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

1974 Germany – Hanne Marquardt studied with Ingham in 1970; then she published Reflex Zone Therapy of the Feet

1978 England – Reflexology Today. The Stimulation of The Body’s Healing Forces Through Foot Massage was published by Doreen Bayly. Her earlier chart was reproduced in colour in 1970

1978 Taiwan – Father Joseph Eugster began his dedicated work, teaching reflexology

1980s England – Complementary medicine and reflexology specifically became a growth area; by this time over 80 books had now been written, and many articles, some with conflicting points but many stating a similar theme. Societies and associations were formed from 1983 onwards around the world. Schools were set up with many offering short training programmes leading to a certificate to practise

1990s England – Directories were set up but are not conclusive, as many people do not choose to advertise this way. The Institute for Complementary Medicine formed a British Register of Complementary Practitioners (BRCP). The British Council of Complementary Medicine is a registered charity, which was formed to establish national standards in all developing areas of complementary medicine. It works in tandem with the BRCP. The British Complementary Medicine Association (BCMA) was formed in 1992 to assist therapists in the setting of standards of practice and to encourage them to join together in self-regulatory bodies. The BCMA is a leading member of the Independent Care Organisations (ICO) – the body charged with setting standards in private health care.

Research programmes are being initiated. The years ahead look promising.

2 A holistic approach to medicine (#ulink_834708e1-1db9-5e4c-b508-ce45b6c65e8a)

The concept of holistic medicine (#ulink_b8b04e40-e567-5f57-ac1e-17599ad087ac)

Holistic medicine is an approach to health care in general; it is based upon the idea that health is the result of harmony between the body, mind and spirit and any extreme stress of any kind, which includes physical, psychological, social and environmental pressure, is inimical to good health.

Natural healing takes place every day. When you cut yourself, the body’s innate power draws and knits together tissue and heals the wound. If we fracture a bone, many parts of the body perform different tasks for healing to occur; a team effort is needed, as no single body part works alone. The body is like a machine with many component parts that perform daily chores in maintaining blood circulation, and ensuring the correct level of fluids and enzymes to keep it in good running order. These functions would not be able to take place without energy. Food is the fuel that provides the energy the body needs for its cells to perform their intricate tasks. Every part of the body is involved with a complex nerve network, with the brain as the control centre, monitoring and co-ordinating every function. All the component parts need to be in balance.

Reflexology provides the means whereby the body can be synchronized to balance the timing of its engine. Reflexology is a fascinating study of the links between reflex points of the feet and hands and longitudinal (vertical) pathways or zones. As we work on the feet, we thus form a picture of the entire body. In this way the feet or hands are considered a microcosm of the body, with all organs, glands, and so on laid out in the same arrangement (for details of the reflex areas, seeplates 1–4 (#litres_trial_promo)).

As mentioned above, all processes that take place in the cells of the body need energy. The energy transfer that is central to reflexology and other healing systems such as shiatsu, acupuncture and acupressure allows the body’s integrated systems to achieve homeostasis. We often hear in traditional medical systems terms such as ‘Chi’, frequently translated as ‘life energy’ or ‘life force’, or ‘Prana’, meaning breath of life. Energy is indeed constantly circulating through the body and is the very foundation of life. At a cellular level, we need energy to survive, we draw energy from the food we eat and this powers every cell within the body, which in turn needs its own energy to function. It is this much deeper level of biotic energy, the innate energy at cellular level, which maintains the metabolic processes that we work on.

At the neurological level, every machine needs a control system, and the complex brain is the control and computer system of the body. The brain, which is the source of conscious awareness of each and every thought process, is also a motor centre initiating and co-ordinating the voluntary movements of the body, and interpreting all the fast incoming information received from the sense organs. It monitors and discharges the necessary signals to muscles, glands or other parts of the nervous system to respond appropriately. It is a vast network, and is the body’s greatest user of energy, to power the many chemical and neurological processes associated with it.

The physical body and its component parts are made up from billions and billions of cells, and even though there are many types, shapes and sizes, the one thing they all have in common is a requirement for energy. According to the holistic concept, for instance as found in TCM theory, if this internal energy is obstructed, deficient or in excess in any way the cells function less effectively. In reflexology, during a treatment session the therapist will utilize those pathways of energy that already exist in the human body and they return the imbalanced or deficient energy flow safely back into harmony. Reflexology treatment is given to look after and nurture the body, and is often likened to the constant maintenance and preservation that a machine needs to keep it in good running order. We know for any effective control of any manmade apparatus it needs power or energy and maintenance. The first often can only be achieved by giving it a motor or engine that drives it, and this in turn must be maintained. The engine may be driven or powered by electricity or another substance.

Two opposing systems are also usually needed to make it work, for instance in a car engine the brake and the accelerator. This again is paralleled in many of the systems within the body. Locomotion is the result of the co-ordinated action of muscles on the limbs. The muscles of the body work in antagonizing pairs. The same is true of hormones which interact in a biofeedback system that enables them to regulate the body towards an almost constant state. For example, glucagon raises the level of blood glucose, while insulin has an opposing effect and lowers the glucose levels. High levels of oestrogen are secreted by the ovaries to stimulate ovulation but (in the absence of egg fertilization) are counterbalanced during the monthly menstrual cycle by progesterone, which in turn is only secreted under the control of other hormones from the pituitary. These gonadotrophin hormones thus work in unison. From this we see how the body must be in balance. Hormones are responsible for certain changes in the body, and work together with the nervous system to monitor and control blood pressure levels. Hormone responses are not so quick as those of the nervous system, and they function more on a long-term basis. By these physiological processes all the internal systems of the body (for example blood pressure, body temperature, the acid-base balance) are maintained at equilibrium despite variations in the external conditions. If there is a homeostatic imbalance in the various systems then disease will eventually occur.

Since all the systems of the body interrelate, only one area needs to be slightly out of balance to lead to disorders in other areas. These problems can often be observed to travel up and down a zone and even affect other parts of the body. Ill-health often falls into what is known as the ‘vague symptom’ category: a general malaise is often felt, every part of the body aches with general stress in neck and shoulders, the person may be irritable, not sleeping properly, picking at or eating too much food, making them feel ill or tense. Such a person may be unsure whether to go to their doctor or not, in case they are labelled neurotic, and the symptoms often continue for a long period of time. It is only when a problem becomes chronic do they begin to be more concerned.

Many complementary therapies, among them reflexology, are natural, non-invasive, and drugless paths to self-help, helping to restore a person to a more tranquil temperament, improve their mental condition and enable the person to cope better with life’s demands. Reflexology treatment encourages a generally healthier body by facilitating the proper functioning of the circulatory system, so enabling the supply of nutrients and oxygen to reach all cells of the body.

Imbalance of our internal environment is often caused by stress (seechapter 10 (#litres_trial_promo) for a detailed discussion of this). The excitatory process of a stress stimulus often changes this internal environment, causing high blood pressure, pain in many parts of the body because the muscles become tense, depression, brooding or morbid thoughts, a change in our circadian (or daily) rhythms and other regular biological body rhythms (e.g. daily body temperature variations, sleeping and waking patterns, the female menstrual cycle). The hypothalamus and the medulla oblongata (seefigure 2.23 (#ulink_6f872807-8502-585e-bb69-19038915b2e4)) contain the main brain centres controlling such homeostatic functions. While in a healthy body slight changes can be coped with, major changes such as going on holiday abroad (time change) can cause a very real problem. Also shift workers, for instance nurses or people who work nights, often find this interference with regular rhythms of the body leads to the so-called psychosomatic disorders (i.e. mental and physical disorders such as asthma, eczema, peptic ulcer, irritable bowel syndrome, headaches, back stresses). All these are caused by the body’s automatic responses to stress, mediated by the autonomic nervous system.

Theories and philosophies (#ulink_009e2ae6-cfda-5826-bfda-4456f46ebedf)

What is energy? (#ulink_b017db3a-0899-53e5-9d19-1c532d0f0722)

The general definition of energy is ‘power’, ‘vigour’, ‘vitality’ or ‘force’; in physics the definition of energy is the work that a physical system is capable of doing. Energy cannot be destroyed but it can change form. The body’s processes utilize electrical and chemical forms of energy. Kirlian photography is a special form of high-voltage photographic process which apparently records the energy field around the body on light-sensitive paper. This process has demonstrated changes in the energy field before and after a reflexology treatment. The exact nature of this energy field is a matter of debate. Eastern and Western systems have tended to have different views on this.

Reflexology is a method of contacting the electrical centres in the body. It aims to create a smooth flow of ‘vibratory energy’ throughout the body. By contacting various points on the feet this energy is thought to travel to the spine and then out to the organs, glands or cells, following set paths, although these are thought not to correspond to the Chinese meridians. However, the nature of the energy is thought to be the same.

Polarity therapy is another therapy based on the Yin and Yang principles (seechapter 1 (#u8a322ebf-5ee3-5814-94f6-0289533f72f0)). Its theory is that life energy flows between the two poles, one positive flowing to a negative pole and vice versa. This concept was applied by Doctor Randolph Stone to the general condition of the human body and mind. He likened the movement of energy in the human body as energetic currents; he referred to this as the ‘wireless anatomy of man’. The ancient Chinese looked at the living body as being one of the expressions of tension between two poles, heaven and earth. Heaven is found above the head, the Creative, awakening our higher nature, our source of ideas. Earth lies beneath the feet, the Receptive. The head and feet, and the hands, can be viewed as mediators channelling Qi energy to various organs or glands that need revitalizing.

The body field can be demonstrated by the following exercise. With your palms facing, rub your hands together quite gently, then move your hands very slowly a few inches apart, you should feel a sensation of warmth, or flow, or a magnetic type of pulling sensation in the fingers between the two hands.

Reflexology aims to stabilize elements lacking or unbalanced in a person’s basic energy; the touch of the practitioner’s hand on a person’s feet can also be thought to create a flow of energy between them. This particular technique of touch has a great ability to calm down and completely relax a person.

In reflexology the distribution of energy in the whole body is considered to correspond to the distribution of energy in the hands and feet. So by holding a person’s hand or foot you become very aware of their internal structure: the limbs, bones, joints, muscles, arteries, nerves, skin and nails. You also begin to feel you can ‘read’ the energy structure within.

Life energy can mean many different things to people working in different traditions. Perhaps we should not try to explain it, but be satisfied with being aware of its existence. We should also keep in mind that we not only touch tissue, muscle and bone but we also ‘touch’ the very life force of the body.

How the nervous system works (#ulink_2b1f0f2a-44fb-52d4-ae59-dc2ef28b813f)

Receptors

We know that any part of the skin is sensitive to touch. Touch has been used therapeutically over thousands of years. The skin is also very responsive to heat, pain and pressure, whether by touch or by other means. Even pressure from air or water brings about a responsive action in the physical body. Each and every area of the body is connected to the incredible nerve network within the brain that acts like an overseer, guiding and supervising as well as modifying the output when necessary.

Study of the body’s anatomy and physiology tells us how these nerve signals are transmitted from the specialized sensory receptors and how they respond to different stimuli. Sense organs are groups of cells that are connected to the brain or spinal cord by nerve fibres (or neurons) running along particular pathways. Those sensory nerve messages originating from the hands and the feet are received in a relatively large area in the brain’s sensory cortex compared with those from other locations, showing the innumerable nerve endings that we have in these areas. An anatomical figure (figure 2.1 (#litres_trial_promo)) depicting the size of the sensory areas in one of the paired, halves of the cerebrum that contains the sensory cortex and associated areas shows how tactile the hands and feet are. The fingertips and toes are particularly susceptible to touch because the tactile receptors called Meissner’s corpuscles are in abundance in the uppermost part of the dermis in this area of non-hairy skin. The free nerve endings found in most parts of the body enable sensations of pain, touch, pressure and temperature also to be relayed to the brain. Even hair plexuses respond to pain and touch, while Pacinian corpuscles in the dermis immediately respond to pressure and send their messages to the sensory cortex of the brain.

Figure 2.1 Anatomical figure depicting the large sensory area the hands and feet occupy in the brain

If there is a stimulus to any of the simple receptors, including all the touch, pain or pressure receptors, this sets off an electrical impulse; a strong stimulus will produce a stronger sensation – for instance, we know how a headache can develop very quickly when we stub our toe. Pain receptors in the skin are known as nociceptors: these include many of the free nerve endings found in the tissues.

The sensory nerve endings lie in the corium, the true skin; they are found within the tiny projections of this deeper layer. Each nerve fibre enters a small rounded bulb. These Pacinian corpuscles, responding to deep pressure, are abundant in the palmar surface of the hands and the plantar surface of the feet, and in all the digits, also around the tendons and ligaments. The smaller corpuscles, the tactile corpuscles of Meissner, are richly abundant in the pads of the fingertips and toes and also in the palms of the hands and soles of the feet; these are in the papillae of the skin.

Every time we stretch the tissue or muscles we contact the group of cells called the mechanoreceptors, found in the basal epidermis, in the form of Merkel’s discs. They adapt very slowly to stimulation and they trigger impulses in the sensory nervous system. The reflex action helps to adjust the tone of muscles and the activity of the internal organs. (The isometric exercises carried out during a reflexology treatment session involve active voluntary contraction of muscles without producing movement of a joint. There is also a passive exercise known as neuromuscular facilitation, used to enhance contraction or relaxation of muscles.)

Nerve transmission

In the very simplest of reflexes a sensory neurone on the skin’s surface, when palpated or pressed, will react by sending a signal along the nerve fibre belonging to it; this signal will pass to the central nervous system (seehere (#ulink_ca373212-5fdf-5b4a-ac7e-85c82fc77733)); once at its terminal end it will connect with another nerve cell, which in turn is also stimulated. The action within this second cell is enough to cause a muscle to contract or to even increase the secretory function of a gland (figure 2.2 (#litres_trial_promo)).

A nerve signal is an electrical impulse produced by chemical reactions on the surface of the cell body of a neurone (a nerve cell). Nerve signals traverse the whole nervous system, both electrically and chemically. Electric signals or impulses are carried from one end of a nerve cell to the other end. However, to cross the gap (the synapse) between nerve cells, chemicals called neurotransmitters are released from the end of the cell in response to the electrical impulse. These chemicals move across the synapse and bind on to the receptor sites of the adjacent cells. This sets off another electrical impulse in the next neurone, and so on.

Figure 2.2 Transmission of nerve impulses

Afferent (sensory) fibres transmit impulses to the centre from the skin, muscles, bones and joints. (However, not all afferent action is consciously perceived.) Efferent (motor) neurons innervate muscle fibres, conveying messages from the brain or spinal cord to muscles, glands or other effector organs (figure 2.3 (#litres_trial_promo)).

When pain or another stimulus is detected the electrical signals are sent to the spinal cord and often ascend to the higher centres within the brain (figure 2.3 (#litres_trial_promo)). The areas in the brain then correlate the information, sending the information by way of the midbrain (a small portion of the brainstem) to the hindbrain, or medulla oblongata (seefigure 2.23 (#ulink_6f872807-8502-585e-bb69-19038915b2e4)). These brain areas are involved in the co-ordination of sensory and motor impulses within the body. The returning neural impulse travels back down a motor nerve pathway to where the pain communication came from, when it may stimulate release of endorphins – natural opiates that are often referred to as ‘mood enhancers’. This may be why people often report a wonderful sense of well-being after a reflexology treatment. Stimulation of these touch or tactile corpuscles triggers a motor reaction. Consideration of an automatic reaction (such as the reaction when you receive a burn) shows how quickly the nervous system can react to stimuli.

Figure 2.3 A section through the spinal cord, to show sensory and motor pathways

Normally when resting there is a relatively low level of electrical activity in the brain because it acts as a switchboard, receiving impulses from the many sensory organs of the body and correlating these various stimuli and interpreting them accordingly, sending off motor signals to supply a muscle or a gland into stimulation or relaxation, and so on (seefigure 2.2 (#litres_trial_promo)). Reflexology may act as a stimulant, by increasing the rate of activity in an organ or system, or it may act as an energizer giving the person more vitality and zest. It is also evident after treatment that it has a calming influence, acting as a relaxant to such a degree that it enables the person to unwind and be totally rested and with muscles that are less stiff or tight.

Pain is a sensation we get when our sensory nerves are irritated or inflamed and injured. We all relieve our pain in a similar way when we rub the affected part or area that is hurting. This stimulates the firing of nerve fibres that inhibit the pain signal. This phenomenon was observed by Dr William Fitzgerald prior to his developing the ‘zone concept’. However, in reflexology the pressure treatment helps to relieve disorders themselves as well as just relieving pain. Because during treatment the patient is able to relax, the pain of a stiff neck or low back pain, or even abdominal discomfort, is able to just ebb away during the treatment. The medical profession often say any benefit is due to the placebo (or ‘expectation’) effect because the client has faith in the powers of the therapist or therapy; if that is so then that is in itself a marvellous phenomenon. However, I feel that its mechanism is far more profound than that. I have treated many sceptics who on the first visit state something like, ‘I am sure you will not be able to help me, but I have tried everything else, so I thought it would not hurt me if I came’, or ‘I only came because my wife suggested it, but I cannot see how fiddling with my hands, feet or ears is going to help my stiff knee’. These are just two examples of typical comments one may get from a sceptical person in the first instance. But even so if a good response is obtained such clients will virtually sing it from the rooftops. My most ardent supporter has recommended more patients to me than any other person to date, but at his first session he was almost disdainfully sceptical, and told me he had only attended at the request of his wife. Reflexology is now part of the lives of many such patients because they see it as a preventative against recurrence of ill-health.

Divisions of the nervous system

The nervous system is divided into a number of parts. First, there is the division into the central nervous system (the brain and spinal cord) and the peripheral nervous system. The peripheral nervous system distributes to the skin or peripheral parts of the body. The spinal nerves emerge from the spinal cord; the cranial nerves emerge directly from the brain. (Seefigure 2.5 (#litres_trial_promo).) There is a functional division between the somatic nervous system, supplying the skeletal muscles, and the autonomic nervous system, supplying the glands, cardiac muscle, and smooth muscle of the internal organs. Reflexology contacts the autonomic nervous system, more than any other therapy, balancing the parasympathetic nervous system and the sympathetic nervous system. These are the two subdivisions of the autonomic nervous system. They exert opposite effects on the end organs, so that homeostasis is maintained. Sympathetic impulses tend to stimulate, and parasympathetic impulses inhibit; for instance, the first increase the heart rate, while the second slow it down. (Seefigures 2.4 (#litres_trial_promo) and 2.5 (#litres_trial_promo))

The spinal cord gives off 31 pairs of nerves in its course from the base of the skull to the lumbar region, each of these nerves arises by two roots, an anterior and a posterior root, one being sensory, the other being motor; these unite prior to leaving the spinal canal, forming a mixed nerve that then separates, supplying the front and back of the body respectively. The nerves that form plexuses are from the top and the bottom of the spinal cord; out of these plexuses a number of branches arise to supply the arms and legs with a network of sensory and motor nerve fibres. These are the cervical, brachial, lumbar and sacral plexuses; the thoracic nerves from T2 do not form plexuses, but supply the skin and muscles in the corresponding area. The eight cervical nerves are divided into two. First there is the cervical plexus, formed from the upper four nerves (1–4); these also communicate with cranial nerves X, XI and XII. They have cutaneous sensory branches and penetrating muscular branches. The lower four (5–8) unite with the first dorsal nerves to form the brachial plexus.

Figure 2.4 Functions of the autonomic nervous system

Figure 2.5 Sympathetic and parasympathetic innervation of the spinal cord

The cranial nerves include the vagus nerve, which contains parasympathetic fibres that help the function of the viscera of the thorax and abdomen, motor nerve fibres to the muscles of larynx, sensory or somatic stimuli to the auditory canal, and also sensory (visceral afferent) stimuli of the thorax and abdomen. These cranial nerves comprise some motor nerves and some mixed nerves. There is also the trigeminal nerve, which has three branches; the ophthalmic nerve, passing through the superior orbital fissure (affecting the areas around the orbits and certain parts of the nasal cavities), the maxillary branch (affecting sensation below the orbits down to the upper jaw and teeth) and the mandibular nerve (again sensory to lower part of face, lower jaw and teeth, and the motor nucleus of this nerve serving the muscles of mastication). These nerves are attached to the brain stem at different levels. The major nerves all originate from nuclei inside the brain.