Foot Reflexology Revisited

By Anne Williams
[Spa Elan]

Reflexology is one of those techniques that people learn in massage school and then forget about, despite its popularity with clients. This article aims to revisit reflexology in a practical way to remind therapists of its benefits for stress reduction and foot pain.

Reflexology is a therapy based on belief that there are points on the feet, hands, and ears that stimulate the function of different parts of the body, including the glands and organs. While hands, ears, and feet can all be manipulated to improve health and well-being, it is the feet that receive the most attention. The feet are considered to be very important because of their rich supply of superficial nerve endings. Circulation tends to slow in the feet, as they are furthest from the heart, and clients often include foot pain or foot tiredness as a complaint on health intake forms. Reflexologists focus on working every surface of the foot to decrease muscle tension and pain, increase circulation, loosen the foot so that it is more flexible, and relax the body.

Modern reflexology owes its development to the American doctor William Fitzgerald who developed a comprehensive method for working the feet in the early 20th century. Dr. Fitzgerald discovered that when he applied gentle pressure to the feet, other areas of the body were affected. He called his work Zone Therapy and mapped out 10 zones in the body that could be accessed by manipulating the feet or hands. (See image 1.)

Eunice Ingham, an American physical therapist, became interested in Fitzgerald’s methods while working on a variety of patients. She kept detailed notes on her sessions over a number of years and charted each body area on the foot. Through trial and error, she created an intricate map that shows the placement of reflex points for each gland and organ in the body. She is credited by many as being the first person to create an anatomical model of foot reflexes in which the feet are a mirror image of the body. (See image 2.)

Reflexology Techniques

The most common technique used in reflexology is thumb-walking. To thumb-walk, the therapist uses the edge of her thumb in an inchworm motion to take small “bites” out of the area she is working. The pressure is steady and firm. To practice the technique the therapist can walk the thumb up her own forearm. The hook and back up technique is used to stimulate a specific point. The thumb is used to apply direct pressure to the point and is then pulled back slightly to hook the point—think of taking slack out of fascia. The point will then be reactivated with direct pressure. Sometimes a therapist will rotate her thumb on a point as a way of stimulating the point. A warm basalt stone or massage tool can also be used to stimulate points and reduce tension on the therapist’s hands.

In general, when a tender area is found it receives focused attention. In the traditional model of reflexology, areas of tenderness are believed to relate to congestion in the corresponding glands and organs of the body. It is important to remember that the foot is a complex structure, prone to adhesions, hypertonicities, and inflammation, just as the rest of the body is. Congestion in an area does not necessarily indicate pathology in a gland or organ.

A Stress Reduction Reflexology Routine

Reflexology might be offered as a 30-minute to one-hour stand-alone session that includes a foot soak or offered as an add-on to massage. It is a nice enhancement to the processing phase of body wraps. This stress reduction routine lasts approximately 30 minutes when paired with 10 minutes of foot massage.

The client is supine on the treatment table with her feet at the very end of the table. A pillow is placed under her head and her knees are bolstered. The therapist may choose to place a pillow under the client’s feet to elevate the feet. The feet are cleansed with a disposable wipe or with foaming cleanser and hot moist towels.

Step 1. Massage the Feet

A foot massage is used to warm up the tissue before the reflexology treatment. After the foot massage, remove the lubricant from the feet, which need to be dry or else the thumb will slip over the reflex points instead of grab them.

Step 2. Solar Plexus Hold

Sit at the end of the table and hold one foot in each hand. The thumb is positioned on the point directly below the ball of the foot, known as the solar plexus point. This is associated with deep breathing and calm. Ask the client to take three deep breaths and apply firm pressure to this point on both feet at the same time. (See image 3.) When it feels appropriate to move to the next step of the routine, release and cover one foot.

Step 3. Clear the Zones

When clearing the zones, make certain that the entire plantar surface of the foot has been stimulated with thumb pressure. Image 1 shows the five zones on the bottom of each foot. Thumb-walk each zone from the heel to the top of the toe in that zone. (See image 4.) It may take 2–3 passes over a zone before the tissue feels soft. When an area of particular tension is felt, thumb-walk it repeatedly to increase circulation.

Step 4. Spinal Walk

Identify the spinal reflexes. They are on the inside of both feet at the medial edge of zone 1. Thumb walk from the heel to the base of the big toe. (See image 5.) Turn the hand over and support the plantar surface of the foot. Thumb walk from the base of the big toe to the heel. (See image 6.) Repeat the stimulation of the spinal reflexes until the tissue softens.

Step 5. Thumb-Walk the Toes

Support the foot with one hand and thumb-walk the toes with the other hand in a technique sometimes referred to as biting. (See image 7.) Bite the big toe first (five passes, 15 bites a pass) and work down to the little toe (three passes, 10 bites a pass). To finish the toes, roll the knuckle of a finger over each of the brain reflexes at the top of each toe.

Step 6. Pituitary Press

Hook and back up on the pituitary reflex point. (See image 8.) This point can be held with direct pressure for up to two minutes. A dot of lemon, pine, or myrrh essential oil (all reputed to balance the pituitary gland) can be placed on this point.

Step 7. Thumb-Walk the Horizontal Lines

Using image 9, identify the horizontal lines on the plantar surface of the foot. These lines include the shoulder line, diaphragm line, waistline, and pelvic line. Thumb-walk each line horizontally from zone 5 to zone 1 and then again from zone 1 to zone 5.

Step 8. Thyroid Press

Thumb-walk the area associated with the thyroid point. Hook and back up on the area at the base of the big toe. (See image 10.) This point can be held with direct pressure for up to two minutes. A dot of pine oil or seaweed essential oil can be placed on this point after it has been stimulated.

Step 9. Adrenal Gland Reflex

Apply direct pressure for up to two minutes to the adrenal gland reflex, which is located below the solar plexus, above the kidneys, and toward the medial side of the foot. (See image 10.) A drop of rose, pine, or rosemary essential oil can be placed on this point after it has been stimulated.

Step 10. Thumb-Walk the Lung Reflexes

Beginning at the diaphragm line in zone 5, thumb-walk diagonally across the lung reflexes to the base of the big toe. Next, thumb-walk from the diaphragm line in zone 1 to the base of the little toe. Thumb-walk from the diaphragm line in zone 4, diagonally across the lung reflexes to the base of the second toe. Thumb-walk from the diaphragm line in zone 2 diagonally, across the lung reflexes to the base of the fourth toe. (See image 10.) The hand that is not thumb-walking is always supporting the foot and holding it upright and open.

Step 11. Solar Plexus Hold and Transition to the Other Foot

Take hold of the solar plexus point on both feet and take three deep breaths together with the client. Cover the foot that was just worked on, and repeat the routine on the other foot.

Session End

At the end of the reflexology session take hold of the solar plexus point and balance the energy between both feet with focused intent before moving on to the next section of the treatment or ending the session.

Designing a Routine

By starting with steps 1–7 and then focusing on specific points in a systematic manner, a reflexology routine can be designed to suit most clients. For example, if the client was receiving a detoxification body wrap, the therapist could use steps 1–7 and then thumb-walk or use direct pressure on the kidney, spleen, stomach, and colon points on the left foot and the kidney, liver, gall bladder, and colon points on the right foot during the processing phase of the wrap.

When therapists revisit reflexology and add it to their menu of services, they provide clients with an additional tool for stress reductions and to diminish foot pain and fatigue.

 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 author’s textbook, Spa Bodywork: A Guide for Massage Therapists (Lippincott Williams & Wilkins, 2007). Anne is also the education program director for Associated Bodywork & Massage Professionals. She can be reached at or