the science of the reflex areas in the hands and the feet.

REFLEX AREAS (also called REFLEXES): these are mirror areas of the various organs and body parts located in the hands and feet which, when activated by specific Reflexology techniques, have direct effect on the corresponding organ or area of the body (click on picture to enlarge; this picture is courtesy of the International Institute of Reflexology).


Purpose of Reflexology:

Healing, pain reduction, and the normalization of all body functions, especially those of the problem (painful) area(s). Reflexology is not magic, it cannot make a scoliosis go away but, in the hands of well-trained Reflexologist, it can optimize blood, lymph, and nerve flow to that area, thus minimizing pain as well as muscle tension and facilitating the body’s natural healing and detoxifying processes.

Does it matter whether you believe in it or not?

Luckily for patients, not at all. There is absolutely no hocus-pocus involved when you are in the hands of a well-trained Reflexologist. It’s all science and nothing but science. Please read on to understand the science behind Medical Reflexology.

There are two types of Reflexology:

The type of Reflexology that is given in spas: I call this an “improved foot massage” with a little bit of pressure here and there. It barely has anything in common with Medical Reflexology and is very wrongly called “Reflexology”. It can be very pleasant nonetheless.
The type of Reflexology this page and this website are about: this type of Reflexology is known either as Medical Reflexology or as Clinical Reflexology. Specific thumb, finger, and hand techniques are used – most with deep pressure – on the various congested reflex areas found. This type of Reflexology will often hurt when the congested reflex areas are treated and in no way resembles a foot massage. As the condition improves with several Reflexology sessions, so will the soreness on the corresponding reflexes in the foot or hand. Pain on a specific reflex is always brief and only lasts as long as the Reflexologist is applying pressure on it. Pain levels are always kept at bearable levels for the patient. The well-trained Reflexologist will adapt his pressure to the pain tolerance of the patient. The Reflexologist will also teach his patient deep breathing techniques (deep breathing releases endorphins, the body’s natural pain-killer) in order to reduce the pain sensation.

Before I begin to throw light on the science behind Foot and Hand Reflexology I want to talk about the REFLEXOLOGIST. If you’ve landed on this web page, my guess is you’re at the end of your tether when it comes to your back pain. You’re looking for help, and so the first thing I’m going to do is explain to you how to find the type of Reflexologist who can really help you with your back pain. In Reflexology, the results are as good as the Reflexologist is, and the Reflexologist’s skills are a combination of his training and his natural talent.

Finding a good Reflexologist:

- Before you make an appointment enquire if the treatment is going to hurt. If you’re told “not at all, on the contrary, Reflexology is very pleasant”… don’t bother making an appointment and keep looking for the Reflexologist who will tell you that there is a good chance that you will feel some pain but that it will always be kept at bearable levels.

Diabetics, very chronically ill people, and very heavy smokers are the only ones who may have a highly reduced sensitivity in the feet. Both the chronically ill and the smokers will recover sensitivity after a few sessions. For diabetics the return of some sensitivity takes longer (weeks or months depending on the person).

- During the session – which lasts approximately an hour – you need to feel that the Reflexologist is applying deep pressure. If you have the impression the pressure is very light then there is a good chance the treatment will not be very effective, if at all. I would suggest you look for another Reflexologist.

- If the Reflexologist is trained in the Ingham Method of Reflexology then there is an excellent chance that you are in very good hands. Eunice Ingham was the American physical therapist who in the 1930’s developed Western Reflexology as we know it today. She is the one who mapped out all the reflex areas of the hands and feet. Likewise, if you find a Reflexologist trained in ART (Advanced Reflexology Training) techniques – the techniques developed by Tony Porter -, you will be in good hands. This is not to say that Reflexologists trained in other techniques will be less capable, not at all. There are other types of very effective Reflexology techniques such as Vertical Reflexology ( or Nerve Reflexology ( The important thing is that the pressure applied in all the back-related zones of the foot be firm.

- In the Links and References page you will find links to worldwide directories of Reflexologists whose quality training I am familiar with. This does not mean that Reflexologists having received a different training are necessarily bad. Base your evaluation on the advice I just gave you and you will be fine.

- In the section Backology: Tips & Facts you will find extensive information on what to expect during a Reflexology session given by a well-trained Reflexologist. This will give you a good set of reference points so as not to waste your time and money in the wrong hands.

Now that you’re all set to get help quickly let’s take a closer look at the science behind Reflexology.

Is Medical Reflexology based on facts or fiction?

The first question that comes to mind is: Why would our bodies be mapped out on our hands and feet? What purpose would that serve? When you try to answer such questions, it is essential that you try to think like Nature and not like a human being. In Nature everything has a purpose, every single cell of every single living thing has a well-defined function favorable to the survival of that species. In fact, for all living beings the same law applies: the function (= the need) creates (defines) the organ (organ = every body part having a specific task). This is the basic law behind the majority of genetic mutations and, simply put, it means that all living things develop the organs/body parts they need to survive. If they don’t, or not quickly enough, the species dies and disappears. Some humpback whales travel 5000 miles every winter to breed in warmer waters. Imagine if we had to travel that far – without planes – to breed: we’d obviously be built differently or go extinct! And actually, when you consider it, Humans, as a species, have fared incredibly well over time. If it had been possible to place bets at the beginning of the species race, I’m not sure many would have bet on us to come this far. Look at us: we’re fragile, we break, we become ill and bleed easily, and we are fantastic spreaders of disease amongst ourselves! And yet we’re so good at surviving as a species. We keep defying the odds. So how do we do it and what does this have to do with Reflexology?

Our inventiveness, resourcefulness, and imagination account for a big part of our ability to survive. They have allowed us to find and build shelter, to create machines, to have a constant supply of food, and so on. Our predilection to live in groups and the realization that this tends to be safer has also played an important part in our ability to survive over time. But what of our bodies? We are not only fragile, we’re also tremendously complex machines within which millions of operations need to occur every second for the machine to keep functioning normally. As a simple example, 2 million blood cells die every second and need to be replaced – every second -, and that’s just one thing that needs to happen every second! Any engineer will tell you that the more complex the machine, the more chances there are of something going wrong. It’s the law of probability. In our bodies, the chance of something going wrong, of something being out of balance, is huge. The very thought that we could have survived as a species over hundreds of thousands of years without a (integrated) rebalancing system is simply absurd. Pretend you’re Mother Nature for a minute and you need to make sure that human beings almost constantly rebalance their body chemistry. Remember, you need to find a system which will make sure that millions of operations transpire uneventfully every second. How would you do it? Well, in the original design, we were supposed to walk barefoot in nature and be active all day long looking for food and shelter. This means that we would have used both our hands and feet a lot. Hands and feet are not just extremities, not just grabbing tools and walking tools. They are our main points of contact with the outside world. People tend to forget this. They constantly transmit motoric and sensory information about the outside world to the brain. Hands and feet are gigantic computers and as such, they are wired, wired with thousands of nerve endings. So, if you wanted a reliable rebalancing system to make sure that the human body didn’t malfunction too often, why not use the hands and feet and their wiring network?

Since feet and hands were supposed to be used repetitively on a daily basis - by walking on uneven surfaces and doing manual labor -, they seemed like the most reliable choice, precisely because stimulation of the system would occur daily. Additionally, they could be each other’s back up, should one or the other be hurt and remain unused for a period of time – a potentially life-saving fringe benefit. So, Reflexology is nothing more than that: the imitation of natural walking on different uneven surfaces – or hard manual labor in the case of the hands. Reflexology activates the body’s natural rebalancing system by stimulating nerves which send signals to the brain which in turn sends signals to the various organs.

Everything I have just said could have been deemed as speculative until a few years ago. One of the most valid and truly interesting studies on the effects of Reflexology which was carried out by the Oregon Research Institute and published in 2005 in the Journal of the American Geriatrics Society points to the same direction. The study demonstrated that cobblestone-mat walking significantly improved the health of older physically-inactive adults (between 60 and 92 years of age) over 16 weeks. This was measured by various physical performance tests, balance tests, and blood pressure. For those of you who are interested, here is the complete reference to the article:

Improving physical function and blood pressure in older adults through cobblestone mat walking: A randomized trial by FUZHONG LI; FISHER K. John ; HARMER Peter, Journal of the American Geriatrics Society ISSN 0002-8614, 2005, vol. 53, no8, pp. 1305-1312 [8 page(s) (article)] (27 ref.)

The study is significant because the health of the elderly people who walked on the cobblestones three times per week improved much more than that of the elderly people who did the normal walking (the control group). This means that the pressure caused by the cobblestones made a very big difference. As a researcher friend of mine put it: “one good study is worth a thousand interpretations about the intentions of Mother Nature.”

As you can see, there is little room left for hocus-pocus when it comes to Reflexology. And future scientific studies will prove many more interesting things about the integrated rebalancing system of the human body. You can also understand now why, in Medical Reflexology, strong pressure needs to be applied.

But the beauty of the system doesn’t end here. In fact, our feet also influence the quality of our blood flow. Feet are the crucial point of return upwards of the blood back to the heart. When arterial blood (clean blood full of oxygen and nutrients) arrives in the feet, it passes into the veins (“dirty” blood charged with toxins and waste materials) where it will be pushed back upwards into the legs and back to the heart. This is no small task. There is a system of “pumps” in the feet and the legs, and another of valves inside the veins, which allow for the pushing upwards of the blood back to heart. But the “pumps” and the valves are mainly activated by the action of walking (= by the pressure exercised on the sole of the foot).

Why is it important to have a good blood flow? A healthy blood flow allows oxygen and nutrients to get to every single cell (all 80 trillion of them), and toxins and waste materials (dead cells, bacteria, etc.) to be eliminated and expelled from the body. Bad blood flow equals poor health. Once again, you see how it is impossible to be really healthy by sitting all day. Our bodies were simply not meant for so much sitting. Perhaps in 10.000 years our rebalancing system will have migrated to our buttocks! Maintaining our bodies healthy was designed around a life of activity and barefoot walking (or walking with moccasin-type shoes – thin enough to enable the uneven ground to pressure the soles of the feet – unlike today’s shoes). I honestly believe this is one of the reasons so many people are so often sick in our modern societies. I also believe that the lack of stimulation of our natural rebalancing health system makes people feel much more pain than they would otherwise feel when a medical condition presents itself. And this goes for your back pain too. Now that you know the key role the feet play in our blood circulation, it will come as no surprise to learn that Reflexology is known to powerfully activate blood flow… because it reproduces natural walking on uneven surfaces and in doing so, it stimulates the “pumps” and the valves.

But how do we know which part of the foot corresponds to which part of the body? Eunice Ingham did it by trial and error on thousands of patients without any modern equipment. She was a physical therapist working closely with a physician, Dr. Riley. She knew what the complaints of her patients were and she looked for the corresponding areas in the foot which appeared to be “congested” and sore. This is how over the years she mapped out the reflex areas of the feet. Also, she realized that when she treated those areas with deep pressure, the complaints of her patients improved or disappeared. What she achieved is absolutely amazing. And now we have methodologically valid medical studies which show that she was right. Thanks to Doppler sonography for instance, Austrian researchers proved in 1999 that Reflexology on the kidney reflex increased blood flow inside the kidney. When Reflexology was applied to reflexes other than that of the kidney, the measured blood flow inside the kidney was not altered (see here below for the exact reference to the study). So, when the specific area on the foot corresponding to one of the kidneys was stimulated by deep Reflexology techniques, the amount of blood flow inside the corresponding kidney became greater. This means that more oxygen and more nutrients were immediately brought to the kidney to improve its function. You see what I mean by a natural rebalancing system? Walking on uneven surfaces on a daily basis would stimulate all the reflex areas of the foot and Reflexology can reproduce that.

Changes of renal blood flow during organ-associated foot reflexology measured by color Doppler sonography by Sudmeier I., Bodner G., Egger I., Mur E., Ulmer H., Herold M., Forsch Komplementarmed. 1999 Jun; 6(3): 129-34

There is unfortunately too little of this type of research. You have to understand that there is little money in Reflexology to be invested in research and these studies are expensive. But as mentioned earlier, one good study says a great deal, and the above mentioned study is one of the good ones. It shows that the zones we work on on the feet and on the hands - as being the reflexes corresponding to the various organs and body parts - are as specific as Eunice Ingham drew them. Hopefully, there will be many more studies of the sort in the future. In some universities, researchers are now also looking at what happens inside the brain when you stimulate certain reflexes. The first results are very encouraging and in the coming 20 years I am certain that many of the benefits of Reflexology will be fully explained by scientific measurements and observations.

Obviously, we can’t all leave our day jobs and go walking every day on a pebble beach. But if you do have the opportunity to walk barefoot on uneven surfaces, do it. For the rest, I suggest you start looking for a Reflexologist as soon as possible and get that natural rebalancing system working again! You’ll be amazed at how quickly you will feel better.

In the next section we examine more in detail how Reflexology can help back pain.


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“It is not the strongest of the species that survives, nor the most intelligent that survives. It is the one that is the most adaptable to change.”

Charles Darwin




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