In ashiatsu, the practitioner uses their feet to deliver treatment. The name comes from the Japanese, ashi for foot and atsu for pressure. This technique typically uses the heel, sesamoid, arch and/or whole plantar surface of foot, and offers large compression, tension and shear forces with less pressure than an elbow, and is ideal for large muscles, such as in thigh, or for long-duration upper trapezius compressions. Other manual therapy techniques using the feet to provide treatment include Keralite, Barefoot Lomi Lomi, Chavutti Thirumal.