REFLEXOLOGY. Reflexology is defined as:

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1 REFLEXOLOGY Welcome to LUMINOUS YOU and thank you for taking our class! We understand that everyone s learning styles differ, and to accommodate we have made it easy for our students to both read and listen to the information presented in our classes. We hope this makes mastery of the material easier as well as make our classes available to a greater variety of students. We hope you enjoy! In this lesson we will be focusing on defining and understanding the practice of reflexology. We will also examine the important distinction between massage therapy and reflexology. Finally, we will cover reflexology s history, research findings, benefits, criticisms, its indications and contraindications. Reflexology is defined as: Massage of the hands, feet, and ears based on the belief that pressure applied to specific points on these extremities benefits other parts of the body (1). Eastern medicine posits that an invisible force, called Qi (pronounced Chee), which means life force or energy, flows throughout the body on meridians that connect to all our major organs (16). If the energy becomes unbalanced or blocked it prevents the body from healing itself. It is thought that reflexology is a powerful way to release these blocks and improve the flow of energy along these meridians (16). To alleviate pain and help the body heal, a reflexologist must use tools to apply pressure to specific reflex points located on a client s hands, feet, and ears. These reflex points are connected to other parts of the body (i.e. the tips of the toes correspond with the head, the ball of the foot corresponds with the heart and chest etc.) and are mapped out accordingly. Stimulating a specific reflex point stimulates the nervous system, which signals the brain to release endorphins in order to reduce pain and stress affecting the targeted area. This allows for a natural process of internal healing. With adequate treatment reflexology techniques should reduce pain, improve circulation, boost immunity, and increase overall well being. These techniques could also alleviate pain during minor surgeries, acting like an analgesic. 1

2 Reflexology vs. Massage Therapy It is a common misconception that reflexology is synonymous with massage therapy. A massage therapy business may offer reflexology, which can cause confusion about the differences between the two. They are in fact two separate and distinct types of therapies, which require different tools, skills, and methods to provide relief. Reflexology is a healing technique that focuses mainly on the hands, feet and ears to relieve tension in other parts of the body. Massage therapy focuses on most or all of the client s body and requires manipulation of the specific area directly. They use a variety of techniques to relax the muscles directly below the focused skin. Reflexologists, however, use exact techniques to activate an internal response that flows throughout the body (5). Reflexology Association of Missouri (RAM), distinguishes the two therapies as follows: Reflexology: Quickly identifies areas of imbalance in the reflexes, which corresponds to parts of the body. Works reflexes for parts of the body that may not be accessible or desirable to address with massage, such as the endocrine glands, deep internal organs and organs of digestion or elimination. Addresses areas that may be contraindicated for massage. Requires no disrobing for hands and ears, and only shoes (and socks) for the feet (10). Massage: Addresses the anatomy, physiology and pathology of muscles, bones, and other structures in the feet, hands and throughout the body. Includes soft tissue techniques to work the feet, lower legs, hands, arms and entire body. Works the body directly instead of reflexively, for example, massaging the shoulder itself instead of working the shoulder reflex (10). 2

3 It is apparent that these two therapies can both be used as treatments for stress relief, pain reduction and tension in a client. However, they are distinct therapies, which require different techniques and tools. Reflexology Tools Another distinction between massage therapy and reflexology are the types of tools used for each method (5). In contrast to massage therapist a reflexologist would conduct treatments without the use of oils and lotions (2). The most popular tools used for reflexology are: gloves, socks, and mats. Reflexologists also use wooden rollers, bands, rubber balls and of course their hands to stimulate reflex points and provide relief. Reflexology gloves and socks (21) are extremely useful tools, and make it easy to practice reflexology. They are made of a stretchy lycra blend of material, and are worn by the client during a reflexology session. These tools provide the therapist with an illustration of the various pressure regions of the hands and feet, and their corresponding body parts (12). This allows the therapist to visualize the corresponding parts of the body, and apply pressure in order to give relief to a specific area (12). 3

4 Reflexology mats (23) are made of a non-slip fabric, and are covered in hundreds of small raised, colorful bumps that are made of durable yet soft rubber (12). These bumps stimulate the reflex points on the feet, improve balance, help with foot and ankle weakness and relieve back tension (12). The raised bumps would target all the reflex points of the feet at once and so would provide relief to the entire body as opposed to a specific area of the body. This tool is also used to stimulate energy flow and works to rebalance the flow of energy throughout the body (12). Wooden rollers, probes, and wooden or rubber balls (24) are tools used to stimulate specific reflex points on either the feet, hands or ears. All of these tools allow the therapist or the client to stimulate reflex points by rolling the tools over the hands and feet. These tools vary in shape and size, which allows the therapist to apply a varied level of pressure and depth (13). 4

5 A reflexologist s hands (25) are also useful tools. They can use their fingers to apply pressure to specific points on a client s hands, feet, and ears to stimulate and relax the nerves that run throughout other parts of the body. Regular sessions of 45 to 60 minutes are standard and will usually be done in a chair, which should allow the client to feel comfortable while pressure is being applied to specific parts of their body. Now that we have defined reflexology and distinguished between reflexology and massage therapy, let us now focus on the history of reflexology. History The practice of reflexology is a tradition that dates back to ancient civilizations such as Egypt, India and China, and was introduced to the West in the early 20 th century (16). The oldest documentation of reflexology therapy is shown in a pictograph in the tomb of an Egyptian Physician Ankhmahor ( B.C.) in Saqquara near Cairo (16). 5

6 The pictograph above (26) illustrates two men working on the feet and hands of two other men. The hieroglyphics above the scene is a recorded dialogue between the patient and the practitioner and reads: Do not let it be painful to which the practitioner replied: I do as you please (16). The practice of reflexology therapy was either carried through or reborn in Asia (5). An ancient medical text titled The Yellow Emperor s Classic of Internal Medicine contains theories about the connections between a person s health and specific points on their hands and feet (5). This text is also evidence of a shift in how people treated and understood diseases. There was a blatant shift from shamanistic beliefs that disease was caused by demonic influences to a better understanding of the natural effects of diet, lifestyle, emotions, environment and age (17). In 1300 AD, Marco Polo is believed to have translated this Chinese text into Italian, thus allowing the process to spread through European settlements (5). 6

7 Pictured above is the Yellow Emperor s Classic of Internal Medicine (27). It is an ancient Chinese Medical text that has been treated as the fundamental doctrinal source for Chinese medicine for more than two millennia (17). In 1582, two European Doctors: Dr. Adamus and Dr. A tatis wrote the first book on reflexology (18). They worked to better understand the notions behind these early theories (5), and they dubbed these early practices zone therapy. The actual word Reflexology however, was coined by two doctors: Ivan Pavlov and Vladimir Bekhterev who had been exploring reflex responses in the body for nearly a century (18). These Doctors recognized this therapy in the late 1800s for its psychological benefits (18). In 1890, Knighted research scientist and medical doctor Sir Henry Head demonstrated the neurological relationship that exists between the skin and the internal organs (18). This research helped describe the mechanism for reflexology therapies, and helped influence other researchers interested in the applications of this therapy. 7

8 Starting from the top left: A photo of Vladimir Bekhterev (28), and Ivan Pavlov (29) the two Russian psychologist who coined the term Reflexology. Bottom Right: Sir Henry Head a neurologist who described the mechanism of reflexology (30). Bottom Left: One of Sir Henry Head s experiments (30), which he usually conducted on himself, in order to map out the relationship between nerves, and their connection to the other organs of the body. Dr. William Fitzgerald is considered the founding father of zone therapy, which is more commonly referred to as Reflexology in western culture. Dr. Fitzgerald was an ear, nose and throat doctor that studied in Europe, and while there, he came across the ideas that inspired him to create and practice zone therapy. In 1917, Dr. William Fitzgerald published a book based on his study of 8

9 zone therapy (5). The book was entitled: Relieving the Pain at Home. In his book Dr. Fitzgerald s outlined ten vertical zones and he noted that there were five zones on the left, and five on the right- sides of the body. He posited that they connected to pressure points on the hands and feet. Dr. Fitzgerald found that applying pressure to these points could alleviate pain and tension in the corresponding part of the body. He created maps that outlined which zones of the feet connected to a particular organ such as: the tips of the toes correspond with the head (3) or the balls of the feet correspond with the heart and the chest. Above; Dr. William Fitzgerald (31), and his diagram of the zones of the body (31), he is considered the founding father of Zone Therapy and utilized reflexology therapies in his medical practice to relieve pain in his patients. Other physicians took notice of the benefits and effects his therapies were having on patients and urged him to publish his findings. Shortly after Fitzgerald published his book, Dr. Shelby Riley produced similar findings, and added that the ears may also contain pressure points (5). Throughout the 1930 s and 1940 s, Eunice Ingham, one of Dr. Riley s nurses and physiotherapists, expanded on Fitzgerald and Riley s findings (5). She noted that the feet were more sensitive than the hands and found that stimulation of reflex points on the feet were producing more amplified results. Ingham updated the 9

10 body s pressure points with their corresponding reflex areas (5), and it is Ingham s methods that are still used today. Left: Eunice Ingham (32), she worked for Dr. Shelby Riley (pictured on the right) (33) as a physiotherapist, and developed the practives that make up what is now modern day reflexology. Dr. Shelby Riley was a student of Dr. Fitzgerald. He made important contributions to the theory and practice of reflexology. In 1957, Dr. Paul Nogier added a reflex map of the outer ear to Ingham s illustration (5), and found that stimulation of these reflex points also had effects on relieving tension and pain in different parts of the body. Dr. Paul Nogier was a neurosurgeon and acupuncture practitioner from France. He started to research the pressure points of the ear. His research would make him recognized worldwide as the father of Auriculotherapy. Dr. Nogier treated patients by stimulating reflex points on the ear. These patients claimed that they were relieved of sciatica as a result of this treatment. He decided to investigate this 10

11 phenomenon and this led to over fifteen years of experimentation. He established a map of the ear with points showing the external ear corresponding to specific reflex points by using an image of an inverted fetus as a reference. Dr. Nogier purported that those areas that corresponded to the organs of the fetus were in fact reflex points. Above: From left to right: Dr. Paul Nogier (34) who is recognized as the father of Auriculotherapy, and (left) a diagram of the reflex points of the ear (35). An image of an inverted fetus was used as a reference in order to create the reflex map. In the 1970s, Eunice Ingham s nephew, Dwight Byers, established the International Institute of Reflexology to promote and monitor the practice of reflexology. The International Institute of Reflexology continues to train and certify reflexologists today. They are based in St. Petersburg Florida, and have been teaching as well as continuously developing the Ingham method for over 70 years. The Reflexology Association of America is a nonprofit organization that also offers training and certification for those interested in reflexology therapy. It was established in 1995, and is dedicated to the growth of the reflexology profession. Reflexology has a long rich history, and is still a profession that is growing and changing today. 11

12 Let us now move on to a more in depth study of the particular parts of the body that are focused on during a Reflexology session: the feet, hands, and ears. Feet Above: A reflexology chart for the feet (36). This is used to identify and treat the parts of the body that are connected to a specific area of the foot. The feet are the most commonly treated part of the body during a reflexology therapy session. This is because they contain an estimated 100, ,000 nerve receptors in the sole of each foot. Thus making the feet one of the 12

13 most nerve rich parts of your body (11). The foot can be broken down into several areas that correlate with specific parts of the body: 1. The Head and Neck correspond to all of the toes 2. The Spine corresponds to the area just under the toes on the soles of the feet. 3. The chest area corresponds to the ball of the foot (often times this varies depending on the coloration of the skin) 4. The waist line corresponds to the thinnest place of the foot, which is usually found in the middle of the foot in between the ball of the foot and the heel of the foot 5. The pelvic area corresponds to the area of the heel of the foot This is just a general outline of specific areas of the body that are posited by reflexologists to correspond to specific areas of the foot. Charts used by reflexologist are very detailed, and can be somewhat complicated if one is not familiar with how to read them. Although this therapy is available to the layperson, it would be wise to do some study and practice on the techniques used by professional reflexologists before attempting any therapies. Reflexologists treat the feet like a mirror of the body. One should think of the toes like the head, the outside of each sole as the edge of the body with shoulders sloping down into the waist and hip area. This would mean then that the middle of the foot is like the spine. Below we have the complete detailed reflexology chart of all of the parts of the foot and what the parts of the body that they correspond with. These charts not only detail the sole of the foot, but also the tops, and sides of the feet as well: 13

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15 Above: The complete Reflexology chart of the foot (37). Note the detail of how each part of the foot corresponds to a specific area of the body. This helps describe the ideas behind zone therapy and also shows how stimulation of specific reflex points can relieve pain and tension in other areas of the body. Zone therapy is the basis for foot reflexology. There are 10 energy zones dividing the length of the body into longitudinal sections. These energy zones run the length of the body to the head and to the fingers and toes. The feet are correspondingly split into zones, with five zones on each respective foot. Above: The 10 zones of the feet (31). Each foot is split into five horizontal zones, with the individual big toes being split into another five horizontal zones each. These zones help reflexologists map and chart which organs are connected to the specific parts of the feet, as well as help reflexologist find the reflex points for those parts of the body. 15

16 The zones are not considered surface markings (21), but rather run through the body and would cut the body into horizontal slices. This gives a better idea of corresponding locations of the parts of the body with the respective zones of the feet. This precision is noticeable when one considers the zones of the feet: The area of the foot that is the thickest (at the metatarsals of the foot) would have a line that passes through the tips of these prominent bones. This is considered the shoulder line (21). This line to the tips of the toes would comprise horizontal Zone 1 and contains trigger points for the organs of the head and neck (21). On the sole of the fore foot the balls of the foot have a line running through them and this area is known as the diaphragm line. The diaphragm is a domeshape muscle that separates the chest from the abdomen (21). The area of the foot between the shoulder line and diaphragm line comprises zone 2, which contains trigger points for organs of the chest (21). The prominent bone on the middle outer border of the foot is known as the waist or navel line and would represent the fourth lumbar vertebra. The area between the diaphragm and the navel area comprises zone 3 and contains reflex points for organs of the abdomen. The sole of the heel is separated by coloration with the lighter colored skin of the mid-sole meeting the darker colored skin in between the navel line comprising zone 4, which contains reflex points for the lower abdomen and the pelvis (21). The upper dorsum s of the feet would contain the reflex points where zone 5 would run through, and would be where one could stimulate the organs that lie near the entire front surface of the body (21). There are five zones on each foot, ten zones in total for both feet. It is the specific masterful stimulation of these zones, which is thought to help relieve pain and tension in various parts of the body. Hands 16

17 Above: The complete reflexology chart of the hand (38) and the corresponding organs associated with the reflex points. Hand reflexology can be just as effective as foot reflexology, but because the hand is smaller than the foot, it makes the treatment slightly more difficult. Like the feet the hands are split into zones, which mirror the body. Each zone has reflex points that correspond to a respective organ in the body: The fingertips of the hands from the distal to the middle phalanges correspond to the eyes, sinuses and the brain. The area directly under the fingers at the beginning of the metacarpals corresponds to the Ears and the Eyes. These two areas span the palm at metacarpals 1-5. Directly below the ears and eyes on metacarpal 5 (under the pinky finger) is a small circular area that corresponds to the shoulder and the arm. The wider portion of the palm below the index finger 17

18 to the pointer finger (metacarpals 1-4) below the ears and eye zones is the area that corresponds to the lungs, breasts, and chest. Below the reflex points for the lungs, breast and chest is a small circular area below the middle finger (on metacarpal 3), which corresponds to the solar plexus. The thumb however, contains several different reflex points. The distal to the middle portion of the thumb corresponds to the brain and the top of the head, as well as the pineal, pituitary and the hypothalamus glands. The proximal portion of the thumb corresponds to the neck, throat, thyroid, and the parathyroid. The hand is separated into an upper portion and a lower portion by the diaphragm line. This line runs horizontally across all metacarpals across the palm of the hand, and through the solar plexus zone. Below the diaphragm line the zone that corresponds to the liver spans metacarpals 2-5 on the palm, and contains the small circular area for the gallbladder. There are several small reflex points located on the palm of the hand (around the 1 st metacarpal) that correspond to the adrenal gland, stomach, pancreas, and kidneys. The side of the hand nearest to the thumb is the reflex point for the spine and runs all the way down to the wrist. The bottom portion of the palm is separated by a line that represents the waistline, and the reflex points located under this line correspond to all organs and body parts that are below the waist. The reflex zone for the hip, knee, and leg are located at the base of the hand (by the fifth metacarpal) and right above the carpals of the wrist. The area that spans the entire bottom length of the palm holds the reflex points for the intestines and transverse colon. The reflex points for the reproductive organs lay on either side of the inside of the wrists. These particular reflex points are understood to relive pain and tension in the connected organ, and therefore unblock or help with the flow of qi energy throughout the body. Stimulation of these points during a reflexology session can be a treatment on its own or can be the beginning or end of a foot reflexology session. 18

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20 Above: Diagram of the reflexology chart for the right palm (39) and a skeletal diagram for reference (40) Ears 20

21 Above: A complete reflexology chart of the ear (41) Ear reflexology is also known as Auriculotherapy, and is heavily influenced by Chinese Acupuncture. Just like the hands and feet, the map of the ear is a mirror of the human body. A diagram of an inverted fetus was used to create the reflex maps of the ear, and so to better understand the chart one should imagine the head being the ear lobe and the body curving up through the central portion of the ear to the top of the ear. It follows then that the reflex points for the head, jaw, eyes, and any other organs in the head region would be found near the lobe of the ear. The fold of the 21

22 ear located in the central portion of the ear would correspond with the spine, and as it curves into the upper inside of the ear would then correspond with the coccyx. The upper inside portion of the ear corresponds with the feet; ankles, knees and upper legs, and the outside portion would correspond with the hands, wrists, elbows, upper arms, and shoulders. The inner regions of the ear correspond with the uterus, genitalia and the diaphragm. Just like in reflexology sessions for the feet and hands, tools are used to stimulate specific reflex points in order to relieve pain and tension in the corresponding body parts and organs. Above: The full reflexology chart for the ear (42). Just like the hands and feet the map is a mirror of the body Reflexology has been practiced for thousands of years, and many medical professionals have dedicated years to understanding and practicing this therapy. 22

23 Let us now consider recent research done in the field of reflexology in order to evaluate the actual effectiveness of this type of therapy. Research Findings A plethora of literature on research has been done to test the effectiveness of reflexology treatments. Despite this there is still not a consensus amongst physicians and massage therapists as to whether or not reflexology therapy can do what it claims. However, there are many findings that support a statistically significant benefit to reflexology therapies: According to a study published in 2007 in the medical journal The Oncology Nursing Forum, which compared the effectiveness of partner- delivered foot reflexology to usual care on pain and anxiety in cancer patients. Following the initial partner-delivered foot reflexology session; patients experienced a significant decrease in pain intensity and anxiety after receiving reflexology therapy (20). The study required that a nurse reflexologist teach partners how to perform reflexology on patients diagnosed with metastatic cancer pain in the hospital, which resulted in an immediate decrease in pain intensity and anxiety in the patients (20). This differed from the control group, which had minimal changes when receiving usual care plus attention (20). Another study published in 2011 in the Journal of Korean Academy of Nursing titled: Effects of foot reflexology on fatigue, sleep and pain: a systematic review and meta-analysis evaluated the effectiveness of foot reflexology on fatigue, sleep and pain, and concluded that foot reflexology is a useful nursing intervention to relieve fatigue and to promote sleep (20). Their results indicated that foot reflexology had a larger effect on fatigue and sleep and a smaller effect on pain. In the article the author concluded that more studies will need to be conducted in order to determine the effects of foot reflexology on outcome variables other than fatigue, sleep and pain (20). Despite there not being consensus in the scientific community about the effects of reflexology on relieving tension, pain and fatigue, there does seem to 23

24 be some relevance to the therapy and there is evidence to support its effectiveness in treating patients. The following is a non-exhaustive list of links to other related studies done in regards to the effectiveness of reflexology: Now we will move on and discuss the benefits, indications and contraindications for reflexology: Benefits and Indications Reflexology provides benefits to the patient in a number of ways: it can be used as a treatment for headaches, arthritis, insomnia hormonal imbalances, menstrual disorders, digestive issues, back pain, diabetes, asthma, anxiety and sports injuries. These are all believed to be treatable with reflexology (3). It s important to note that reflexology and its benefits are meant to compliment treatment prescribed by a medical professional. Reflexologists are prohibited from diagnosing patients. A study in the Journal of American Cancer Society found that one third of cancer patient s utilized reflexology as a supplemental treatment. (3) In Denmark, reflexology is a popular alternative form of treatment. (5) In 2005, 21.4 percent of the Danish population had used reflexology at some point during their lifetime. Correlation studies have indicated that reflexology patients use fewer sick days at work, noting improved health conditions. These are just some of the benefits of utilizing this therapy as a means to gain relief. Contraindications Reflexology is usually a safe and effective treatment for patients, but there are certain things that should be considered before seeking this as a treatment. According to simplefootsolutions.com these contraindications should be considered before scheduling and attending a reflexology treatment. Ignoring 24

25 these could be hazardous to one s health or the health of the therapist, and after any appearance of one of these reflexology therapy should be stopped until a medical professional clears the patient for more reflexology therapy: 1. Any contagious skin disease (impetigo, scabies, chicken pox, mumps etc) 2. Sever psoriasis or eczema on the foot (the foot may be to sore to work on) 3. Any untreated severe medical condition 4. Undesirable characters 5. Anyone under the influence of alcohol or recreational drugs 6. Internal bleeding 7. Severe varicose veins i.e. phlebitis (Reflexology may increase pressure of blood to veins) 8. Diarrhea and vomiting 9. Any form of infection, disease or fever 10. Bruising of the feet 11. Cuts, grazes, open skin, rashes, bites, burns, fractures 12. Immediately after a heavy meal 13. First few days of menstruation (treatments may make period heavier) 14. Sunburn 15. Hormonal implants 16. Cervical spondylitis 17. Hematoma It may be possible for a Reflexology therapist to work around some of the above contraindications, but written permission from a health professional must be given for the below contraindications: 18. Medication for serious conditions 19. Cancer 20. Recent operative patient 21. Post natal 22. Severe swelling 23. Cardiovascular conditions such as thrombosis 24. Arthritis 25

26 25. Osteoporosis 26. Acute rheumatism 27. Epilepsy 28. Asthma 29. Pregnancy 30. Spastic conditions 31. Trapped/pinched nerve Concerns Throughout its history Reflexology has come under great scrutiny, and there is no general consensus among reflexologists about how reflexology actually works (7). The application and chemical reactions of pressure zones have not been demonstrated either (9). Yet some reflexologists counter these claims by saying that many health problems are the result of stress, which can be alleviated through reflexology treatment (2). Concerns raised by the medical community have required reflexologists to be honest with their patients before beginning treatment. Reflexologists should remember that only licensed medical professionals should diagnose and properly treat any illness a patient cites. Reflexology is not an effective treatment on its own, and should be used in conjunction with prescribed treatments. Refusal to make these points aware to a potential patient may delay proper treatment, likely causing them more harm in the future. Reflexology coordinated with an active lifestyle and healthy diet, may allow for a more peaceful state of being. Extra Here are some helpful resources to help understand the concepts of Reflexology:

27 Closing Reflexology proposes that by stimulating specific reflex points on the hands, ears, or feet one can treat other parts of the body. This therapy has a long rich history and is today continuing to make strides and gain support in both the massage therapy world as well as in the medial field. There is growing interest in research, methods of practice and tools used to stimulate the reflex points on the hands, feet or ears in order to alleviate pain, fatigue, and anxiety for patients suffering from cancer, and other debilitating diseases. It is a minimally invasive therapy, which is distinctively different from other therapies, and despite its complexities is relatively simple making it available to anyone who wishes to learn. It is important that reflexologists work in conjunction with a patient s doctor in order to avoid causing harm or pain to a client, and one should be aware of any contraindications before beginning reflexology therapy. In conclusion, there are many benefits to patients undergoing this therapy; its techniques have been studied and continually 27

28 perfected over the years, and it can prove to be an effective treatment for those suffering from pain, and tension throughout the body. 28

29 References Kunz, K; Kunz, B. (1993). The Complete Guide to Foot Reflexology. Reflexology Research Project Natural Standard. Harvard Medical School. July 7,2005. Archived from the original on Norman,L.; Cowan,T.(1989).The Reflexology Handbook, A Complete Guide. Piatkus. pp.22, Ernest,E. (2009). Is Reflexology an effective intervention? A systematic review of randomized controlled trials. Med J Aust 191 (5): Ernest,E.; Posadzki, P.; Lee, M.S. (2011). Reflexology: an update of a systematic review of randomized clinical trials. Maturitas 68 (2): "Spa Sister Reflexology Socks & Gloves Set." Amazon.com. amazon.com, n.d. Web. 29 Aug < 13. small nylon reflexology walking mat. 1b3health.com.N.P.,n.d.web.29Aug.2015.< /ws-044_smallwalkingmat.asp>/. 14."Reflexology Massage Tools." ebay.com. N.p., n.d. Web. 29 Aug < 15. "Reflexology." tripadvisor.com. N.p., n.d. Web. 29 Aug < Healing_Hands_Massage_Ayurveda_Spa-Puerto_Vallarta.html>. 16. "History of Reflexology." fertility-reflexology.co.uk. N.p., n.d. Web. 8 Sept < 17. "Huangdi Neijing." wikipedia.com. N.p., n.d. Web. 8 Sept < 18. "Reflexology History." reflexology.co.nz. N.p., n.d. Web. 8 Sept < 19. "Henry Head." wikipedia.com. N.p., n.d. Web. 8 Sept < 20. "Partner-delivered reflexology: effects on cancer pain and anxiety." Europe Pub Med Central. N.p., Aug Web. 17 Oct < 21. "What is Hand Reflexology?" wisegeek.com. N.p., Web. 17 Oct < 29

30 22. "Spa Sister Reflexology Socks & Gloves Set." Amazon.com. amazon.com, n.d. Web. 29 Aug < 23. small nylon reflexology walking matt 1b3health.com.N.P.,n.d.web.29Aug.2015.< ology/ws-044_smallwalkingmat.asp>/. 24. "Reflexology Massage Tools." ebay.com. N.p., n.d. Web. 29 Aug < 25. Foot Reflexology Massage. Therapeutic Massage. N.p., n.d. Web. 19 Oct < 26. First Image of reflexology. International Institute of Reflexology. N.p., n.d. Web. 19 Oct < 27. "Huangdi Neijing." wikipedia. N.p., n.d. Web. 19 Oct < Huangdi_Neijing>. 28. "Ivan Pavlov." Wikipedia. N.p., n.d. Web. 19 Oct < Ivan_Pavlov>. 29. "Vladimir Bekhterev." Russiapedia Science and Technology. N.p., n.d. Web. 19 Oct < 30. Sir Henry Head and His experiments. Oscillatory Thoughts. N.p., n.d. Web. 19 Oct < 31."Dr. William H. Fitzgerald, M.D." Modern Institute of Reflexology. N.p., n.d. Web. 19 Oct < 32. Eunice Ingham. International Institute of Reflexology. N.p., n.d. Web. 19 Oct < 33. Dr. Shelby Riley. Mind Body and Sole. N.p., n.d. Web. 19 Oct < 34. "Dr. Paul Nogier." My Light Therapy. N.p., n.d. Web. 19 Oct < 35. Inverted Fetus. Prothinspo. N.p., n.d. Web. 19 Oct < earacupressurepoints.html>. 36. Foot Reflexology Map. Foot Reflexology Map. N.p., n.d. Web. 19 Oct < 37. Reflexology Foot Chart. Reflexology Thai Foot Massage. N.p., n.d. Web. 19 Oct < 38. Reflexology Hand Chart Map. reflexology Map.com. N.p., n.d. Web. 19 Oct < 39. Right Hand Reflexology Chart. Lighthouse Wellness Center. N.p., n.d. Web. 19 Oct < 40. The Bones of the Hand. Natural Height Growth. N.p., n.d. Web. 19 Oct < 41. Ear Reflexology Chart. Ear Reflexology Chart. N.p., n.d. Web. 19 Oct < 30

31 42. Ear Reflex Points. Frugal Geek. N.p., n.d. Web. 19 Oct < reflexology-points-feet-hands-ears/>. 31