Reflexology: The Definitive Practitioner's Manual: Recommended by the International Therapy Examination Council for Students and Practitoners

The Bladder meridian

The Bladder meridian (figure 2.19 (#litres_trial_promo)) is a Yang channel with 67 points. It originates on the face on the medial edge of the eye, contours the head and the neck then descends the lateral side of the vertebrae to connect with the bladder and the kidney. An offshoot from the lumbar area passes around the gluteal muscles of the buttocks to terminate at the popliteal fossa, the depression at the back of the knee. There is a secondary channel running from the neck area down the vertebrae to this point, but this secondary branch carries on down splitting the gastrocnemius muscle of the calf to emerge on the lateral side of the malleolus to run alongside the lateral side of the fifth metatarsal and terminate in the little toe.

The nerve line is along the ophthalmic branch of the trigeminal nerve, the fourth cranial nerve, the trochlear, and the third cervical nerve. It then descends the thoracic nerves that serve many muscles of the back, carrying on to connect with all the lumbar nerves 1–5 and the sacral nerves; it continues down through the buttocks, serving all the hamstring muscles, and along the peroneal nerve, connecting to the digital plantar nerves of the foot.

Figure 2.20 The Kidney meridian

Disorders of this meridian, with signs and symptoms, include: all head and neck problems; some urogenital disorders; lumbago; foot and leg problems.

The Kidney meridian

The Kidney meridian (figure 2.20 (#ulink_1c5f18e8-8ba2-58b0-9cd8-2d66dbde852a)) is a Yin channel with 27 points. It originates on the fifth toe and emerges on the plantar surface of the foot, passing to the medial edge of the internal malleolus where it ascends the leg, entering the body at a point at the coccyx. There it runs deeper to connect with the kidneys and bladder through the lungs, to be lost in the roots of the tongue. An offshoot leaves the lungs and connects with the heart to terminate in the clavicle.

The nerve line is along the plantar nerves, connecting with the saphenous and tibial nerve, a branch of the sciatic nerve. It then enters the lumbar-sacral plexus and continues on into the upper thoracic, and intercostal and pectoral nerves.

Disorders of this meridian, with signs and symptoms, include: all head-related disorders of an acute nature; distension or pain of the abdomen or gastritis; most urogenital disorders and irregularities; all lower back and knee problems; most of its problems end in ‘itis’ or are of sudden onset.

Conclusion

By looking at the nerve pathways involved it is possible to answer why working on a meridian or zone has such a powerful outcome. Nerve transmission works on the ‘all or none’ principle, so that the channel will open to stimuli that are strong or long enough; providing there is no congestion of toxic matter the impulse will travel right along the pathway. If there is a blockage then several treatments are usually needed to clear the nerve pathway.

It has been found empirically that the distal points used for acupuncture and acupressure are particularly efficacious. These are in many ways the same points that we may cross at some time throughout the reflexology treatment session. Comparing the two systems, the point SP-1, for example, the first point on the Spleen meridian, is for the nose. This is also the point for the nose in reflexology. Qi is considered to be ascending in this channel. Equally, the last point of the Stomach meridian, ST-45, is known as the ‘sick mouth’, because it is an ideal point to treat those problems at the opposite end of the body. Qi is considered to be descending in this channel. So by treating distal points, and regardless of which way Qi or nerve energy is moving, we get a response. This is exemplified by the aphorism that stubbing your toe gives you a headache, and by the Babinski reflex, the foot indicating what is happening in the brain.

A recent hypothesis to explain the effect of acupressure and acupuncture is that when a needle or pressure is applied at a certain skin depth it seems to stimulate the nervous system in a series of reflex arcs, thus releasing endorphins into the system and producing pain-relieving and opiate effects. We know that the Chinese use acupuncture for anaesthesia and pain relief, and this practice often relieves some other physical symptoms in the process. Acupuncture can be explained by a wave of electrical depolarisation that travels along the nerve pathways activating the deep sensory nerves which cause the pituitary and midbrain to release endorphins, the brain’s natural painkillers. The problem the person is suffering from is often alleviated after a few treatments.

Since the early 1960s, electroanalgesia has been used as a safe and effective method of pain control, regardless of whether it is acute or chronic. There are many manufacturers of electroanalgesic instruments. The theory regarding this therapy is that stimulation by a small electric current, like the stimulation caused by insertion of an acupuncture needle, activates descending inhibitory neurons that block the transmission of pain signals. It is said to ‘close the pain gate’, so this theory is known as the ‘gate control theory’.

The Chinese state in many books that the meridians follow the pathways of the major nerves, and needling or acupressure will activate a point. The nerves lie very close to the bones, and we know that peripheral nerve innervation of the skeleton closely follows muscle innervation. This shows that the same nerve innervates muscles that are attached to that bone. Did Dr William Fitzgerald simplify this whole concept? He stated that pressure over any bony eminence or on the corresponding zone to the location of injury or problem would relieve pain. One of the theories he put forward was that certain control centres in the medulla are stimulated, or that the function is carried out by the pituitary body and its multiple nerve paths from it. He went on to explain that we induce a state of inhibition throughout the body when pressure is brought to bear. When inhibition or irritation is continuous, many pathological processes disappear. He also stated that it was certain that lymphatic relaxation followed lymphatic pressure.

Today there is no concise explanation of the rationale of how or why reflexology works. We as practitioners just accept and know that it does. A recent hypothesis for the effect of acupuncture is that when pressure or needles are applied at a certain depth it stimulates the nervous system in a series of arcs or reflex actions; this may send a motor impulse down a nerve to supply a muscle or gland into stimulation, either contraction or relaxation. One other theory is that this technique stimulates production of pain-relieving endorphins within the brain. These recent theories confirm Fitzgerald’s early thoughts and writings.

The zones and the divisions of the feet and hands (#ulink_7992b07e-3fae-50bc-9f85-78e4a328a319)

The zones and divisions of the hands and feet according to contemporary reflexology are shown in figure 2.21 (#litres_trial_promo) and plates 1 to 4. (Note that in the anatomical texts the person is depicted standing upright with the feet on the ground and the palmar surface of the hands are facing the front. In the zonal or reflexology position the body is depicted with the palmar surface of the hands facing towards the posterior part of the body. However, this is not adhered to in all representations of the zones.) The dorsum of the hand and foot represent the anterior surface of the body. The palmar surface of the hand and the plantar region of the foot depict the posterior portion of the body. Each numbered line represents the centre of its respective zone (seefigure 2.21 (#litres_trial_promo)). There is considered to be an imaginary line showing the division between the anterior and posterior parts of the body. (Fitzgerald said this was so that when treating any of the viscera, it was usually preferable to treat both anterior and posterior zones simultaneously.)

Figure 2.21 The ten longitudinal zones on the hands and feet

The theory behind reflexology is that the feet and hands are not just the extremities at the end of our body; these appendicular organs are a somatic reproduction of the entire condition of the body. However, many books show the picture of the human body superimposed on just the foot or hand. This is to outline the need to know the location of the appropriate point for all the principal organs and glands so that they can have pressure applied on the correct area. The distal limbs are not usually shown other than where there is an area that is supposed to connect to the area to work on.

Figure 2.22 (a) The four curves of the spine represented on the foot. (b) The vertebrae and spinal nerves represented on the foot.

The feet and the spine

The feet are extremely important to the general health of our body, and because of certain similarities reflexology theory considers there to be a relationship between the body and the foot. For instance, there are 26 bones in each foot and there are 26 bones in the adult spine. Further, the vertebral column has four natural curves when it is viewed from the side: the cervical curve is rounded forwards, the thoracic curve is gently curved convex towards the posterior, the lumbar spine is also curved convex forwards creating a hollow, while the sacrum curve is like that of the thoracic curve, convex towards the posterior. The foot appears to have four natural curves also, almost imitating the line of the spine. So the curves and the bones of the foot are designated in reflexology as representing the curves and the bones of the spine (figure 2.22a (#litres_trial_promo)). From this, particular areas of the foot are considered to represent areas of spinal innervation that correspond to those bones (figure 2.22b (#litres_trial_promo)).

The following four curves or divisions of the feet represent the four body divisions as follows (the two feet symbolize the whole human body including the limbs, not just the torso).

1. The phalanges of the feet represent the head, the uppermost division of the body, containing the brain and chief sense organs.

2. The metatarsus represents the thoracic cavity from the neck to the abdomen, containing our breathing apparatus, the lungs, also the heart and other structures within.

3. The tarsus represents the abdominal cavity, which is between the thorax and the pelvis area, and all organs and structures within it. The tuberosity of the cuboid bone represents the waistline.

4. The calcaneus and talus represent the pelvic cavity, the almost bowl-shaped area that is formed by the pelvic girdle and the adjoining bones of the spine; this creates the central support for the body, and is composed of the two hip bones, the sacrum, and the coccyx and organs and structures within.

Reflexology and the body systems

The theory of reflexology is that a congestive state creates blockages of energy pathways; it has been conjectured that this blockage causes crystals to become deposited around the nerve endings, causing congestion right through the zone. The deposition around the nerve endings also causes a painful area when pressed or palpated. Over a period of treatment these areas become less sensitive as changes are induced within the circulatory and the nervous system by means of pressure stimuli. Such stimuli trigger the body’s inherent ability to move back to a state of correct balance and positive health and well-being. Working all areas of the hands, feet or ears and using a combination of reflexes will therefore eliminate most of these blocked energy pathways, energizing and revitalizing the recipient.

The natural homeostasis of living things can be disturbed by stress, which upsets the internal environment. Every part of the body is involved in maintaining this environment within the normal limits. It is only in cases of extreme or severe stress that the body is unable to cope. Homeostatic functions are maintained by nervous and chemical connections, with the pituitary body and other endocrine glands all working in unison. Feedback systems detect even the slightest change, setting off an immediate response in the form of neural impulses which are sent to neutralize any stress this may cause and to counterbalance the organ in question. If the body systems are not functioning at peak efficiency then disorders may manifest.

In the brain, three areas, the medulla oblongata, the hypothalamus and the pons Varolii (figure 2.23 (#ulink_6f872807-8502-585e-bb69-19038915b2e4)), are very important for this process. The first contains vital centres that control the rate and depth of breathing ‘respiration’, the rate of the heart beat and blood vessels, and not so vital centres that control reflexes such as swallowing, sneezing, coughing and vomiting. It also forms the major pathway for nerve impulses entering and leaving the skull. The hypothalamus also contains vital centres controlling body temperature, thirst, hunger, eating, water balance and the libido, and is also closely connected to emotional activity and sleep. The pons Varolii contains many nerve tracts running between the cerebral cortex and the spinal cord; it is where the trigeminal nerve emerges and also the sensory fibres relaying information about pain, touch and temperature.

Figure 2.23 A section through the brain

We can therefore see that reflexology might assist the homeostatic function by removing obstruction at the level of the autonomic nervous system. Fitzgerald said all zones must be free from irritation and obstructions for best results. He spoke of all existing pathological conditions being relieved and some even cured by zone therapy. He stated, however, that his work was not a panacea to all ills, but he was glad to offer his knowledge of zone therapy to physicians, surgeons and patients/clients to aid medicine and surgery and for them to make use of it in the practice of their profession.

Conclusion

This section has examined how the ideas of acupuncture, acupressure and reflexology relate to our present knowledge of the nervous system. The main practical difference between the three therapies is that reflexology and acupressure are less invasive and they use the fingers or thumbs for manipulation on given points; but they are equally powerful, often bringing quicker relief from the presenting symptoms. Acupuncturists use needles to stimulate very precise points located according to TCM theory, and can reach a greater depth. Acupuncture treatment is often thought to have longer-lasting effects than massage treatment, but can take longer to work.

There are also many contraindications to acupuncture: certain nerves must never have needles applied to them, and many conditions cannot be treated if the person is already depleted by a great emotional experience, or if they are too fatigued. However, reflexology and acupressure are completely safe with only a few cautionary warnings of the timing of treatment sessions; they cannot make a problem worse if applied in the correct way.

Western medicine and complementary medicine working together (#ulink_c66da9ca-3a6a-5eec-8a9e-a794ab9e0b73)

Western medical science has overcome so many things. The prevention, diagnosis and treatment of disease have benefited greatly by the development of injections and vaccinations, and of sophisticated surgery incorporating pain management, anaesthetics, antibiotics, and vital organ transplants. However, it is still powerless to treat a lot of the common everyday ailments, and is still largely unable to relieve the emotional and stress-related problems that we suffer from today without resorting to the use of drugs.

The definition of medicine does not include only substances used for treating disease; it also involves the wider art and science of treating and understanding disorders, which includes their prevention, and the maintenance and restoration of health. We need to realize there are alternatives to drugs. Drugs suppress rather than cure the problem; also, they form only part of the total care of the patient. It is not my purpose here to emphasize the differences between reflexology and Western medicine, but to show that the two should work hand in hand and share their knowledge. However, disquiet about the safety of some of the day to day medicines has led to a growing refusal by people to accept the attitude of some doctors that ‘you will have to learn to live with it’. They also may find it frustrating when visiting their general practitioners (GPs) to find that only a few minutes can be spent with them. Not all GPs are so rushed, though, and, more than ever, many are now adopting a more holistic approach to their patients. Many treatments formerly considered ‘alternative’ are now being included in some general practices. For example, GPs may often incorporate counselling, hypnosis, psychotherapy, but also include some of the complementary therapies; the latter include reflexology, which can be administered by non-medical but qualified practitioners.

Even so, often powerful drugs are given, which take away symptoms fast, yet may do nothing to correct the underlying cause. The real cause could be that you are angry with your partner, or that you are having problems at work, or you could be in a non-fulfilling job. All of these types of problems create stress, and in turn many disorders such as troubles with the digestion, headaches or back problems. The drugs that are prescribed may provoke new problems or cause more side-effects than the original illness. For instance, tranquillizers are often given in times of extreme stress, but can easily become addictive. As reflexologists know, side-effects of such drugs can cause sore spots in the reflexes of the hand, feet and ears.

The medical profession themselves are still uncertain as to the safety of the chemicals referred to as medicine or ‘prescription drugs’. No drug is ‘safe’ in the sense that it can never harm anybody; the dose may be critical, and one person may not be able to take the same amount as another. Furthermore, regardless of how clear instructions are, human error can create difficulties with proper usage. Patients are more aware now of the possibility of side-effects and contraindications to some drugs than ever before. However, many people buy vitamins, patent medicines and other remedies over the counter and these also are not entirely free from side-effects. For instance, vitamins are important for good health, but if taken in excess can cause toxic effects and sometimes an allergic response. It is common knowledge that we have become a nation of pill takers, and often the temptation to take medication is at its greatest when we are unable to seek medical advice. There is always a temptation to indulge in self-medication, but a sensible selection of basic medications for everyday needs is all that is required. No drug should be taken casually or carelessly.

Drug dependence is a term that is now used daily; it indicates that the person suffers in some way if the medication is stopped. This effect is typical of the benzodiazepine group of drugs, which act as a depressant on the central nervous system. These common tranquillizing and antianxiety drugs cause the body to become tolerant to a given dosage, so the dosage has to be increased, causing the person gradually to become dependent. As holistic practitioners, we have a responsibility never to encourage patients to come off any drugs, as this issue is between the medical practitioner and the patient and usually drug treatment must be decreased gradually. However, it is possible to encourage patients into making sure the GP is aware of their feelings if they wish to pursue a more holistic approach, as there are alternatives. Natural healing therapies may be time-consuming in the long term, but are generally less invasive and in many cases far more effective. Complementary treatments such as reflexology are a sensible idea for the busy GPs in these situations, and may even save the medical profession a lot of extra expense and time.

Patients are also guilty of pressuring doctors, and some people expect to be given a prescription, feeling that they must not leave empty-handed. These type of people are often not receptive to the concept of holistic medicine. However, drugs and surgery should be used as a last resort, not as a routine measure. The members of the medical profession themselves are now becoming more hesitant in the use of operations, for instance the removal of tonsils, which used to be a standard childhood procedure, or appendectomy, which was formerly often performed routinely when doing other routine procedures for abdominal surgery. Even the extent of vital radical surgery such as a mastectomy or a Caesarean is being re-examined for necessity.

When the British Medical Association set up a committee to look into alternative medicines, they were interested in looking at the effects of alternative therapies as measured by science-based research, which demands measurable proof that a patient’s condition has been improved. To date, however, there have been very few clinical trials. Therefore a scientific inquiry is needed into the efficacy of reflexology, to test the fact and to elucidate on our theories, different levels of pressure must be adopted for true verification of relief of symptoms and pain. As practitioners, we know reflexology is a therapy that gives measurable benefits and in some cases relieves the problem completely. However, for the scientific community just feeling better is not enough proof.

Many doctors now use acupuncture for pain relief. That said, many do not use the TCM ideas of affecting the energy flow to give a complete comprehensive treatment of the whole person. They adhere to scientific research showing that acupuncture works by stimulating nerve fibres to send out pain-blocking messages stimulating production and release of endorphins and encephalins. Reflexology cannot be so wholeheartedly and equally accepted by them unless it can also be explained in this way. This may be at odds with the ideas of complementary therapists who claim that their sensitive hands or fingers feel ‘blockages’. Nevertheless, as practising complementary practitioners, healing the whole person is of paramount importance.

Within the therapy session, sympathetic listening and talking become a way of communicating and healing, in which anxieties are reduced and a more positive attitude of mind is encouraged to bring about swift healing, in which individuals also adopt more self-help measures. Relaxation is a must and it is an essential part of acquiring physical and mental well-being to relieve day-to-day tensions and stresses. There are so many techniques that can be encouraged for relaxation: for example, simple breathing exercises calm the mind and body, and many ancient traditions used breathing to alter mental states. Many methods use this, including meditation and yoga and, over the last decade, Tai Chi and Qigong; the latter ancient arts also include focused awareness and relaxed exercises. Daily use of these methods is reputed to increase a resistance to ill-health and in many cases cure the disease, improve the digestive and circulatory systems, enhance many of the internal secretions and increase vigour. Some research seems to substantiate these claims.

A reflexologist working on the solar plexus and diaphragm reflexes points also often induces a state of calm. It is recognized that different breathing patterns are connected to general health problems and anxious people often breath more rapidly, causing shallow breathing, which robs the tissues of oxygen and nutrients. Reflexology is not a cure-all, but it has been used to treat many common ailments and apparently can significantly reduce anxiety and stress.

3 Basics of consultation and diagnosis (#ulink_4a9d4293-c06b-5b08-b422-10ee6d6324bf)

The Fundamentals of Good Practice (#ulink_7c194ba6-f55e-5aaf-8ce3-68c7dbc6e8f4)