Since reflexology is not recognized by law, no formal training is required to practice reflexology or call oneself a reflexologist. However, some nurses and massage therapists offer reflexology as part of their licensed practice. Some courses are accredited for continuing education for nurses and massage therapists. The most widely publicized training source is probably the International Institute of Reflexology, of St. Petersburg, Florida, which claims to have 25,000 members worldwide [9]. Its seminar on the "Original Ingham Method of Foot Reflexology" are taught by Ingham's nephew, Dwight Byers. Its "Certified Member" status requires 200 hours of instruction plus passage of written and practical tests. As far as I know, this certification process has neither legal nor medical recognition. The Institute's Web site states:

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The study involved 263 volunteers with an average age of 48.5. Overall muscle spasm/muscle strain was described as either moderate or severe for each patient prior to treatments, which consisted of a massage between 45–60 minutes in duration. Results demonstrated an average systolic pressure reduction of 10.4 mm/Hg, a diastolic pressure reduction of 5.3 mm/Hg, a mean arterial pressure reduction of 7.0 mm/Hg and an average heart rate reduction of 10.8 beats per minute following massage treatment. (6)
“Many athletes and weekend warriors put themselves under a great deal of mental stress in preparation for a competition,” says Pietrunti. “For many amateur athletes, this is exacerbated by other day-to-day stressors from their jobs, families and life. Sometimes, just setting aside an hour to relax and unwind can be a huge step towards better performance and quality of life.”
The Elements Promise™ is not transferable and may not be redeemed for cash, bartered or sold. Void where prohibited or otherwise restricted by law. Substitute massage session equal in value and duration to original massage session; gratuity not included. Substitute massage session cannot be combined with any other offer. Other restrictions may apply; see individual studios for details.

Accredited sports massage therapists must first complete a course in general massage from a school accredited by the American Massage Therapy Association/Commission on Massage Training Accreditation/Approval (AMTA/COMTAA) or their State Board of Education. They must then complete an additional training program approved by the AMTA National Sports Massage Certification Program. Many sports massage practitioners also complete the National Certification Examination for Therapeutic Massage and Bodywork.
Massage therapists who have received specialized training and are certified in prenatal massage know how to position and support the woman's body during the massage, modify techniques, and avoid certain areas and techniques during pregnancy. Most will have a special table that allows the woman to rest comfortably and safely during the massage. Ideally, you should seek out a practitioner who is experienced and licensed in prenatal massage.
But the relief model is certainly tempting. There are many painful-but-relieving analogies in medicine and biology.15 That’s similar to what good pain in massage feels like, but it’s not the same: no one thinks that lancing a boil or popping a shoulder joint back in is anything but painful while it’s happening.16 And we can’t necessarily take the good pain sensation at face value and assume it means there’s actually going to be a positive outcome. Brains are not all-knowing. Sometimes they see danger where there is none, and sometimes they see help where there is none.

The first study I know of was supervised by William T. Jarvis, Ph.D., a professor who taught research methods to graduate students at Loma Linda University. Using questionnaires, 70 subjects were asked to state whether they had had health problems during the previous two years in any of 43 anatomical areas. These data were then compared with the findings of a reflexologist as recorded on a report form. The results did not differ from what would be expected by blind guessing. To prevent the reflexologist from asking questions or observing subtle clues, the experimental subjects were asked to remain silent and a curtain was placed so that their feet were the only part of their body visible to the reflexologist [12].


Reflexology is a systematic practice in which applying some pressure to any particular points on the feet and hands give impacts on the health of related parts of the body.1 Each point of the pressure acts as the sensors on the feet and hands and is links with different parts of body specifically.1 These sensors will be stimulated by applying the reflexology technique in order to improve the blood and energy circulation, give sense of relaxation, and maintain the homoeostasis.2 Reflexology session can be improved by other elements such as aromatherapy, peaceful music, and good environment settings.3 There is a term in reflexology called reflex zone therapy. Reflex zone therapy is where the body is divided into ten longitudinal zones from head to toe. In the reflex zone therapy, there are five zones on both sides of the body in which each zone diverge down the particular arm, and also continue straight down the body and down the particular leg to line up with a toe on the respective foot. Practitioners usually choose the suitable technique to be applied to the reflex zone therapy to gain optimized efficiency and impact. Reflexology is a complementary therapy instead of an alternative therapy to other treatments which patient already has based on reflexology maps.2 Complementary therapies nowadays are applied in many of palliative care or to alleviate a problem without dealing with the underlying cause in order to make patient's emotional, physiological, and spiritual health improve and increase the value of their life.4 Two methods of reflexology that have been accepted internationally are Ingham method and Rwo Shur method. The first method does not use any tools in its practice and the second method utilizes the use of tools such as a wooden stick.2 There are five theories that support how reflexology gives impacts to body health.5 First and second basic theories are related to energy. Energy theory advocates that body parts can communicate using electromagnetic fields and the communication can be blocked based on the surrounding respectively.6 Third and fourth theories indicate that energy flow can be restored and the fourth is about the pathway which is blocked can be opened.7 The last theory proposes that reflexology can break up the lactic acid crystal that usually deposited in the feet and allow energy to flow efficiently.5

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The recognition of reflexology as a specific type of treatment began with Zone Theory, in which the body is divided into 10 vertical zones. Each zone corresponds to fingers and toes all the way up to the top of the head. For example, if you are standing up with your hands on your thighs (palms facing down) the thumbs and great toe would be zone 1. On either side of the body, the index finger and second toe would be zone 2, etc.


Evaluating its effectiveness in treating anxiety based on the Women’s Health Questionnaire (WHQ), researchers discovered that while reflexology was not shown to be more effective than non-specific foot massage in the treatment of psychological symptoms occurring during the menopause, it nonetheless led to a 50% decrease in anxiety, which surpassed the control group two-fold. (4)
Reflexology in Thailand is abundantly offered even at spas, centres, markets, and chair beside the street because it is widely known as one of the most relaxing therapies. Colorado School of Thai Massage offers a short course of reflexology about the fundamental practice of Thai Foot Reflexology. For those who are interested, no bodywork experience required to join this course.

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