Massage and Bodywork Magazine

Practical Ayurveda

Indian Head Massage and Shirodhara (Part

Two)
By Anne Williams

Figure 1. Marma point locations on

the head and face.

Note:in part one of the Practical

Ayurveda series ("Core Concepts",
June/July 2007, page 66), we
discussed core concepts in ayurveda
and looked at the characteristics of
the tridoshas. Part two explores
Indian head massage and
shirodhara.

Prana
Prana is most often understood as
the life force of the body, as well
as the soul. Prana is the energy
that animates the being and also
the consciousness of the being.
Prana is life and living. 6 Ayurvedic
therapies are a form of
communication with prana, and so
the attitude of the therapist is
important. Sincerity, a sense of
wonder, honor for the client and
for the self, and respect for the
beauty of ayurveda lead to
positive outcomes in the session.
The breath is the main medium
that prana uses to enter the
body, entering the body on
inhalation and leaveing the body
on exhalation. As the therapist
applies pressure or begins a
stroke, she exhales through the
mouth (not the nose, as is done
in meditation) and becomes the
quality she wants to give the
client. For example, a client who
has aggravated pitta may need

Indian head massage and shirodhara are ayurvedic treatments

that are deeply relaxing for recipients and introduce something
of the spiritual element of ayurveda to clients. The ultimate
goal of these services is to relax the face, scalp, neck, and
shoulders, soothe and comfort the mind, and bring the body
into harmony through the senses.1 These services allow
massage therapists to focus in on an area that is often
touched on only briefly in a full-body massage.
Indian Head Massage
Every day, the muscles of the scalp and face get a workout,
and tension in these muscles can play a significant role in
headache pain or pathologies such as temporomandibular joint
syndrome (TMJ). Indian head massage is indicated for neck
tension, tension headache, face tension, relaxation, stress
reduction, and revitalization.
In a typical session, the head, neck, and shoulders are
massaged, the scalp and hair are oiled and invigorated, and
marma points are stimulated. Marma points are energy centers
in the body traditionally used with Indian massage and
ayurvedic healing.2 The word marma means secret, hidden,
and vital. The points connect the physical body with subtle
energy bodies and often relate to specific organs or body
areas. In the ayurvedic healing tradition, marma point therapy
is believed to enliven pure consciousness in the body and
stimulate a spontaneous healing response. The points are
massaged in order to restore the body to normal function,
balance the bodys energies, and either energize or relax the
body as necessary for improved health. Although specific
marma points and gentle balancing methods are described in
this article, it should be understood that this is a brief
introduction to a complex system of healing. In fact, many
traditional ayurveda physicians warn against the practice of
marma therapy by anyone without specific training. Therefore,
practitioner sensitivity and respect are crucial when working
with these dynamic marma points.
Marma points are located on the body by taking finger
measurements from identifiable starting points. An individuals
marma points are specific to his or her body. For this reason,
the clients fingers are traditionally used to measure for the
first point and then the therapist palpates for the points that

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cooling. An image of a quiet pool
of water might be generated in
the therapists mind. She imagines
that water as self while she
exhales and begins a stroke. The
image of the water will affect the
quality of the stoke and this, in
turn, affects the therapists
communication with prana. It
sounds mysterious, but the
important point is that the
therapist has clear positive intent
for each stroke or technique.

follow.3 On the head, these points are primarily massaged with

the fingertips and thumbs. Most often, the point is massaged
in clockwise circles to strengthen and tone the tissue, or direct
pressure is applied to the point for up to three minutes. 4,5 The
pressure should be firm but not hard. If the client experiences
any discomfort, the pressure on the point is too deep.
The Session
1. First, the client is dressed in a robe and seated in a
comfortable chair. A towel is placed around the clients
shoulders to protect the robe from oil. Ask the client to take
three slow deep breaths in and out through the nose and close
the eyes. (Warm, refined sesame oil or bhringaraj oil is used
for the session. Bhringaraj (Eclipta alba) is noted by many
ayurveda therapists for dry scalps and hair growth.)
2. Holding positions to open the head massage: place the
hands on the clients shoulders and wait for the client to take
a long slow breath. Move the right hand gently to the top of
the clients head, while the left hand remains on the clients
left shoulder. Wait for the client to take a long slow breath.
Change hands so that the left hand is on the top of the
clients head; the right hand is on the clients right shoulder.
Wait for the client to take a long, slow breath. Move both
hands gently to the top of the clients head and wait for the
client to take a long slow breath. Move to stand at the clients
right shoulder and place the right hand on the clients
forehead and the left hand on the back of the clients head.
Wait for the client to take a long, slow breath.

Clients help measure where the first

marma point is located.

Stimulate the simanta marma by

twisting the hair.

3. Oiling the simanta and krikatika marmas: the simanta

(summit) marma falls along the lines of the sutures of the
skull, so it covers a large area (see point no. 2 in Figure 1).7
The first point to oil in this area is found by measuring eight
finger widths up the head using the point between the
eyebrows as a starting point. A generous amount of oil is
poured on this spot and then the hairs are lifted and twisted
to stimulate the point.8 The second point to oil is found where
the clients hair forms a whorl. After the point is oiled, the
hairs over this point are lifted and twisted to stimulate the
marma. Between these two points is the adhipati (overlord),
which is located at the top point of the skull (point no. 1). This
marma has a ruling action over the simanta marma and
controls the seventh chakra, pineal gland, and nervous
system. Oil and stimulate this point with hair twisting. To oil
the krikatika (joint of the neck) marmas, the client is asked to
bring the head forward so that the chin sits on the chest. The
points are directly beneath the occipital protuberance on each
side of the neck. Oil and stimulate these points with hair
twisting. Using zigzag finger movements, work the oil evenly
through the hair and into the scalp. Go back to each of the
points that were oiled and use gentle circular finger friction in
clockwise circles to release the energy and tension in these
areas.
4. Pounding: place both hands together in a prayer position.
While keeping the wrists loose and flexible, the edge of the
joined hands is used in a tapotement-like action over the
entire head.

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5. Circular finger friction: reaching up under the clients hair,

the entire scalp is massaged with gentle circular finger friction.
The forehead, above and behind the ears, and the base of the
skull are also massaged in this manner.

Next, apply circular finger friction down along the sides of the
nose, under the eyes, and out across the cheekbones until the
entire facial area is relaxed.
6. Skull squeeze: interlace the fingers over the top of the skull
and press the hands together gently. Repeat this four to six
times, working over the anterior and posterior sections of the
skull. Place one hand on the forehead and the other at the
back of the head and repeat the skull squeeze.

Use zigzag finger movements to

work the oil evenly into the hair
and scalp.

7. Massaging specific marma points on the face: there are two

marma points called phana (a serpents hood) on the side of
each nostril (point no. 8). These points can be massaged with
strong circular strokes to decrease headache pain, decrease
sinus pressure, and decrease congestion. Usually, the whole
side of the nasal bone is treated. The apanga marma points
are located on the outer corner of the eye and are massaged
to relieve headaches caused by eye strain (point no. 7). These
points also help to clear the upper sinuses. Shankha (conch) is
the name of the point located on each temple. These points
aid sleep and are associated with directing energy to the brain
(point no. 6). The points named utkshepa (what is cast
upward) reside above the ear and are gently massaged to
calm vata and the mind (point no. 5). Just above the center of
each eyebrow is a point called avarta, which is massaged to
decrease vata and improve energy and adaptability (point no.
4). The sthapani marma (point no. 3) resides between the
eyebrows and is often called the third eye. This point is
discussed further in the shirodhara section below.
8. Ear massage: rub oil into the external regions of the ear,
pulling the ear backward as the oil is applied. Pull the earlobe
in a downward and backward direction and then pull the
earlobe across the opening of the ear to stretch it.
9. Massage the shoulders, neck, and upper arms of the client
by pulling the robe off the shoulders (but leaving it to cover
the rest of the body).
10. Finish the Indian head massage with the same series of
holding positions used to open the session.

Use a tapotement-like movement to

pound the entire head.

Enhancing the Session

Adding a foot soak and brief foot massage at the beginning of
the treatment can enhance the Indian head massage session.
The foot soak is the spiritual element of welcoming and
purifying the client. In the Rigveda (one of four ancient Hindu
religious texts), the feet are referred to as organs of action,
and children in villages still carry out the tradition of
massaging their parents legs and feet as a symbol of respect
and veneration. 9 Indians remove their shoes before going into
a temple. This symbolizes leaving behind earthly and worldly
activities before reflection and prayer. 10 Ayurveda teaches that
negative emotions accumulate in the soles of the feet and that
the feet can be soaked and massaged to alleviate

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psychological imbalances. Dr. Vasat Lad, a well-known

ayurveda physician and teacher, recommends rubbing oil on
the soles of the feet at bedtime to calm vata dosha. Pitta
conditions like headache, or tired eyes, are calmed with
coconut oil rubbed on the soles, while kapha conditions, such
as colds or mucus, are treated with mustard oil rubbed on the
root of the toes. 11

Apply circular finger friction on the

scalp.

To prepare the foot soak, place one-half cup of dried mixed

herbs in a muslin bag and cover it with boiling water. Allow it
to steep for twenty minutes while it cools. Add warm or cool
water as appropriate until the desired temperature for the foot
soak is reached. A foot soak for vata might include ground
ginger (Zingiber officinale), sandalwood (Santalum album),
eucalyptus leaf (Eucalyptus spp.), calamus (Acorus calamus),
and basil (Ocimum basilicum). Pittas respond well to cooling
herbs like chamomile flowers (German: Matricaria recutita, or
Roman: Chamaemelum nobile), lavender (Lavandula
angustifolia), peppermint (Mentha x piperita), and lemongrass
(Cymbopogon citrates). The kapha foot soak might include
ground ginger (Zingiber officinale), basil (Ocimum basilicum),
eucalyptus leaf (Eucalyptus spp.), common sage (Salvia
officinalis), and clove buds (Syzygium aromaticum).
Place the foot soak container on top of a hand towel under the
clients feet. At the conclusion of the head massage, remove
the foot soak container and dry the feet. Rub the feet with
warm oil and wrap them in a warm towel. Other nice touches
that enhance the session include ringing Indian chimes at the
start and conclusion of the session, playing traditional Indian
music, and offering an ayurvedic beverage, such as a sweet
lassi (a drink made with yogurt, sugar, and water) or spice
tea.

Use circular finger friction on the

face.

Shirodhara
Shirodhara (shiro means head, and dhara means threadlike
stream) is the application of a thin stream of sesame oil on
the forehead, or applied in a pendulum-like motion that pauses
for a moment each time it reaches the point between the
eyebrows, sometimes called the third eye. The marma point
between the eyebrows is known as sthapani, meaning what
gives support or holds firm. This point is associated with the
sixth chakra, prana, mind, senses, and the pituitary gland. 12
The purpose of the treatment is to center the mind and body,
to increase relaxation and inner peace, and to settle vata
disorders such as anxiety and insomnia.
In the shirodhara treatment, refined sesame seed oil is
traditionally used in the shirodhara vessel, but warm milk
cooked with herbs (pitta), seawater (kapha), buttermilk
(pitta), coconut milk (pitta), medicated oils, and other
products can also be used. The treatment lasts between
twenty and thirty minutes and is often offered at the
conclusion of an abhyanga session (which will be discussed in

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part three of the Practical Ayurveda series).

Perform a skull squeeze four to

eight times.

To set up for the session, plastic body wrap is placed so that it

covers the top quarter of the treatment table, falls over the
top of the table, and has its ends tucked into a large bowl (to
prevent oil from running on the floor). Tissues are placed in
the bowl on top of the plastic to dampen the sound of the oil
hitting the plastic. A bath towel is placed over the plastic so
that the clients upper body is resting on a soft surface.
The Session
1. The client begins the treatment in the supine position with
the head at the very top of the treatment table. She is
bolstered and covered by a warm blanket. A warm pack can be
placed on the belly and under the feet if appropriate. The
therapist begins the treatment by gently massaging the neck
and face to relax the client.

2. To position the clients head for the treatment, a small

pillow or rolled towel is placed under the clients head in such
a way that the head tips back slightly. It is not necessary for
the clients head to be tipped at an extreme angle. An eye
pillow can be placed over the clients eyes, or the clients eyes
can be left uncovered, if desired by the therapist. Warm
refined sesame oil is taken from the hot water bath and
tested, with the thermometer, for a desired temperature of
100F104F. It is then poured into the vessel that is
positioned over the clients head and adjusted to the
appropriate height. Some therapists use a small cup to recycle
oil that has run off the clients head into the bowl at the
bottom of the table. The oil is poured back into the vessel to
prolong the treatment.
Readjust hand position as shown
and repeat the skull squeeze.

3. A drop of warm oil is place on the therapists index finger.

The therapist circles this finger around the clients forehead in
a clockwise direction where the oil will be drizzled. By
performing these initial circles, the therapist prepares the
client for the stream of oil and awakens the clients nervous
system. The therapist holds a small cup under the vessel and
opens the tap so that the oil begins to flow into the cup. The
stream is adjusted so that it is thin and even. After it is
adjusted, the therapist warns the client so that she is not
startled, then removes the cup so that the oil begins to flow
onto the clients head. The therapist must now check that the
vessel is positioned correctly and that the oil is hitting the
sthapani marma between the eyebrows. The practitioner will
also check that the oil flowing off the clients head runs into
the bowl on the floor and not onto the floor itself. The stream
of oil can either be left in the same position for the entire

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treatment or it can be moved backward and forward in a

pendular motion across the forehead. Any movement must be
steady and even, so this requires practice.

Massage specific marma points on

the face.

As the oil begins to run out at the end of the treatment, place
a cup under the stream of oil and turn off the tap on the
vessel. It is important that the oil is not allowed to sputter out
and drip unevenly on the clients head. A critical thing to
remember with shirodhara is that the less there is happening
in the treatment room, the better. The clients senses will be
heightened by the treatment. Any excess movement by the
therapist, any chatter in the hallway, and any crinkling of
plastic will be distracting to clients while they are focusing in
on their own thoughts. The darker and quieter the room can
be, the better. For this reason, music is not recommended.
4. The therapist removes the rolled hand towel from
underneath the clients head and the eye pillow from her
eyelids. The neck, shoulders, and scalp are massaged with
very gentle strokes. The therapist can also mist over the client
with a light aromatherapy mist or simply allow the client to
relax for fifteen minutes undisturbed. It is important that
shirodhara is the last service the client receives during a day
at the spa or clinic. Clients often emerge from shirodhara
calm, open, sensitive, and awakened to all that is around
them. If they are taken to another treatment, it is likely to
overstimulate them and leave them feeling irritated and
restless. The exception is a soaking tub, because clients can
relax quietly in the warm water and remove the oil from their
hair at their leisure.

Massage the ears.

Offer clients a snack or cup of herbal tea at the end of the

treatment to help them return to present time and prevent
low blood sugar or shakiness. Some therapists give clients
their shirodhara oil to use at home for self-oiling. This is a
nice way to salvage the oil and encourage clients to bring
ayurveda more fully into their lives.
Note: in part three of the Practical Ayurveda series, we will
discuss abhyanga and medicated ayurveda oils, called taila.
Anne Williams is a licensed massage therapist, esthetician, aromatherapist,
certified reflexologist, registered counselor, educator, and author. The work
outlined in this article and the images are adapted from portions of the authors
textbook, Spa Bodywork: A Guide for Massage Therapists (Lippincott Williams &
Wilkins, 2007). Williams is also the education program director for Associated
Bodywork & Massage Professionals. She can be reached at anne@abmp.com or
anne@spabodywork.com.
Notes
1. V. B. Dash, Massage Therapy in Ayurveda (New Delhi, India: Concept

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A foot soak represents the spiritual

element of welcoming and purifying
the client.

Publishing Company, 1992).

2. L. Miller and B. Miller, Ayurveda and Aromatherapy: the Earth Essential Guide
to Ancient Wisdom and Modern Healing (Twin Lakes, WI: Lotus Press, 1995).
3. H. Johari, Ancient Indian Massage: Traditional Massage Techniques Based on
the Ayurveda (New Delhi, India: Munshiram Manoharla Publishers Pvt. Ltd.,
2003).
4. D. Frawley, S. Ranade, and A. Lele, Ayurveda and Marma Therapy (Twin
Lakes, WI: Lotus Press, 2003).
5. D. Frawley and S. Ranade, Ayurveda: Natures Medicine (Twin Lakes, WI:
Lotus Press, 2001).
6. Atreya, Secrets of Ayurvedic Massage (Twin Lakes, WI: Lotus Press, 2000).
7. J. Morrison, The Book of Ayurveda: A Holistic Approach to Health and
Longevity (New York: Fireside Books, 1995).
8. H. Johari, Ancient Indian Massage: Traditional Massage Techniques Based on
the Ayurveda (New Delhi, India: Munshiram Manoharla Publishers Pvt. Ltd.,
2003).
9. S. Sexton, Footwork: Vibrant Health Through Ayurvedic Massage,
www.himalayaninstitute.org/articleread.aspx?code=926 (accessed summer 2007).
10. N. Poojanand, Shoes Off: Barefooted Reflections,
www.hinduismtoday.com/archives/1989/01/1989-01-05.shtml. (accessed summer
2007).
11. S. Sexton, Footwork: Vibrant Health Through Ayurvedic Massage.
12. A. Selby, Ayurveda (Minnetonka, MN: Creative Publishing International, Inc.,
2001).

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Notice that in the setup for

shirodhara, the plastic body wrap is
anchored by a bath towel and runs
over the top of the table and into a
bowl on the floor.

Please close window after reading.

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The clients head position for

shirodhara is tipped back slightly so
that the oil runs over the head,
onto the plastic, and into the bowl
on the floor.

The oil stream hits the sthapani

marma between the eyebrows.

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Shirodhara can also be applied

using a pendulum motion.

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