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Reflexology Around the World

by Beryl Crane(more info)

listed in reflexology, originally published in issue 63 - April 2001

There is a concept that we are all one – that we are all part of humanity and everything that makes up the elements of the universe.

No one person lives in isolation; we are all part of a larger consciousness. This concept can be applied to reflexology. Whatever happens to any individual reflexology practitioner may affect other reflexologists. Wherever the ability to practise reflexology is threatened or granted credibility, it will affect other reflexologists globally. That is why we keep a watchful eye on how reflexology is received by health authorities around the world.

Reflexology has been defined as a touch therapy. It involves the application of the appropriate pressure to the reflexes of the feet and hands by a trained practitioner to bring about a physiological and psychological change by stimulating subtle energies. Treatment in the East and West is very much patient centred regardless of which technique is used.


Beryl Crane and her husband (seated) getting ready to be received by the Minister for Health Beijing, Professor Hang Xiongwen

Beryl Crane and her husband (seated) getting ready to be received by the
Minister for Health Beijing, Professor Hang Xiongwen

As I travel around the world lecturing, I come into contact with many different types of reflexology with different training methods, and reflexology is recognized in too few countries.

I personally have always used combination treatments incorporating the hands, feet and, in later years, the ears. I have always embraced the zonal and meridian theory. I find a reasonably firm pressure, working within the patient's pain threshold and adapting my pressures on the reflexes according to the state of the body, to be my best guide. I have utilized acupressure therapy, which is really a traditional Chinese art technique, as a further adjunct to my reflexology. Using specific acupressure points on the feet, legs, hands and arms stimulates the meridians, which promotes healing either directly or indirectly to modulate the autonomic nervous system.

When training other graduates in reflexology, I have always aimed at the highest level. All my graduates achieved over a 70% pass in anatomy and physiology and reflexology. This ensured that the education was maintained. Contra-indications should always be addressed. It should be borne in mind that if any factor suggests that the treatment is unsuitable, one should err on the side of caution and if in doubt, do not treat.

The capacity of reflexology and its all-embracing range of benefits are even more remarkable today. Every reflexologist can attest to an increase in the blood circulation. Tension is immediately relaxed in the nervous system and the normal energy flow is restored, and numerous disorders are helped.

Many explanations have been given for the marvellous results a reflexologist obtains when giving treatment. Basically, I think the most important thing is to cover the dorsal and plantar areas as thoroughly as possible. If the foot is in the correct position, not only the nerves but also the acu-points can be worked from toes to knee. Even though reflexology and the meridian theory are totally different concepts, the nerve line at the commencement of the meridian will access the central nervous system.

We know the acu-points on the extremities are particularly potent, with the points on the feet being more dynamic than those on the hands. These are designated as the fountainhead or well points on the fingers or toes, and the source points are found around the ankle or wrist. We know that the energy or Qi at this point is very powerful and has a very strong action. The energy at the sea points, which lie on the elbows or knees, is said to be more general and less active, thus achieving a slower response. Therefore, if these acu-points are incorporated into every treatment session the patient benefits twofold.

Reflexology is at an interesting stage in its development: research programmes are emerging from around the world; there is a greater demand for complementary therapies, and some countries are beginning to recognize their worth.

Recently Prince Charles urged the government to put millions of pounds of public money into researching alternative health-care. The Prince of Wales is Patron of the Foundation for Integrated Medicine (FIM) its aim being to raise the profile of complementary medicine. FIM have been very instrumental in helping us to further our quest to be recognized at the professional level that reflexologists deserve.


Because the issue of safety is paramount, the regulation of reflexology is very much under way. Regulation is most important, as it means that the general public are assured of having treatment by suitably qualified practitioners. Here in the UK we launched both the newly formed Reflexology Forum and World Reflexology Week (WRW) on Monday 25 September 2000 at the Royal Society of Medicine, Wimpole Street, London. Invitations had been sent to government officials and over 500 members of the press.

At the Royal Society of Medicine at the Launch of the Reflexology Forum

At the Royal Society of Medicine at the Launch of the Reflexology Forum

The launch took the form of an address by three speakers: Michael Fox, chief executive of the FIM, which had been instrumental in bringing the Forum together and had allowed us to use its head office, which provided us with neutral territory for the organizations to meet; Simon Mills, independent chair of the Reflexology Forum, who had helped us to develop the regulatory path we must now follow; and myself, as president of the International Council of Reflexologists (ICR).

The Reflexology Forum has created a body with two main aims:

1. To develop a national qualification framework based on the revised National Occupational Standards (NOS) for reflexology, which should be published later this year;
2. To pave the way for regulation – 'Paving the way to regulation' is the wording that is on our banner.

We are still on the bottom rung of the stepladder. We still have to examine the options open to us, i.e. voluntary or statutory self-regulation. There is still a lot of work to be done before we become totally unified. The Reflexology Forum may well be a pilot scheme for other complementary therapies to follow. It is quite true that there is a great variation of training throughout the UK. There must also be some monitoring of quality and this can only be achieved by having a controlling body, which will go some way towards creating the correct structure to regulate reflexology.

In my launch address, I spoke about how the initiative of WRW was first formulated in London in 1997 at one of the ICR board meetings and how, in 1999, the Governor of the State of Hawaii issued a proclamation to this effect, announcing that every year, during the last week of September, celebrations for WRW would take place. Over 32 countries had been notified about WRW, and information is still coming in from them, reflecting the enormous amount of enthusiasm that everyone entered into this global event.

Hopefully, we can all look back on our achievements in the coming weeks to see if all the hard work and time spent have been worthwhile and maybe this year there will be even more participants.

For many weeks the Education Working Group of the Reflexology Forum have been meeting, discussing and finalizing the revised National Occupational Standards for Reflexology with the help of Stephanie Kiryluk, the Complementary Medicine Project Manager of the Health Care National Training Organization. Eventually a final draft was agreed and Stephanie then forwarded the finished documents to everyone who would be attending the Reflexology Forum Meeting on the 7th February 2001 at the FIM Head Office in North London. All representatives of the major reflexology organisations agreed these standards, and the Project Manager will now be submitting them to the Projects and Standards Advisory Group for approval. This is another step forward in the development of Reflexology in the UK as a profession.

Various Types of Reflexology in the UK

The Ingham method was formulated by Eunice Ingham, who is known as the 'mother' of reflexology, and this forms the basis of Western reflexology practice. This specific method utilizes the finger and thumb to walk all areas of the feet. Doreen Bayly was also a pioneer in reflexology. She trained with Ingham and returned to England to practise and teach reflexology. Many different versions have grown from this as people adapt their method, but hopefully the key principles have not been lost.

From this original technique of pure reflexology, many of the light touch techniques emerged, some linking one or more points; when linking, constant light pressure is maintained. There is a lengthy list of differing techniques for contacting the reflexes, which can be positively daunting to a reflexologist who wants to pursue all avenues. For instance, there is synergistic reflexology and colour reflexology, and also the MagneTech, which is an instrument that can be used with perfect safety on the reflex points. The rotational effect changes the poles 260 times, far too fast for the body to recognize that the north pole is supposed to calm the body down and the south pole revitalize the body. A pure magnetic field is produced, and this provides a sustained and stabling effect, thus enabling the body to regain control and balance.

Vertical reflexology is a system that you can read about in another article in this issue of Positive Health, (see page 15) the theory being that, when treatment is given in the standing position, the vertical weight bearing amplifies the stimulation. This only confirms the use of the many implements sold to the public in China: many weight-bearing stones and appliances, some of which are electrical with a lower platform moving, some excruciating to stand on, and some with an area shaped like the feet with raised nodules on the spinal area – this multi-pointed sole massager is specifically used for low back pain. The standing position is usually recommended for only three minutes. Stimuli are on the arch of the foot, and the treatment is repeated 3-4 times each day until the person has more mobility and less pain.


In Germany there is a method called energetic reflexology. There is no physical contact; the hands are held as near to the feet as possible without touching, and movement can be all over the feet. If the therapist feels there is a blockage, then the hands become static, the theory being that the energy from the therapist's hands unblocks any imbalance.


Education is now quite comprehensive. There is a state authorized exam in reflexology, and there are over 1000 reflexologists in practice either working from home or in clinics.


The Rwo Shur method was brought to China in 1986 by Father Joseph, a Catholic priest who was born and raised in the eastern part (German section) of Switzerland. Father Joseph, who speaks English, French and German plus several Chinese dialects, went to Taiwan in 1970. He belongs to the Missionary Society of Bethlehem, which has missions in several different countries around the world. He suffered with rheumatism in the knee and could hardly walk. A colleague had brought a reflexology book back to Taiwan and this friend worked on him, following the diagrams in the book. Father Joseph found the treatment very painful, but received almost instant relief. He obtained and read the book Good Health for the Future through Foot Reflexology, written in German by a Swiss nurse, Hedi Masafret, and started practising immediately. He was a totally self-taught man.

Father Joseph worked on the many Christians who could not attend church due to ill-heath. He would go and visit them, treating them and training many others on the way. Over a period of time many thousands of people were helped. Some doctors heard about the priest who could help most problems, and it had already been noted that there was a drop in the amount of medication being prescribed. Father Joseph then received a letter from the Health Minister forbidding him to do any more reflexology. He immediately wrote a letter to the President and Vice President of Taiwan, and he also encouraged anyone who could speak on his behalf to do so as well. The Vice President invited him for a meeting together with the Health Minister. The Vice President was quite sympathetic and said to the Health Minister, "You cannot forbid Father Joseph from doing reflexology. Just because it is a method that you do not understand, how can you forbid other people from doing it?" The Vice President found a hospital where Father Joseph could continue his work, and he worked under the guidance of a doctor. Many doctors still wanted to get rid of him, but he had the protection of the Vice President.

Soon, however, Father Joseph became exhausted and he realized that he could not continue the work by himself. He started to train many other Chinese helpers, and there was hardly anyone in Taiwan that had not heard of reflexology. He was then asked to introduce the method to Japan, Singapore, Malaysia and China.

Rwo Shur are the two characters of his name Joseph, and it was subsequently called the Joseph method. The Rwo Shur Health Method came to China in 1986, although Father Joseph never went to China until 1990. That is where I first met this most remarkable, wonderful man. The Chinese people loved him, as he is a very charismatic character. Treatment was very aggressive and painful in those early days; nowadays, hopefully because of the Western influence a much more nurturing touch is used. Treatment can still be painful, as the theory is such that you only get the best results if you work a little deeper. Sometimes treatments are twice a day and they work to the level of pain that you can stand. It is quite amazing how many successful case histories they have amassed.

Many of the Far Eastern practitioners now use wooden or magnetic implements to push and probe the reflexes; many also use the knuckles. A lubricant, cream or oil, usually herbal in origin, is always used during a treatment session.

My first visit to China had been a personal visit in 1987, and this was brief but most exciting. It was a short trip that became a memory of a lifetime; the country was steeped in history. I was told that a short trip into China would only be a preview and little did I know that I would visit time and time again as I grew to admire and love the people that I became involved with in the reflexology world. I saw great changes in the people and watched the country change and develop further over a few short years, even from the wearing of their traditional blue outfit to modern Western dress.

I had become interested in reflexology in the early 1980s, and my obsession grew. This science became so fascinating that I was hungry for information from every source. Unknowingly, in 1987, I had already become involved with China, as on this first visit I had a body massage at the hotel where we were staying, which also involved my feet being worked. The Chinese therapist had asked me if I was involved in healing because my surname 'Crane' denoted 'longevity'. I replied that I was already participating in a growing and deep commitment to reflexology, which was beginning to take over my working life. He did not understand about reflexology, as all areas of my feet were worked in the most excruciating way. So, when I started my school in 1988, I used the Latin term of 'Longus Aevum' (meaning 'Long Life') on a banner beneath two graceful Crane birds, and this is my individualistic logo to date.

So when an invitation arrived on my desk six years later inviting Westerners to attend the first China Reflexology Symposium in Beijing in 1993 and also offering me the chance to present a paper, I decided that this visit was a must. It was the start of many return trips to China and a wonderful friendship with Hang Xiongwen, chairman of the China Reflexology Association (CRA) and Zhang Hongjing its general secretary. I also developed a friendship with Christine Issel, the Australian and Danish reflexologists and the many worldwide reflexologists I have met and exchanged views with since. Of their 31 regions, 29 sent a representative to the first CRA Symposium, so many people practise in China. Many doctors, because they have to retire at the age of 65, find that doing reflexology in private practice is an advantage. Many have submitted anecdotal evidence to the CRA on the therapeutic value of reflexology.

The culmination of all these marvellous visits took place in October 1998, when the CRA took us on an awe-inspiring visit to the Great Hall of the People, where we were introduced to leading personnel of the Chinese State Government. Not only was Chairman Hang Xiongwen proud and visibly moved by this acceptance and endorsement of reflexology by the Chinese Health Officials, but as an early visitor my heart also swelled with pride that this wonderful science was shared by so many, as over 800 delegates gathered together to have a photograph taken.

When we returned this time, there was evidence of even greater change – the brand new futuristic airport was open. The pavements and pathways have all been renewed; several more shopping malls have opened and there are also walk-in reflexology clinics. Reflexology has become big business. One of the reflexology clinics had 100 couches laid out, and at 10 pm in the evening every one of these was occupied. Clients are allowed to smoke, and many overseas visitors and businessmen frequent them. Some of the smaller centres have as few as ten beds. Treatment is very uniform and very painful; no contraindication list is given to you, as the therapist tells you what is wrong with you. This is not how I see reflexology progressing.

China has gone through a transition, but the experience will always be different to anything else because of its culture, which is evolving and exciting and, as is often stated in many guide books, 'China is still a country like no other'.


Receiving treatment at Reflexology Clinic Beijing

Receiving treatment at Reflexology Clinic Beijing

United States of America

Reflexology in practice in the United States is the same as in the UK. Most people work from home in private practice, some have their own clinics or work within a beauty salon or other multi-discipline centre, and a few work within a hospital setting. Treatment is the same, and you go to whomever you are most comfortable with. In the United States the Reflexology Association now covers a similar curriculum to the UK. You can still get the short courses, but most people now realize that educational standards are of the utmost importance and they aim for the highest level.

The situation in the US is somewhat unique, as, unlike most nations, the United States has no national health laws. Most of the power to make laws regarding health is held in the hands of each individual state. To obtain a reflexology law with the necessary standards would require legislation being passed 50 different times. This would require an immense amount of time and thousands and thousands of dollars.

Reflexology treatment is seen as a stress reducer, with less emphasis on disorders. People in the US use the term massage very loosely to include many of the touch therapies. Massage therapy is very powerful in the United States: each state has its own association and millions of dollars in its national treasury to spend on legislation. So it is very hard to work against the massage profession in the US, as they are most determined to have anyone who touches and works on the body in any way to be licensed and ruled by them. However, because of the reflexology following, and in order to keep its regulation separate from the massage laws in the US, the Reflexology Association and the American Reflexology Certification Board (ARCB – a voluntary independent certification board) work hard to promote public safety through the recognition of practitioners meeting certain standards. Part of the ARCB's time is spent in educating other bodywork disciplines and government officials about the differences between reflexology and massage.

Massage has to be licensed to protect the public in order to:

* separate themselves from prostitution;
* receive insurance rebates, because insurance companies usually only reimburse licensed professionals.

Reflexology has only 24 state associations; many are very small, some having less than 50 members. There is only one state that has its own reflexology laws – the state of North Dakota – and there are two states, Washington and Arkansas, that have reflexology mentioned within the massage laws.

South Africa

The following in-depth report came from the South African Reflexology Association (SARS), which has been working for many years to become recognized, and reflects the current status. The reflexology world has been and still is watching with great interest to see the outcome. We can only thank Jessica Hart, the chairperson, for such a full picture of the work to date.

* An application was made to the Chiropracters, Homeopaths and Allied Health Service Professions Interim Council in 1995;
* After due consideration, the Interim Council invited the professional associations of the ten modalities, therapeutic reflexology being one, to be involved in rewriting the Act in order to be included in same;
* A presentation was made to the Parliamentary Portfolio Committee on Health in June 1998, in support of the application for therapeutic reflexology to be considered for statutory registration;
* A further presentation was made to the Parliamentary Portfolio Committee on Health on 30 October 2000;
* After extremely wide consultation with all stakeholders, the Chiropracters, Homeopaths and Allied Health Service Professions Second Amendment Bill was passed on 3 November 2000;
* The Bill was signed by the State President at the end of November and the Act was published in the government gazette on 1 December 2000;
* This allows for inclusion of ten professions under the Act: chiropractic, homeopathy, Ayurveda, osteopathy, naturopathy, phytotherapy, therapeutic massage, therapeutic aromatherapy, therapeutic reflexology and Chinese Medicine/Acupuncture;
* The draft regulations for the Act have been published in the government gazette, and will lie open for public comment for one calendar month. The public comment period should close by mid-January;
* Once relevant public comment has been worked into the regulations by the Department of Health, the regulations will be published for the final time in the government gazette;
* At that time the State President will sign off the Act, and the Minister of Health will instruct the registrar to open the necessary registers, therapeutic reflexology being one;
* The Minister will also give special notice in the government gazette for the setting up of professional boards;
* Once the register has been established, it will be mandatory for every therapeutic reflexologist to register with the Council in order to practise legally;
* It is anticipated that the register for therapeutic reflexology will be opened by February 2001;
* Nominations for, and election of, the candidates to represent therapeutic reflexology at professional board and Council level will be decided by the registered therapeutic reflexologists;
* The Council, after consultation with professional boards, will make recommendations to the Department of Health in terms of legislation for the professions that fall under it.

Jessica further informs us that, in terms of education, with statutory registration the Council will take on the role of education quality assurers, and all training institutions offering therapeutic reflexology will be assessed by the Council to ensure that the education criteria are set and standards maintained.


In Denmark it said that over 26% of the population have received reflexology treatment. Reflexology graduates are now listed in the thousands and reflexology research is funded by the government.


Reflexology is not recognized by the authorities. It is in fact illegal to practise it. It is not well known by the general public, although they do embrace complementary treatments such as massage and bodywork.

New Zealand

In New Zealand, government recognition is also being sought for a national educational curriculum.


There are no laws governing reflexology in Japan. The Reflexology Association of Japan (RAJA) is run by a mother and daughter. Maki Fujita, the daughter, trained in the UK, and when she returned to Japan she set up a school. Since 1997, she has trained 5,990 graduates of reflexology. There are over 30 reflexology centres dotted around Tokyo and the outlying districts, and approximately 6,000 treatments per month are undertaken in their salons, which are located in shopping malls and other busy areas. They are most professional in their décor, some having as few as ten treatment couches and others as many as 30. They have an appointment system, but also pick up a lot of passing trade.

Japanese Contraindication List

  • Contagious and infectious disorders of the feet or body
  • Pregnancy
  • Those on heavy medication
  • Heart disorders
  • Inflammation of the venous system, such as phlebitis or thrombosis
  • Schizophrenia, phobias and epilepsy
  • Cancers, tumours and AIDS
  • Oedema
  • Diabetes
  • Gallstones
  • Kidney stones
  • Thyroid imbalances

If you have any of these disorders you are advised not to have treatment.

The couches are low lying and the therapist kneels at your feet. After reading a contraindication list (see table) and assuring the therapist that you do not have any of the problems stated, you commence your treatment. Your feet are first soaked in a hot tub of a herbal mix for a few minutes, and you then have a choice of whether oils or powder are applied to your feet prior to treatment. This is very uniform, each patient getting the same treatment, and you can have 30 minutes or one hour. Knuckles are used on the plantar surface of the foot, and, even though there is no verbal exchange, you are very much aware of the therapist finding every sore spot. There is a lot of work and probing on the longitudinal and transverse arch. The massage strokes are very firm on the leg, and almost agony in certain places as they work the line of the meridians. After treatment there is an increase in your sense of well-being, and greater flexibility and relaxation of the musculature of the leg and foot. On a side note, a headache that I had had for two days was completely eradicated, and not a word had passed between the therapist and myself. I was handed a small cup of herbal tea before I left feeling very invigorated and refreshed.


Reflexology has also come to our high street. Boots the Chemist has now set up complementary clinics in some of its flagship stores around the country, where reflexology as well as massage and aromatherapy are being offered to the general public. It is vital for the success of reflexology that there is some form of unification and registration. Do not let us lose the whole ethos of reflexology, which offers a gateway to health and healing.

Further Information

Contact numbers for all Reflexology organizations can be obtained from The Reflexology Forum Tel: 0800 0370130.


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    Love you article and all the information I will share. I am a certified professional reflexologist , 20 years in the field and have a passion to continue to serve others with reflexology. I also use the acupressure points and eft tapping as the icing on the cake or feet with amazing results, Love Caroline

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About Beryl Crane

Beryl Crane is the founder and director of the Crane School of Reflexology which holds the prestigious James Accreditation Award and was the International Therapy Examination Council as their examining body. She became a Fellow of the Reflexologists' Society in 1989 and a Fellow of the Association of Reflexologists in 1997, an Honorary Award for those members of the profession who have made some special contribution to reflexology. Beryl also teaches and lectures internationally and can be contacted on Tel: 01279 421 682.

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