Reflexologists believe that the standing human body is divided vertically into 10 zones, five zones on each side of the imaginary vertical line that divides the body in two. On both sides, the zone closest to the middle is zone one, while the zone farthest from the middle is zone five. These zones also appear on the hands and feet. Reflexologists believe that by massaging a spot in a zone on the foot, they can stimulate a particular area in the corresponding zone of the body. By massaging the reflex in the middle of the big toe, for example, a reflexologist attempts to affect the pituitary gland, which is the corresponding body part.

Reflexologists also believe that their ministrations help their clients in two other ways. First, they believe that their treatments reduce the amount of lactic acid in the feet. Lactic acid is a natural waste product of the metabolic process, and its presence in large quantities is unhealthful. Second, they believe that their treatments break up calcium crystals that have built up in the nerve endings of the feet. It is their theory that the presence of these crystals inhibits the flow of energy, which is increased when the crystals are removed. Reflexologists also emphasize that their techniques improve circulation and promote relaxation.

It is worth noting that modern science has not validated the theoretical basis of reflexology, which is even less well accepted in the scientific world than are some other alternative therapies. Yet it is also worth noting that some therapies whose underlying theories have not been validated by science have been shown to be effective. Relatively few scientific studies of reflexology have been completed, but much research is underway at present, and it is likely that reflexology will be better understood in the near future.

An initial visit to a reflexologist generally begins with the practitioner asking the client questions about his or her overall health, medical problems, and the reason for the visit. The reflexologist makes the client comfortable and begins the examination and treatment.

Although most reflexologists, such as the followers of Eunice Ingham, use their hands to work on their clients' feet or hands, some prefer to use instruments. In either case, the reflexologist works on the feet and looks for sore spots, which are thought to indicate illness or other problems in the corresponding part of the body. On occasion, the problem will not be manifested in the corresponding organ or part of the body but will instead be manifested elsewhere within the zone. Usually, the reflexologist will spend more time on the sore spots than on other parts of the foot. On the basis of information provided by the client and information obtained by the reflexologist during the examination, the reflexologist will recommend a course of treatment that is appropriate for the client's physical condition. In some cases, such as those of extreme illness, the reflexologist may ask the client to check with his or her physician to determine whether the treatment may be in conflict with the physician's course of treatment. Most reflexologists will not treat a client who has a fever. In addition, because reflexology treatments tend to enhance circulation, it is sometimes necessary for a client who is taking medication to decrease the dosage, on the advice of a doctor, to compensate for the increased circulation and the resulting increased effectiveness of the medication.

One of the most important aspects of the reflexologist's skill is knowing exactly how much pressure to apply to a person's feet. The pressure required for a large, healthy adult, for example, would be too much for a young child or a baby. Different foot shapes and weights may also require different levels of pressure. The practitioner must also know how long to work on the foot, since the benefits of the treatment may be offset if the treatment lasts too long. In her book Reflexology Today, Doreen E. Bayly, one of Ingham's students, recalled that Ingham once told her: "If you work on the reflex too long, you are undoing the good you have done." Ingham recommended 30-minute sessions, but most modern reflexologists conduct 45-minute or 60-minute sessions unless the client's condition dictates otherwise.

Most reflexologists work primarily on feet, but some work on the hands or even the ears. If a foot has been injured or amputated, it is acceptable to work on the hands. For the most part, reflexologists work on the feet because the feet are so sensitive. In addition, feet that are encased in shoes during most of the day typically require more attention than hands do. Furthermore, the feet, because of their size, are easier to manipulate. It is somewhat more difficult to find the reflexes on the hands.

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