The feet are my favorite part of the body to work on. In massage school, the foot reflexology class carried my biggest “aha” moment and I knew I would massage the feet of every client I touched from that day forward.

The first person I worked on after graduating was the owner of a destination spa during a job interview. During that treatment, he said in his European accent, “I like what you’re doing on the feet; do some more.” I knew I had the job. Twenty-seven years later, I still love massaging feet and reflexology is the foundation of that aspect of my work.

Here, I offer a brief overview of this technique I love, and share my favorite reflex points to address with clients during a massage.

Reflexology and Energy

Reflexology gives therapists the tools they need to take foot massage to a whole new place. Foot reflexology is the manual manipulation of points on the feet to stimulate, through subtle energy reflexes, various parts of the body as a means to promote health and well-being. 

Reflexology works with homeostasis, the body’s desire to maintain balance. When it is hot outside, your body cools off. When it is cold, your body warms itself. This is homeostasis in action. This process works with the autonomic nervous system to help your body adapt to each moment. Reflexology also works through the body’s desire for this balance.

Think about your liver. It is doing the best job it can at all times. It does not take breaks. Our lifestyle, the air we breathe, the alcohol we drink, and the foods we eat can make it hard on the liver to do its job. The idea behind reflexology is that by stimulating the liver reflex, the point on the foot associated with this organ, we can “exercise” the liver so it can better do what it does naturally. If the liver has problems, we can stimulate the reflex, but this will not “fix” the liver. It only stimulates and exercises the reflex and the subtle energy of the liver.

When I was in massage school, I was taught that reflexology worked through the nervous system; that there were nerves in the feet that connected to all the organs and glands of the body. However, newer theories indicate that reflexology instead works through subtle energy. One such theory suggests fascia is the communication pathway for the subtle energy meridians of Chinese medicine, or the nadis of ayurveda. Can you find connective tissue pathways that line up with the meridians and nadis? Yes. And you can also find connective tissue pathways from the feet to the rest of the body.

The Benefits of Reflexology

Like traditional massage, foot reflexology can reduce stress. When people are stressed, they are usually stuck in their heads, thinking, thinking, thinking. Massaging the feet draws the energy away from the head and into the body, allowing people to relax the mind.

Foot reflexology also increases circulation. If you have poor circulation, where do you notice it first? In the extremities—the hands and feet. Foot massage helps get the blood moving.

Sometimes due to diet, genetics, or lifestyle, calcium and uric acid build up on the reflex points and can feel like grains of sand or crystals. Reflexology can break up those deposits on the reflex points.

Perhaps my favorite benefit of reflexology is that it feels good. Feet top the list for the most abused area on the body, and massaging them simply feels good for clients. People stand on their feet all day, and many people wear high heels or tight shoes, so the feet can take a beating. Spending a quality amount of time working with the feet can bring much needed nourishment and joy.

A Word About Technique

There are a variety of techniques you can employ when giving a reflexology treatment. The main technique I prefer is a friction technique, either circular or back and forth. You can also use effleurage techniques or press-and-release techniques. Everybody’s hands are different, so you have to use what works best for your own body mechanics. Some reflexologists have used their thumbs for many years without issue, while others prefer to use fingertips or knuckles. Some even incorporate the use of hot stones. The best stones to use are small, oblong stones that are a little larger than a finger.

Use the appropriate amount of pressure. Reflex points may be tender, and you do not have to massage with all your might to elicit an effect. You can also stimulate points with a light energy technique. If a point is tender, you can have the client take deep breaths, and as they inhale, massage around the reflex point lightly. As they exhale, massage into the reflex point more specifically. Repeat for several breaths. If you massage so intensely that the person is tensing up or holding their breath, you are activating the sympathetic, or fight-or-flight, response. This means the client is fighting the work and will not get the most benefit from it. Reevaluate the depth of your work. We also want to stimulate the parasympathetic, or rest and digest, nervous system, as this is how the body enters recovery mode. In general, you can stimulate each reflex for 5–10 seconds. Tender points can be massaged for several minutes, but there is not much need beyond that.

Regular stimulation is better, so feel free to share a point with your client and have them massage it as part of their self-care. In fact, one of the best ways to practice reflexology is on yourself. Your feet are always within reach, so try to massage your feet every day, if even for only a few minutes.

Now, let’s explore a few points you might address in a typical session.

The Diaphragm  

Curl your hand. Notice how the hand is directed all toward one point. Now do this with your feet. This point, located below the third toe, is the main point of the diaphragm reflex (Image 1A). The diaphragm is the major breathing muscle. Just as the diaphragm stretches across the torso, the diaphragm reflex stretches across the foot.

Massage the diaphragm reflex with the thumbs using effleurage motions. As the client inhales, move the thumbs from the center point out to mimic the flattening motion of the diaphragm (Image 1B). As the client exhales, move thumbs to meet at the center point of the diaphragm reflex. Repeat three times.

The points of the feet are located similar to the way the organs and glands are located in the body. The diaphragm reflex separates the foot into two parts: superior and inferior to the diaphragm reflex. Even though it is not technically accurate, you could look at anatomical positions reflexively. In other words, distal reflexively would be superior and proximal would be inferior. Every organ in the body that is superior to the diaphragm is located distal or “superior” to the diaphragm reflex, and every organ in the body that is inferior to the diaphragm is located proximal or “inferior” to the diaphragm reflex. In addition, you can think of each toe as a zone that extends across the foot. Zone 1 is the big toe down to the heel, zone 2 is the second toe to the heel, and so on until the fifth zone, which is from the fifth toe to the heel.

Spine  

The spinal reflexes are located along the inside arch of the foot.
If you feel along the back of your neck and upper shoulders, the
most noticeable bony protrusion is the spinous process of cervical vertebra 7 (C7).

The area that protrudes the most on the foot is the head of the first metatarsal. This is the reflex for C7. The spine has four natural curves: cervical, thoracic, lumbar, and sacral. The inside arch of the foot has four curves that relate reflexively to the spinal curves.

The sacral curve is located along the medial aspect of the calcaneus (Image 2A). The lumbar curve is located along the medial aspect of the first cuneiform to the navicular bone. The thoracic curve is located along the medial aspect of the first metatarsal to the first cuneiform. The cervical curve is located along the medial aspect of the proximal phalange of the big toe (Image 2B).

Massage the spinal reflexes with the thumbs, fingers, or knuckles using effleurage motions, moving from the heel toward the big toe in a continuous motion. You may also use press-and-release motions. Use circular friction motions on any tense areas. When massaging tense areas, pinpoint the curve of the spine (and even the vertebra) you are working on.

Pituitary Gland  

The pituitary gland is the master gland of the endocrine system. It sends messages to the other glands of the body to regulate hormone production. The pituitary gland reflex is located on the distal phalange of the big toe (Image 3). To find this reflex, find the widest part of the big toe, move to the center, and massage it using circular friction motions.

Pineal Gland  

The pineal gland is associated with the intuitive faculties of the brain. It produces melatonin and helps the body adjust to the circadian rhythm. The pineal gland reflex is located distal to the pituitary gland reflex on the distal phalange of the big toe (Image 4). Massage this reflex at a 45-degree angle using circular friction motions.

Liver   

The liver produces bile; stores glycogen, minerals, and vitamins; and converts one nutrient into another. It is the largest internal organ in the body, therefore, the liver reflex stretches across a large area. Because the liver is located on the right side of the body, the liver reflex is located on the right foot only. Specifically, the liver reflex is located in the fifth zone proximal to the diaphragm reflex and distal to the tuberosity of the fifth metatarsal along the lateral plantar fascia and abductor digiti minimi muscle. To find this reflex, find the tuberosity of the fifth metatarsal, and move into the fifth zone. The reflex continues distally to the diaphragm reflex in the fifth zone and then medially to the fourth zone. Massage the liver reflex using deep effleurage motions, moving from the fifth zone toward the fourth zone (Images 5A and 5B). Use circular friction motions on any tense areas.

Gall Bladder  

The gall bladder reflex is located on the right foot in the fourth zone proximal to the head of the fourth metatarsal and proximal to the area where the liver reflex crosses into the fourth zone at the flexor digiti minimi brevis muscle and lateral plantar fascia (Image 6). The gall bladder releases bile into the digestive tract in a medial inferior direction; therefore, when stimulating this reflex, massage in the direction of the medial inferior arch.

Spleen  

The spleen is a secondary lymphoid organ that acts as a blood filter and regulates the amount of B cells used during immune responses. Because the spleen is located on the left side of the body, the spleen reflex is located on the left foot only.

Specifically, the spleen reflex is located in the fifth zone proximal to the head of the fifth metatarsal and proximal to the diaphragm reflex at the lateral plantar fascia and abductor digiti minimi muscle (Image 7). Massage this reflex using circular or back-and-forth friction motions.

Stomach  

The stomach reflex is located in the first zone along the first metatarsal proximal to the diaphragm reflex along the digital slip of the plantar aponeurosis and flexor hallucis brevis muscle (Image 8). The stomach begins at the cardiac sphincter on the left side of the body. The fundus and body of the stomach stretch across the left side of the body to the pylorus, which crosses the midline to the right side of the body. When you stimulate the stomach reflex on the left foot, you are working on the upper stomach. When you stimulate the stomach reflex on the right foot, you are working on the lower stomach. Massage the stomach reflex using circular effleurage motions in a proximal direction. Massage the right foot using a “C” motion and massage the left foot using a reverse “C” motion.

Pancreas  

The pancreas is both an endocrine gland that releases hormones to regulate blood glucose levels and an exocrine gland that secretes digestive enzymes. In the body, it is located behind and just inferior to the stomach.

The pancreas reflex is located deep to the stomach reflex, proximal to the head of the first metatarsal in the central area of the stomach reflex at the flexor hallucis brevis muscle (Image 9). Massage this reflex using back-and-forth friction and deep press-and-release motions.

Colon  

The colon reflex consists of five parts. On the right foot, the ascending colon reflex begins in the fifth zone just distal to the heel along the lateral band of the plantar aponeurosis and abductor digiti minimi muscle. The reflex stretches across these muscles until the level of the tuberosity of the fifth metatarsal, at which point the reflex is the hepatic flexure of the colon where the ascending colon becomes the transverse colon (Image 10A).

The transverse colon reflex stretches across the zones at the level of the tuberosity of the fifth metatarsal to the inside arch of the foot. The transverse colon continues on the left foot at the inside arch and stretches across to the fourth zone at the level of the tuberosity of the fifth metatarsal. In the fifth zone, the reflex is the splenic flexure of the colon and moves distally to the spleen reflex.

The transverse colon reflex becomes the descending colon reflex and moves proximal in the fifth zone toward the calcaneus. The descending colon reflex becomes the sigmoid colon reflex just distal to the heel and moves medially to the first zone distal to the heel. The sigmoid colon reflex becomes the rectum reflex and ends in the first zone distal to the heel. Massage the colon reflex using effleurage motions. On the right foot, begin at the ascending colon reflex near the heel and move distally, then move medially along the transverse colon reflex. In other words, move up and over. On the left foot, begin at the transverse colon reflex, move laterally to the descending colon reflex, then proximal to the sigmoid colon reflex, then medially along the sigmoid colon reflex to the rectum reflex (Images 10B and 10C). Use circular friction motions on any tense areas. Spend extra time on the hepatic and splenic flexures, as these are often the most congested areas.

Small Intestine  

In the body, the small intestine generally moves back and forth (laterally and medially) on the right side, and up and down (superior and inferior) on the left side. The small intestine reflex is located in the center area formed by the colon reflex at the plantar aponeurosis and flexor digitorum brevis muscle. Massage the left foot in proximal and distal directions (Image 11A), and massage the right foot in lateral and medial directions (Image 11B).

Reflexology is a great tool to have at your disposal. Whether addressing specific issues or more global concerns, reflexology has something to offer both client and therapist.