the actual activity. This is an analogy, notShiatsu-specific guidance.
ESCO – European Commission	Lists “shiatsu practitioner” as a distinctoccupation mapped to ISCO-08 group 3255.ESCO classifies occupations but does not confer Czech legal authorisation or an EQF level.