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It’s been widely speculated that the origins of reflexology date as far back as 5000 years to China. As part of Traditional Chinese Medicine (TCM), some form of hand and foot therapy was being practiced alongside herbal therapy, acupuncture and qigong. Its roots have also been traced back to ancient Egypt through pictographs dating to 2330 B.C. Commonly referred to as the “Physician’s Tomb” for its depiction of several medical procedures, the pictographs were found at the burial site of a high ranking official named Ankhmahor. One of the images depicts two practitioners applying pressure to the hands and feet of two other people, with the inscription loosely translating to “Do not let me feel pain” and the response, “I will act as you please.”

Other cultures such as those of India, Japan and the Native Americans, have also used some form of pressure therapy to the feet as part of their tradition. The Native Americans for example believe that because our feet make contact with the earth, that we are connected to the whole of the universe through the energies that pass through them. In Europe, a form of pressure therapy known as “zone therapy” was being practice as far back as the 14th century.

In 1898, an English Neurologist by the name of Sir Henry Head discovered what are now known as “zones of hyperalgesia” or “Head’s Zones.” In a series of experiments, Head was able to demonstrate a link between diseased organs connected to a specific “zone” of skin by nerves and a hypersensitivity to pressure in that zone of the skin. Around this same time the work of two notable Russians: Ivan Pavlov – a physiologist, and Vladimir Bekhterev – a neurologist & psychiatrist, made their contribution through what are known as “conditioned reflexes”. Pavlov and his work with classical conditioning were able to demonstrate a causal link between a stimulus and a response. Bekhterev’s work was very similar in nature to Pavlov’s, although he referred to this link as an “association reflex.” Bekhterev however has the unique distinction of coining the term reflexology in 1917.

The first instance of a “reflex action” being attribute to massage occurred in Germany in the late 1890’s. What the Germans referred to as reflex massage was being widely practiced as a way of treating various diseases. A German doctor by the name of Alfons Cornelius had experienced first hand the therapeutic effects of a reflex action while recovering from an illness. He noted that during his massages, focusing on the tender and painful areas helped to significantly reduce his pain levels and speed up his recovery time.

It wasn’t until the work of an American physician named Dr. William Fitzgerald, that the reflexology that we know and practice today took form. Fitzgerald was the head of the Nose and Throat Department at St. Francis Hospital in Hartford, Ct in the early 1900’s. Commonly regarded as the father of zone therapy, Fitzgerald discovered the anesthetic effects created through the application of pressure to the fingers and toes. A series of ten longitudinal zones for the hands and feet, where found to run the length of the body from the fingers and toes all the way up to the head. Through the use of clamps, pins and rubber bands which he used to apply pressure to the digits, Fitzgerald was able to map out the distinct areas on the body where the anesthetic effect took place. He soon realized that could relieve pain and the underlying causes of the pain using this technique. Fitzgerald became so skilled at this that he was able to perform small surgeries using his technique, which he referred to as zone analgesia. Along with colleague Dr. Edwin Bowers, Fitzgerald co-wrote the book “Zone Therapy” in 1917. In it they discuss the general principles behind this therapy. The idea being that areas of the body found along specific zones will be linked to one another through energy that flows through that zone. The zone therapy that’s used today in reflexology is largely based on Dr. Fitzgerald’s pioneering work.

Another physician by the name of Dr. Joseph Shelby Riley was so fascinated by Dr. Fitzgerald’s work with zone therapy, that he went on to refine and use his techniques in his own practice. Riley was the first to create detailed diagrams of reflex points on the feet. He also discovered the eight horizontal divisions governing the body. It was his assistant however, a physical therapist by the name of Eunice Ingham, that finally charted the reflexes we use today in reflexology. Ingham has been called the “Mother of Modern Reflexology”. It was Ingham who focused on the feet as a means of treatment. By applying the techniques used in zone therapy, she meticulously checked and rechecked the reflexes until she had created a detailed map of the body on the feet. After writing her first book, “Stories The Feet Can Tell” in 1938, she tireless promoted the practice of reflexology throughout the general public. Along with her nephew Dwight Byers, which she often practiced on, the two of them helped bring the modern practice of foot reflexology to the forefront.

Another key contribution worth noting came around the mid 1960’s. In 1965, Ronald Melzack and Patrick Wall published an article in the journal of “Science” entitled, “Pain Mechanisms: A New Theory”. In it they describe how the body transmits and inhibits pain signals through a gate response found in the spinal cord. This theory would go on to explain one of the possible ways that this anesthetic affect was being created in the body. The theory was called the “Gate Control Theory” of pain.

The body’s normal response to pain is to inhibit it through the use of endorphins; the body’s natural pain relievers. Endorphins are endogenous opioid compounds produced by the pituitary gland and the hypothalamus in response to strenuous exercise, excitement and trauma. And they are as strong as any opiate out there, including morphine. As a matter of fact, the word endorphin is actually an abbreviated version of “endogenous morphine”. When you stub your toe for example, pain signals are sent to the brain where they are processed by the thalamus. During this time, the first wave of endorphins is released into your system. But there’s a curious thing that happens along side this. Our immediate reaction is often to reach for the area in pain to try and soothe it. Ever wonder why that is? Somehow it helps to diminish the pain and the gate control theory can explain why.

The gate control theory states that a competing signal can essentially block pain signals from reaching the brain. Nociceptive pathways or pain pathways, have two different types of nerve fibers. A-Delta fibers are myelinated pathways that conduct pain signals to the spinal cord at approximately 40mph (fast, acute, sharp pain). C-fibers are unmyelinated pathways that carry signals at approximately 3mph, (slow, continuous, throbbing pain). Sensory neural pathways however, are myelinated but also larger in diameter, which essentially means they can transmit signals faster than both pain pathways. Basically, sensory information reaches the spinal cord faster and takes precedent over pain signals. This explains why rubbing your toe seems to miraculously help ease the pain. When the sensory input reaches the spinal cord it stimulates inhibitory inter-neurons, which act as gates that can close and suppress the pain signals. It’s a complex interplay and not an all or nothing phenomenon, which is why we still feel some pain. Interestingly enough, the theory goes a step further. Melzack and Wall also state that “the psychological condition and cognitive content of the mind” can affect our experience of pain. This includes emotions, thoughts and our overall outlook! This could explain why pain is such a subjective experience.

This last theory has wide implications for the therapeutic effects of touch therapy such as massage, Reiki and in particular, reflexology. Firstly, the sensory input created when pressure and movement are applied to the feet and hands help to close the gates, lessening the effects of pain. Secondly, the psychological effects of stress reduction can help generate feelings of ease and comfort, and ultimately give us hope that relief is within sight.


joe-azevedo2Joe Azevedo is a New York State/NCBTMB Licensed Massage Therapist, ARCB Certified Reflexologist, and an Advanced Reiki Practitioner. He is a graduate of the Swedish Institute and is the owner and founder of Brooklyn Reflexology.

Zone therapy is often considered the foundation for the theoretical and practical application of reflexology. In the late 1800’s, an English neurologist by the name of Sir Henry Head discovered through a series of experiments that there was a link between a diseased organ and specific areas of skin on the body. These areas often displayed a heightened sensitivity to pressure and touch that other areas did not. Twenty to thirty years later, an American doctor by the name of Dr. William Fitzgerald would take these findings and refine them into the practice of zone therapy used by reflexologists today.

Fitzgerald discovered that there were ten longitudinal zones on the feet and hands, which ran the length of the body. Five zones on either side of the body, with each zone corresponding to a section of the foot and hand that lead up to each toe and finger. See the diagram below. By applying pressure to these zones, Fitzgerald was able to create and observe an anesthetic effect in that part of the body. He became so adept at doing this, that he was able to perform small surgeries using his techniques.

zone therapy

Over the years reflexology has evolved into a finer application of these findings, but the underpinning of it has always been zone therapy. The practical application of zone therapy in a reflexology session can serve several purposes. If an area of the foot displays a heightened sensitivity to pressure, zone therapy can be used as a diagnostic tool for the organs and systems in that region of the body. Someone who is prone to chronic neck and shoulder tension for example may find that the toes, base of the big toe, and 5th metatarsal joint (pinky toe joint) are particularly sensitive. The good news is that applying systematic pressure to these zones will create an analgesic effect in the part of the body, essentially reducing tension and pain levels.

In addition, visual cues can provide a wealth of valuable information for what’s occurring in an area of the body. Bunions, calluses, and dry skin are just a few examples of these cues, which could ultimately signify a longstanding condition in a particular part of the body. The use of zone therapy can therefore help reflexologists ‘zone’ in on specific reflexes that may need extra attention. Having an open dialogue between the therapist and the client is also an integral part of the therapy. The simple reason fort this is that reflexology, or any form of bodywork for that matter, does not have to be painful experience to be effective. Research has shown that touch alone helps to release a flood of endorphins which the body uses to relieve pain. Staying within an individual’s pain threshold helps to relax the body while still creating the desired effect. The feet truly are mirrors of the body. And if we listen to them carefully and treat them accordingly, the health benefits could be immeasurable.


joe-azevedo2Joe Azevedo is a New York State/NCBTMB Licensed Massage Therapist, ARCB Certified Reflexologist, and an Advanced Reiki Practitioner. He is a graduate of the Swedish Institute and is the owner and founder of Brooklyn Reflexology.

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November 2018
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