Reflexology in OT Practice
Applying pressure to hands and feet may improve health and healing

By Emmy Vadnais, OTR/L
Originally published on ADVANCE Magazine on October 24, 2014

Download this article as a PDF.

Reflexology is a wonderful tool that can easily be incorporated into OT practice. According to leaders in the reflexology community Barbara and Kevin Kunz, “reflexology is the physical act of applying pressure to the feet with specific thumb, finger, and hand techniques without the use of oil or lotion, based on a system of zones and areas that reflect an image of the body on the feet and hands, with a premise that such work affects a physical change in the body.”

There are similarities between reflexology, acupressure, and massage therapy. Reflexology is similar to how acupressure uses static or circular pressure on specific points to improve homeostatic balance to body parts and organ systems. Massage therapy is manipulation of soft tissues, and reflexology does manipulate soft tissues with its unique approach.

A client may undress for massage therapy. In a reflexology session only shoes and socks are removed. Reflexology can be performed with or without lotions, oils, creams, hands, tools, rocks, stone, crystals, plastic or wood tools.

Benefits of Reflexology

There are many researched health benefits of reflexology. Kunz and Kunz report that hundreds of reflexology studies have been conducted. Their survey of 170 studies show a positive result for 83% of areas researched. A Chinese survey of 8,096 case studies noted a 94% effective or significantly effective rate.

Benefits of reflexology may include inducing the relaxation response, lowering stress, anxiety, cortisol levels, heart rate, and blood pressure, increasing lymph movement, improving the immune system and healing recovery time, lowering physical and emotional pain, improving range of motion, increasing circulation to body parts and organ systems, increasing respiration and oxygenation in the blood, improving neuropathy, plantar fasciitis, arthritis, joint mobility, edema, muscle tone, motor reflexes, depression, mood, emotional regulation, communication, social skills, insomnia, headaches, and nausea, decreasing use of medications, improving digestion, decreasing constipation, and improving reproduction, proprioception, and body awareness.

People report increased energy levels from reflexology, and ease of participation with activities of daily living.

Brief History

Many cultures for thousands of years have practiced reflexology to positively affect health. Evidence of reflexology can be seen across cultures, including the earliest examples of 2300 B.C. in Egypt and 690 A.D. in Japan. Reflexology was also practiced in Tibet, China, India and Europe.

In 1582, a book was published by two European doctors on zone therapy, stating that applying pressure to certain zones in the feet and hands will correlate to all areas in that zone of the body. During the early 1900s, Dr. William Fitzgerald, an ear, nose and throat physician, studied zone therapy and used it in his practice. He found that applying pressure to parts of the body — specifically hands, fingers, mouth, and feet — deadened pain in other areas of the body, and reduced the need for anesthesia during surgery and other procedures.

Dr. Joseph Riley, a contemporary of Fitzgerald’s, used his techniques in his practice and passed them down to his assistant-nurse, Eunice Ingham. Ingham was involved in reflexology in the 1930s. She found that applying pressure on the feet not only controlled pain, but could promote healing as well. She conducted seminars, wrote books on reflexology, and brought this knowledge to the general public. Her techniques are taught through the International Institute of Reflexology.

In America today, reflexologists can become nationally certified through the American Reflexology Certification Board. Reflexology is being offered in more health care facilities due to its many health benefits.

Reflexology in Rehab, Wellness, and Prevention

Reflexology can easily be provided to a person’s hands and feet, because they are so accessible. If a person is lying in bed, it’s easy to remove socks or shoes and provide reflexology even if they’re connected to various tubes. A person may sit or rest on a therapy table, in a hospital bed, in a reclining chair, or anywhere where the feet and hands may be accessed.

Relaxing music may be playing softly. Pressure techniques are applied to feet and hands within the recipient’s comfort level for 10-60 minutes. People generally experience deep relaxation and revitalization. It can be applied to all ages, in all settings, including hospitals, rehab, transitional care units, hospice, and literally anywhere.

Reflexology can help a person connect to their body, relax, lower pain, and align their energy to assist participation in ADLs or other therapeutic activity to be successful. It can be its own treatment for the above-researched health benefits, including relaxation, lowering pain and anxiety, and improving immune system functioning.

While receiving reflexology, your client may feel more cared for by you, and you may feel more calm. This may create a greater rapport and a healing relationship between you and your client. Empathy and compassion studies have found that if a person feels they are taken care of, they will have better health outcomes. reflexology

In addition, simple reflexology techniques can be taught to caregivers and loved ones so they have tools for providing caring, therapeutic touch, and healing presence.

Reflexology Story

I learned about reflexology during my massage therapy training. We were required to take a reflexology course. I loved how it made me feel. I had received many massages, but reflexology seemed to massage me from the inside out. I experienced a deep calm, and balanced state that was unlike anything else.

I decided to complete all the requirements and become an American Board Certified Reflexologist. However, there was still a part of me that was skeptical about all the health claims and how it seemed to work. How could a holographic map of the body correspond to those body parts when only touching the hands or feet?

After giving thousands of reflexology sessions and seeing more research validating many healing benefits, including MRI scans that have shown a somatotropic correlation to reflexology points, I know now there is great power and potential in this ancient healing art. I continue to provide a great amount of reflexology in my practice.

While working at the Penny George Institute for Health and Healing in Minneapolis, I provided reflexology in all units, helping people reduce pain, anxiety, stress, and tension, and heal more quickly. I taught reflexology to caregivers, loved ones, and health care practitioners.

I even provided reflexology to people with paralysis due to a stroke or spinal cord injury. I spoke about using reflexology in the rehab setting at a nursing rehab conference around the time I was working with this population.

A physiatrist spoke after my presentation. His talk was about the future of spinal cord injury recovery and the promising use of stem cells. At the beginning of his talk he commented on mine. He stated that the sensory input with the use of reflexology can be beneficial. This is in line with sensory integration theory.

One of the people I provided reflexology to on the rehab unit, along with other holistic services, is now walking with an assistive device. His physicians had not given him a prognosis that included that ability.

Reflexology Resources

If you would like to learn more about reflexology consider looking into these resources. I will be teaching reflexology courses in the coming year.

Here is a reflexology video I made:

The American Reflexology Certification Board.

International Reflexology Institute.

Kunz and Kunz.

To learn more and connect with OTs interested in mind, body, spirit medicine, prevention, and wellness visit the website, the Holistic Occupational Therapy Page, group on Facebook, LinkedIn, and HolisticOT on Twitter, and join the Holistic OT e-mail list.


Tony Balluff & Sid Korpi (1996). Reflexology: Therapeutic foot & hand massage…and other matters concerning the soles.

Defining a field. Retrieved from

Is there research in reflexology? Retrieved from

Study: Doctors with more empathy have patients with better outcomes, fewer complications. Retrieved from

Somatotopical relationships between cortical activity and reflex areas in reflexology: A functional magnetic resonance imaging study. Retrieved from

Emmy Vadnais is an American Board Certified Reflexologist and holistic OT. She is certified in and teaches many holistic healing approaches to health care professionals. She is in private practice in St. Paul, MN.

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