While a foot massage can be very enjoyable, foot massage and reflexology are vastly different in many aspects, including definition, scope of practice and purpose.

While a foot massage can be very enjoyable, foot massage and reflexology are vastly different in many aspects, including definition, scope of practice and purpose.

The public is oftentimes unaware of these differences—and many massage therapists are unaware as well.

I am continually asked by prospective clients if my services are a foot massage or reflexology. One prospective client asked, “Please describe your reflexology service in detail, as I’m looking for a true reflexologist. I’ve had reflexology before and that is what I want. I don’t want a foot massage.” She went on to share her story of how she’d paid for reflexology sessions and was very disappointed that she ended up receiving a foot rub with lots of lotion.

On the opposite end of the spectrum, I remember a gentleman who came in for a session, and at the end of the session he said, “I thought I was getting a foot massage and thought you would be using lotion.” I explained what reflexology was and the science behind reflexology and how it is different from a foot massage. Interestingly enough, the gentleman came to see me the next day for a reflexology session.

What is Reflexology’s Definition?

In 2016, the three national reflexology organizations—the Reflexology Association of America, the American Reflexology Certification Board and the National Council of Reflexology Educators—worked together to create one definition to describe the discipline:

 “Reflexology is a protocol of manual techniques, such as thumb and finger walking, hook and backup and rotating on a point, applied to specific reflex areas predominantly on the hands and feet. These techniques stimulate the complex neural pathways linking body systems, supporting the body’s efforts to functional optimally.”

reflexology chart

What is Reflexology’s Scope?

Reflexology is a noninvasive discipline and clients remove only their socks and shoes to receive it. Reflexology is limited primarily to the hands and feet, while in some states practitioners may also be able to include the outer ears. Reflexologists use specific techniques that are very different from massage techniques.

What are Reflexology’s Purpose and Benefits?

Reflexology focuses on the reflex points that correspond to the glands, organs and various other parts of the body. Theory suggests that the specific manual techniques that are used in reflexology stimulate the complex neural pathways linking body systems, supporting the body’s efforts to function optimally, by promoting a relaxation response via the nervous system that encourages the body to seek balance and, in so doing, assists the body to function more efficiently.

The effectiveness of reflexology is recognized worldwide by various national health institutions, including the National Institutes of Health and the National Center for Complementary and Integrative Health, as a distinct complementary practice within the holistic health field. Our understanding of reflexology is informed by over 300 research studies.

The first-ever reflexology research study to be published in a peer-reviewed journal, Obstetrics and Gynecology, in 1993, demonstrated that ear, hand and foot reflexology were useful in the treatment of both psychological and physical symptoms associated with PMS. More recently, three longitudinal, randomized, controlled studies funded by grants through the National Cancer Institute studied the effects of reflexology on breast cancer patients.

While one study is ongoing, results from the first two studies found reflexology to be safe and of benefit to breast cancer patients in improving their ability to function in everyday activities, such as walking up a flight of stairs or carrying a bag of groceries, and in reducing pain and fatigue, among other symptoms.

Equally important, these studies indicated that reflexology is fundamentally different from massage in that the individuals assigned to the control group who received “lay foot manipulation” (in other words, massage) did not see considerable improvement in their symptoms versus those individuals assigned to the reflexology group.

In my practice, numerous clients have shared the benefits of receiving reflexology. One young female in her mid-20s had suffered from migraines since her early teen years and was on medication to prevent the migraines. After two sessions of reflexology, she shared she was having fewer migraines and she was not taking as much medication. Other clients have reported benefits that range from relaxation and increased energy to deeper sleep, and they had been able to manage their pain better. Each person is in a different situation, so the benefits for each client may vary.

What is Reflexology’s Training?

Reflexology training can range from a few hours to certification. The interested individual should consider state laws and how they intend to include reflexology in their practice. A one- or two-day class does not qualify a practitioner to consider themselves as a reflexologist. Individuals looking for a reflexologist should inquire as to the training and experience in reflexology specifically. The Reflexology Association of America (reflexology-usa.org) and the American Reflexology Certification Board (arcb.net) are valuable resources for finding a qualified reflexologist.

The American Reflexology Certification Board (ARCB) offers the opportunity for eligible applicants to take the national board exam, a 300-question written exam based on psychometric standards, a hands-on practical and the submission of documented sessions. Upon successfully completing the national exam, the reflexologist would earn the designation of National Board Certified Reflexologist (NBCR). To maintain the NBCR designation, a reflexologist will need to complete required continuing education requirements.

What are Reflexology’s Statutory Requirements?

It is important to understand that every state has different requirements related to massage and related bodywork therapies. Check with your state board of massage to see if reflexologists must be licensed in massage therapy; also check with your state to see if it requires separate registration or licensure to practice reflexology.

Many reflexologists work independently, and there are a variety of business models, including corporate, wellness centers and sole proprietorship. Reflexologists should represent themselves based on their education and should also make the details of their training available to clients.

Furthermore, reflexologists don’t present themselves as massage therapists—and massage therapists should not present themselves as reflexologists without the proper training.

Where Can I Learn More about Reflexology?

Three national professional organizations developed over the years to meet the various needs of the reflexology community: the Reflexology Association of America (RAA), the American Reflexology Certification Board (ARCB), and the National Council for Reflexology Educators (NCRE). The roles and responsibilities of each are as follows:

Reflexology Association of America

RAA, established in 1995, is a membership association open to reflexologists, reflexology schools and others outside the field who support reflexology. RAA offers multiple levels of membership, ranging from student, to supporter, practitioner and professional. To qualify as a professional member of RAA, an individual must provide proof of at least 300 hours of education and training specific to reflexology from an accredited school.

American Reflexology Certification Board

Established in 1991, ARCB is an independent national testing agency that is not affiliated with any school, instructor, business or association. Its primary aims are to protect the public through certifying the competency of trained reflexology practitioners and to act as a national referral source for its certified practitioners. ARCB certificants must pass a 300-question written test, a hands-on practicum, and submission of 90 documented sessions meeting ARCB standards.

National Council for Reflexology Educators

NCRE emerged in 2016 as a 501(c)3 corporation and is dedicated to the advancement of reflexology education. Its mission is to meet the diverse needs of the reflexology educational community by bridging the gap between the individual’s desire to teach and their potential lack of formal educational training; and to give a voice to experienced teachers and those who provide instructional aids.

About the Author:

Debbie Hitt, NBCR, is a nationally certified reflexologist and has been sharing reflexology since 2001. In 2012, she began teaching reflexology through the Reflexology Certification Institute, of which she is executive director and owner. Debbie is committed to continuing her education, is involved in the reflexology community and is currently president of the Reflexology Association of America. Certified reflexologist Adrianne Fahey contributed to this article.