Holistic medicine

Reflexology - application and effects

Reflexology - application and effects

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Anyone who has ever dealt with Traditional Chinese Medicine (TCM) knows that it contains many treatment strategies that are based on the principle of the Qi flow. The teaching states that various channels in our body enable the flow of life energy (Qi). Said guideways (better known as meridians) can be stimulated according to traditional Chinese medicine by certain medicinal herbs, but also by special manual therapy methods such as acupuncture, acupressure or massages.

The Reflexology focuses on the flow of qi in the feet. Depending on the symptoms, the meridians of various organs should be stimulated and their functional disorders should be eliminated with targeted actions. You can find out exactly how a foot reflex zone massage works and which health complaints can be treated in our overview article on the topic.

The feet - more than just there to run

Our foot (Pes, Majority: Pedes) is one of those parts of the body that are sometimes the most stressed. Without it, we would not be able to stand, jump, walk or run, which is why it is essential for getting around every day. In addition, the feet must also lift the body weight during the said movements and are therefore exposed to enormous pressure. Our foot has a highly complex structure so that it can handle all these tasks without any problems:

  • Heel bone (Calcaneus) and anklebone (Talus): Together with the ankle belonging to the lower leg, the heel bone and ankle bone form the ankle joint, which acts as a flexible connecting piece between the lower leg bone and foot. While the ankle forms the upper ankle, the ankle and heel bone form the lower part of the ankle. This joint is indispensable for the ability to rotate, as well as to bend and bend the feet, which is why it is surrounded by a series of flexible straps that hold the elements of the strut in their position but do not fix them unnecessarily stiff at the same time.
  • Scaphoid (Os naviculare), Sphenoid bone (Os cuneiform) and cuboid bone (Os cuboideum): Together with the ankle and heel bone, these three bones form the section of the tarsal bone. They are located in the back of the foot and serve as joint and support surfaces for the surrounding bone structures. On the other hand, the ends of various muscle tendons are anchored to them, which support the mobility of the foot.
  • Metatarsal (Ossa metatarsalia): In the middle of the foot, i.e. between the tarsal and the toe bones, there are a total of five metatarsals in humans. They form the basis of the toes that follow each other and allow the foot to adapt to unevenness in the ground when standing, walking and running. For this purpose, the metatarsals can be spread out in a fan shape.
  • Toes (Digiti pedis): The toes form the front section of the feet or the forefoot. They are particularly important for trouble-free rolling of the feet when walking and stretching the feet. For this, the toes can be spread very flexibly, bent and also easily turned. This special flexibility is made possible by three joint sections in each toe.

In addition to the bony sections of the foot, it can be divided into side areas and a front and back. A distinction is made here between the instep or back of the foot on the top of the foot and the sole of the bottom of the foot. The latter in turn divides into the heel, the arch of the foot, the ball of the foot and the outer edge of the foot. Not to be forgotten are the foot nerves that extend through the foot and provide sensory support to the foot muscles.

The foot nerves in particular have another important task in addition to locomotion and support. Because the nerves are not only responsible for the immediate motor reflexes of the foot muscles, they also generally perceive nerve impulses from completely different parts of the body. This can be observed well with sciatic pain, i.e. pain on the sciatic nerve (Sciatic nerve), which can sometimes radiate down to the foot.

The nerve arises between the lumbar spine and the coccyx and then extends from the hip to the thigh, where it finally joins a branch, the fibula nerve (Fibular nerve), and a main branch, the tibial nerve (nerve tibialis). The shin nerve then runs into the heel and sole of the foot, which is why pain stimuli from the upper area of ​​the sciatic nerve reach the foot very easily. In general, the sciatic nerve is a veritable signal node for disturbance stimuli, since it is directly connected to the spinal cord and thus forms an interface between the central nervous system and the peripheral nervous system.

For a reflexology therapist, it is now important to know both the individual foot sections and to be aware of the nerve connections between the foot and spinal cord. The different foot reflex zones are distributed over the foot segments, sometimes depending on the left or right side position of the foot. According to the assumption of reflexology via the foot of the sciatic nerve, these are in constant communication with the nerves of other parts of the body and organs. Certain nerve reflexes within the reflex zones of the foot are therefore evaluated as signal stimuli from the organ associated with the respective reflex zone. Likewise, certain nerve signals should be able to be passed on to the corresponding organs, which is ultimately the purpose of the foot reflex zone massage.

What happens during the reflexology massage?

The American doctor William Fitzgerald, who developed the method at the beginning of the 20th century, is considered the inventor of modern foot reflexology. According to him, he had observed the massage technique among the indigenous people of America and had perfected it according to the standards of modern conventional medicine. Later, the procedure was further developed by the German naturopath Hanne Marquardt, with which one might assume that the foot reflex zone massage is a more recent massage procedure. In fact, variants of this form of massage have existed for significantly longer. Already in ancient Egypt, people knew how to massage according to the reflex scheme.

In Asia, the special form of foot massage is even closely linked to the origins of traditional Chinese medicine. The principle of foot reflexology originates from the Qi teaching of Taoism, according to which physical health depends on an undisturbed flow of life energy, the Qi. The Qi flow is regulated by the meridians - a body's own network of energy channels, each of which symbolizes a specific organ. Traditional Chinese medicine believes that massages, acupuncture or acupressure of said meridians can dissolve blockages in the area of ​​the Qi flow and thus eliminate organ-specific health problems.

In addition to the teaching of the Qi flow, the foot reflex zone massage is closely linked to a concept that deals with a location-based division of the central and peripheral nervous system - the so-called somatotopia. This assumes that the anatomy of the body is reflected in the segments of individual body or organ sections. This can best be explained using the sensorimotor cortex in the brain. It lies in the cerebral cortex and is responsible for the processing of signals which are detected by haptic perception, i.e. perception through active exploration. The functional sections of both halves of the cortex are arranged in such a way that the individual areas lie next to one another in accordance with their position in the body.

The situation is similar with the reflex zones of the feet. For example, the head and neck organs are represented by the toes on top, which are thus understood as the apex of the foot. Connected to it are those in the upper body (thorax) located organs as well as the abdominal organs, which are reflected by the midfoot section. The area of ​​the foot root in turn represents the hip and buttocks area. The classifications may vary slightly depending on the reflexologist, although many masseurs are guided by the Fitzgerald raster image. Roughly there is the following division on the foot according to the principle of reflexology:

Reflex zoneThe location in the foot
brainTips of the toes or toes
eyesMiddle of the second toe limb
EarsMiddle of III. Toe end
SinusesInner surface of all toe links, but especially those of the IV toe and the small toe
noseInside of the large toe end, above the reflex zone of the neck
neckInside of the large toe end, under the reflex zone of the nose
shoulderouter ball of the foot or outside of the fifth toe bone
Midbrainupper inside of the ball of the foot or the first toe middle bone
heartlower inside of the balls of the feet, large parts of the balls of the feet themselves on the left foot
lung Middle of the balls of the feet; on the right foot a significantly larger area, on the left foot with recess for the cardiac reflex zone
diaphragmThreshold between forefoot and midfoot
bileouter approach of the right longitudinal vault
spleenleft outer edge of the metatarsus
stomach left arch
Large intestineInner surface of the front metatarsus and the outer edge of the metatarsus, on the left side with a recess in the spleen reflex zone
Small intestinerear inner surface of the metatarsus
appendix left, lower approach of the right metatarsus
liver right edge of the sole of the foot, above the kidney area
Kidneysleft and right margin of the upper arch, left below the area of ​​the liver
bladderleft and right edge area of ​​the lower arch
Pelvis and buttocksTarsal
Spine and sciatic nervea narrow strip that extends from the edge of the lower arch to the root; the section in the edge area of ​​the tarsus marks the exit of the sciatic nerve from the spinal area at the level of the pelvis and then draws a slightly curved line between the hip and buttocks area

Reflexology now assumes that foot reflexes in the reflex zones shown are also to be understood as reflexes of the associated organs or nerves. Accordingly, a targeted massage of the reflex zones can have a positive effect on the functionality of the assigned organ and nerve sections and achieve an improved Qi flow in this area. To do this, the patient must lie down barefoot on a treatment couch or couch so that the reflexologist can carry out appropriate massage operations on the relaxed foot.

However, the therapist does not start massaging, but also pays attention to special sensitivities in the reflex behavior of the patient's foot during his treatment. These can give him information about which organs react particularly sensitively and are therefore possibly weakened or sick, which is why they require particularly intensive stimulation.

However, a detailed patient survey (anamnesis) must be carried out beforehand in order to find out about known organ complaints and possible contraindications. The foot to be treated is then checked for its temperature as well as possible redness, swelling and water retention (edema). The first steps are only taken after a thorough examination, whereby a distinction must be made between two handle variants:

  • Toning handles: These handles consist of circular movements at a somewhat accelerated pace. They are intended to stimulate or activate the respective organs and thus generate a resonance reflex. The pressure exerted on the foot tissue with toning grips can vary to produce stronger or weaker organ reflexes.
  • Sedating handles: These handles have a calming effect and are used in particular to treat pain. The masseur presses the reflex zone to be treated without movement until the pain subsides.

A single session with the foot reflexology massage takes about 20 to 45 minutes. In the case of specific health problems, it is advisable to book about two to three sessions per week, provided that the symptoms are very severe.

Foot massage oils

A special massage oil can be used as an aid for the foot reflex zone massage. It not only makes it easier for the masseur to process the foot manually, it also contributes to well-being, as it makes the foot tissue and masseur's hands supple. In this way, handles can be carried out more fluently and generate a cozy warmth that is created by gentle friction between the hands of the masseur and the patient's foot. In addition, there are some special oil additives that are particularly good for the foot:

  • for circulatory disorders in the foot area: mugwort, ginkgo, rosemary, juniper
  • for foot and joint pain: field horsetail, comfrey, juniper
  • against sweaty feet: field horsetail, oak bark, coltsfoot, lavender, sage, willow bark
  • against swollen and tired feet: mugwort, comfrey, lemon balm, chamomile, mountain pine, evening primrose, peppermint, worm fern roots
  • against cold feet: mugwort, mustard flour
  • for aching feet: comfrey, mountain pine, lavender, peppermint, white willow

Herbal oils can also be massaged into the foot via the bloodstream, which help with specific health problems. Herbs such as peppermint or sage help with colds, for example.

When can a reflexology massage help?

Basically, reflexology massages are treatment methods of alternative medicine, which do not replace medical or physiotherapeutic measures for certain health complaints, but can certainly supplement them.

Reflexology for circulatory disorders

This massage technique should be very helpful, especially in the case of circulatory disorders, since the feet are known to be the turning points of the blood circulation. It is therefore no wonder that any disturbances in the blood circulation are often first felt in the feet. Because good blood circulation, as well as regulated blood pressure, is extremely important so that the blood can be pumped from the lowest point of the body back to the heart.
The same also applies to the hands, which together with the feet represent the most distant extremities. A decisive reason why there are reflexology massages not only in the foot but also in the hand area.
Overall, the foot reflexology massage is said to be

  • with impaired blood circulation,
  • with high blood pressure
  • and for the discharge of vascular slag, for example in case of hardening of the arteries (arteriosclerosis),

successfully applied.

Pain relief thanks to foot reflex massage

Another health area in which foot reflexology massages are used regularly is pain therapy. According to patients, especially shoulder, back and neck pain, such as occurs in the course of tension, responds very well to the reflex zone massage. In general, complaints in the area of ​​the musculoskeletal system, muscles and nerves make up a very high proportion of visits to the reflexologist. The list of possible diseases includes here:

  • Arthritis,
  • Arthrosis,
  • Cervicobrachialgia,
  • Inflammation of the sciatic nerve,
  • Malformations of the spine,
  • Gout,
  • Ankylosing spondylitis,
  • Scheuermann's disease,
  • Multiple sclerosis,
  • Neuralgia,
  • Parkinson's,
  • Rheumatism,
  • Shoulder arm syndrome
  • and scoliosis.

For many patients, illnesses associated with severe headaches, such as migraines, are also a reason for having targeted massages on their foot reflex zones. This type of massage can even alleviate period pain. Overall, nerve disorders play a major role in reflexology, as they can cause massive functional disorders of the organs and muscles in addition to pain.

By the way: foot reflexology massages are therefore an insider tip for people with nerve paralysis. The sensitivity of the patient can often be achieved in a very targeted manner via the feet, which does not remove paralysis, but does relieve side effects such as muscle cramps or tension.

Foot massage for indigestion

The gastrointestinal tract is an organ complex that is particularly affected by nerve disorders. Its function is largely determined by the contractility of the gastrointestinal muscles. In the intestine, for example, a trouble-free digestive process can only take place if the muscle contractions of the intestinal muscles work smoothly and thus generate a healthy intestinal peristalsis. Inconsistencies in the signal line of the nerves often lead to

  • Stomach pain,
  • Intestinal colic,
  • Stomach and intestinal pain,
  • Stomach cramps
  • and indigestion.

In addition, the stomach and intestines are usually the first organs to react to a persistent stress on the nerves. Pain and cramps, which subsequently lead to digestive problems, are therefore not uncommon in the case of permanent stress. The reflexology massage can also improve things here.

Reflexology for stress and mental stress

With acupuncture, there is already a TCM treatment measure that is used repeatedly for stress and mental complaints. Some even use it to combat sensory disorders caused by seasickness or fear of flying. The foot reflex zone massage is said to have a similar psychotherapeutic effect. Both the gentle treatment and the human attention of the masseur as well as the targeted stimulation of nerve reflexes ensure that many people with

  • Fear,
  • Panic attacks,
  • Burn-out,
  • Depressions,
  • inner unrest,
  • Phobias,
  • mental imbalance
  • and enormous stress in everyday life

take advantage of the offer of a reflexology. The aromatic and soothing essential massage oils make a decisive contribution to the success of the treatment, particularly with these types of complaints. This can sometimes even be seen in coping with traumatization, where foot reflexology massages are sometimes used in addition to the psychotherapeutic care of trauma patients.

Contraindications to foot reflexology

The careful examination of the foot before the treatment has its reason in the foot reflex zone massage. There are some clinical pictures in which the symptoms can worsen due to the pressure exerted during the massage. This is for example with existing vascular inflammation (Vasculitis) the case. Here, additional vessel pressure could lead to serious damage to the already stressed vessel walls. Other vascular diseases such as thrombosis are also a contraindication to foot reflexology. They are one of the reasons why the feet are examined for water retention before the massage begins, in order to rule out the presence of damaged blood vessels on the foot.

Since the foot reflex zone massage is intended to consciously influence bodily functions such as metabolism, blood circulation or the immune system, use with appropriate infections and autoimmune and systemic diseases is unsuitable. These include:

  • Autoimmune diseases (for example in the area of ​​the skin),
  • Fungal infections,
  • bacterial infections,
  • Viral diseases,
  • diabetes
    (especially if you have a diabetic foot)
  • and rheumatism.

If there are any injuries to the foot, a reflex zone massage should also be avoided. The wounded area could otherwise be disturbed in its healing process. It is irrelevant whether there are serious breaks or superficial cuts and abrasions. In any case, the feet need rest to regenerate. In addition, irritating essential oils or germs could otherwise be massaged into the wound during the massage, which increases the risk of wound infection.

Chronic pain diseases such as Sudeck's disease also tend to react to a reflex zone massage with aggravation. The pain symptom goes hand in hand with extreme hypersensitivity of the skin and limbs to touch, which is why massage movements here do not improve, but rather intensify the pain symptoms.

Reflexology during an existing pregnancy is completely excluded. The nerve contractions that are deliberately brought about during the massage could contribute to premature contractions and thus miscarriage. This applies in particular to high-risk pregnancies, i.e. pregnancies in which mothers are older than 35 years, have existing medical conditions such as diabetes or are extremely overweight. Pregnant women who take medication or consume intoxicants and stimulants also belong to the risk group.

In the area of ​​mental illness, people with an existing psychosis should refrain from a reflexology massage. In contrast to stress and mild mental complaints, psychoses are serious and profound psychological disorders in which certain manipulations of the nervous system could possibly trigger a psychotic surge. Side effects such as hallucinations, delusions and perceptual disorders cannot be excluded.

What else is there to consider about the reflexology massage?

It should be noted that a reflexology massage can never replace professional medical treatment. The massage only offers a supportive treatment procedure for symptom relief or to accelerate the healing process. Since there are also no conclusive study results on the medical effectiveness of reflexology, the treatment costs must be borne by the patient. Unfortunately, the health insurance does not pay anything here.

Please have a reflexology massage performed only by trained specialist staff. This includes doctors, physiotherapists, massage therapists and naturopaths with certified training. Laypeople should rather not mess around with reflex zone points, as this can lead to undesirable side effects. And even in professional treatment, you should immediately report changes in your condition. For example, increased pulse, sweating, dizziness and nausea can occur when certain nerve strands are activated via the reflex zones. Please pass on corresponding body reactions in detail to the masseur so that he can adjust his movements or stop in an emergency. (ma)

Author and source information

This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.

Miriam Adam, Barbara Schindewolf-Lensch


  • Hanne Marquardt: Practical textbook on reflexology therapy on the foot, Karl F. Haug, 7th edition, 2012
  • Association of German Alternative Practitioners: Foot Reflex Zone Therapy (accessed: 10.10.2019), bdh-online.de
  • Swiss Association for Foot Reflexology Massage (SVFM): Reflexology (accessed: 10.10.2019), svrt.ch
  • Franz Wagner: Reflexology massage, GU, 2009

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