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  • Writer's pictureLuke Stephan

The importance of bodywork for the belly

Updated: Jan 20, 2023


When it comes to massage, the belly is one of the most ignored parts of the body.

It is also the most important.

There's a direct relationship between gut health and stress, inflammation and mental health. Tension stored in the belly is also the great referrer. It has a tendency to contribute to lower back, neck and shoulder pain.

This blog summarises why work on the belly can be so critical and what good bellywork looks like.

The belly – a natural home for stress, tension and toxins

Toxins love to accumulate in the belly.

A toxin can be physical in nature but also emotional. Negative emotions have a particular tendency to accumulate in the intestines.

Common sources of physical stressors in the belly include:

  • Over-exposure to trigger foods such as gluten, alcohol, nightshades, high-fat meals

  • Improper eating (too fast, over-eating, eating when stressed)

  • Dysbiosis (too few beneficial bactiera and/or too many bad bacteria)

Common sources of emotional stress in the belly include:

  • Work, relationship and other psychological stress

  • Excessive thinking/worry

  • Unnatural levels of social isolation

Negative emotions can be experienced in the intestines as congestion, pain, slow digestion and impaired absorption.

Toxins have a particular tendency to accumulate in lymph nodes where they harden and cause blockages. There is a huge collection of lymph nodes in the belly but they are especially concentrated around the navel and psoas muscle.

Small intestine

Traditional systems of medicine have an understanding of the small intestine’s role in digesting not just food but any kind of stress or emotional trauma.

Targeted bodywork can release all the knots, blockages and hardness that accumulate in the small intestine. There is one particular Zenthai Shiatsu technique we love called “bag of snakes”. In this technique the entire small intestine is scooped up, wrung out like a wet towel and given a vigorous shake. The results often include hysterical laughter, deep sobs and the occasional psychedelic journey.

Large intestine

The large intestine is the centre of our ability to “let go” – both physically and emotionally. Toxins, tension and stuck energy released in the small intestine flow to the large intestine, where they can then be released from the body.

Our inability to let go is often experienced as constipation. Heavy constipation can easily be identified by light pressure causing significant pain around the main valves.

Blockages will commonly occur in:

1. The sigmoid colon valve (where the large intestine empties into the rectum)

2. The ileocecal valve (where the small intestine empties into the large intestine)

3. The splenic flexure (the sharp bend in the large intestine, under the spleen)

4. The hepatic flexure (the less-sharp bend in the large intestine, under the liver)

Massage is wonderful for releasing these areas where blockages typically occur. The release allows toxins and waste to pass freely from the body, reducing abdominal tension and pain.

Psoas muscle

The psoas is the largest muscle in the body and the first to be formed in the embryo. It runs from the top/front of the thigh up to spine at the base of the ribs. It allows you to run, walk, make love, dance and balance.

Stress causes the psoas to harden and shorten. Sitting at a desk or in the car doesn’t help either. A tight psoas places stress on the lower back and/or sacrum. A tight, tense psoas is rarely felt in the muscle itself but nearly always experienced as lower back pain.


The diaphragm is the muscle under the lungs that enables deep breathing. A tight psoas and tension or congestion in the large intestine will restrict the diaphragm.

A restricted diaphragm prevents the deep breathing that activates the parasympathetic (rest and digest) nervous system. Instead people remain in the sympathetic (fight or flight) nervous system increasing the stress load on the body and interfering with digestion.

Further, with breathing not being led by the diaphragm, the neck and shoulder muscles are instead relied upon for breathing. This causes tension in the upper trapezius, levator scapula, scalene and sternocleidomastoid muscles.

This neck and shoulder tension contributes to migraines, temple headaches and psychological impacts, especially the feeling of “carrying the world on one’s shoulders”

When should a therapist work on the belly?

The following are indications for bellywork:

  • Digestive dysfunction (malabsorption, SIBO, constipation/diarrhoea)

  • Back pain

  • Neck & shoulder tension

  • Fatigue

  • Stress

  • Signs of lymphatic stagnation (impaired immunity, oedema etc)

  • Signs of vagus nerve shutdown (monotone voice, limited facial activity, depression etc)

  • Reproductive issues – menstrual irregularities, low libido, etc

Belly work should be avoided in:

  • Active Chron’s disease / painful IBD

  • Pancreatitis

  • Open ulcer

  • Unexplained weight loss

What does good bellywork look like?

The massage therapist will generally:

  1. Begin by relaxing the surrounding fascia, primarily through stretches and superficial pressure. The fascia is the moist weblike structure that holds everything in our body together and transmits energy and information. A stiff, dry or hard fascia impedes energy flow.

  2. Relax the psoas and diaphragm muscles

  3. Work directly on the small intestine to break up congestion and hardness, relax tension and release stuck energy and toxins. This requires plenty of movement and penetration.

  4. Work to release tension and congestion in the large intestine, with particular focus on the two key valves which are the most prone to constipation and inflammation.

  5. Potentially work on the liver.

What part of the session a therapist chooses to include bellywork can depend. The belly is one of the most vulnerable parts of the body so it is common for a therapist to work on other areas first, such as the back and shoulders, to sufficiently relax the body before touching the belly. Some powerful traditional therapies such as Chin Nei Tsang and Mayan abdominal massage work almost exclusively on the belly for the entire session.


A massage to relieve a sore back, neck or shoulders can be powerful therapy. But belly work is arguable both more powerful, and longer lasting. Root causes are often found in the belly. If your intention in receiving bodywork is to optimise longevity, vitality and wellbeing it should be including belly work.

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