Reflexology – A Therapeutic Art Form, Not a Procedure

Foot massageWhat exactly is Reflexology?  At first glance this might seem a relatively simple question to answer.  Look a little deeper however, and the question is actually much more complex.  Undoubtedly this is an important question, and one worth some considerable reflection by both individual reflexology practitioners, and indeed our wider therapeutic community.

Reflexology has been defined by the the Department of Health (UK) as:

“Application of pressure to the hands and feet to promote well-being.”

Recently the Reflexology in Europe Network agreed upon their own working definition of reflexology:

“Reflexology deals with the principle that there are reflex areas on the feet that correspond with different parts of the body and it is a method that affects these reflex areas to attain wellbeing.”

Encouragingly in recent years our therapeutic modality has started to collate a small body of favourable valid clinical research.  Understanding for example, the specific mechanics of action relating to reflexology is indeed an important and utterly worthwhile endeavour.  Every piece of research, no matter how small, either suggesting or better demonstrating specific physiological mechanics, undoubtedly strengthens the reputation of the modality, and helps to promote a wider understanding of any potential therapeutic worth.

It is worth remembering that one of the reasons the modality has been able to attract higher levels of clinical research interest is because the general public keep choosing to utilise reflexology.  It is undoubtedly our clients positive reaction to reflexology, across many decades; their antidotal evidence and their personal recommendations, in addition to the observations of experienced practitioners, that has enabled the modality to reach a place now deemed worthy of more in-depth clinical research and investigation.

The heavy lean in research towards examining the mechanics of action (using sham reflexology points) means the modality has the unfortunate tendency to be viewed from a somewhat limited perspective; that being one of only examining the relationship between the feet (potential reflex points) and any associated potential neurological impact. That said, from a practitioner standpoint it is entirely encouraging and affirming to read about any positive research emerging.  One such recent Japanese study (Naoki et al, 2013) looked at the effects of using specific reflexological stimulation to the eye reflex point/area, whilst utilising a MRI scan to examine related brain activity in recipients.  The research demonstrated:

“a robust relationship exists between neural processing of somatosensory percepts for reflexological stimulation and the tactile sensation of a specific reflex area in the left middle postcentral gyrus, the area to which tactile sensation to the face projects, as well as in the postcentral gyrus contralateral foot representation area.”

and that:

“This activity was not affected by pseudo information.”

So here we have some pretty wonderful positive research.  No conjecture, no opinion, just good solid scientific fact.  The nature of the research, whilst limited by construct and pre-defined question, is precisely the kind of positive clinical enquiry required to demonstrate the underlying principles of reflexology.

So does this Japanese research go someway to explaining what reflexology really is?  The research certainly tells us more about what happens when we stimulate feet through touch and pressure.  It also clearly helps to back up the hypothesis stating there are areas on the feet which correspond to certain parts of the body, but does the research help explain why so many people report such positive reactions to reflexology, or to explain the dynamics of what might be occurring within the confines of a practitioners therapy room?  A realistic and balanced answer to these questions is clearly, only in part.

What this research fails to tell us is if any related brain activity reaches the eye directly; or how any neurological activity might be affecting the eye specifically?  Nor does this type of research help us to examine the wider aspects of a therapeutic reflexology encounter.  Even in those instances where practitioners choose to carry out reflexology sessions in complete silence, fuller and more realistic research parameters would need to consider:

  • The physiological effects of touch on the brain and body – blood pressure, heart rate, the effects of touch on cortisone and adrenaline levels related to the release of endorphins, neuropeptides, serotonin and dopamine.
  • Client intention – simply picking up the phone and attending for reflexology might be considered as demonstrating positive mental intention. This can promote both a psychological and associated physiological response via the HPA axis.
  • Internal emotional responses – even during reflexology performed in silence clients are often not fully asleep, but more in a deeply relaxed, potentially internally reflective state.  These individual psychologically based processes are extremely difficult, if not impossible, to quantify within the classic scientific paradigm.
  • The therapeutic relationship – even on a basic level the consultation period is likely to be impacting therapeutic outcomes primarily because of the focus of attention being placed on client experience and past history.
  • Promoting existential thinking – even on a very basic level practitioners often encourage client self care towards the end of the reflexology session; rest, water, avoiding stimulants etc.

Each new piece of clinical research, new advanced technique, or theory of application presented to practitioners represents a small piece of much more complex jigsaw.  It is important we are able to remain open and objective as we move forward in attempting to defining reflexology more fully.  We should strive to encompass a wholly holistic overview; otherwise we are potentially in danger of becoming represented by only one medically and scientifically defined aspect of the whole reflexology package.

Leaning too heavily towards understanding the exact mechanics of a reflexology encounter from a scientific, quantifiable stand-point might be akin to trying to understand the taste and texture of a chocolate cake through describing its molecular structure.  Whilst it might be useful to know how it is constructed, it is perhaps the taste which ultimately matters!

The scientific field of psychoneuroimmunology is encouragingly beginning to bring together previously fragmented medical, psychological and sociological disciplines.  In the future this more complex multi-dimensional approach to understanding human health will undoubtedly require a far more complex holistic and kaleidoscopic form of research enquiry.  An enquiry better suited to exploring the multi-dimensional phenomenology of the reflexology package.

I am a reflexologist.  I might define this personally by stating; I engage therapeutically with people using reflexology’, as opposed to stating, ‘I work with peoples feet’.  I am a therapist, and my modality is a therapeutic art form, not a procedure.

I hope as we move into the future we never lose sight of that.


Naoki, et al. (2013).  Activity in the primary somatosensory cortex induced by reflexological stimulation is unaffected by pseudo-information: a functional magnetic resonance imaging study.  BMC Complementary and Alternative Medicine. 2013. 13:11


3 thoughts on “Reflexology – A Therapeutic Art Form, Not a Procedure

  1. “I am a reflexologist. I might define this personally by stating; I engage therapeutically with people using reflexology’, as opposed to stating, ‘I work with peoples feet’. I am a therapist, and my modality is an therapeutic art form, not a procedure.”

    Well said, Nichola, may I adopt this as my newest affirmation, please?


Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

%d bloggers like this: