What it is
In the UK, reflexology and massage therapy are separate disciplines. The Complementary and Natural Healthcare Council, which registers 18 therapies, lists them separately.
The UK's National Occupational Standards, written by Skills for Health, also keep the two apart. Reflexology has its own standard, approved in 2010, and massage therapy has another.
How it works in the body
The foot contains 26 bones: 7 tarsals, 5 metatarsals and 14 phalanges, grouped into the hindfoot, midfoot and forefoot. It has 33 joints, and more than a hundred muscles, tendons and ligaments work together in it to bear weight and move the body.
The sole has 19 small muscles of its own, arranged in layers. Further muscles start in the lower leg and reach the foot by tendons.
The skin of the sole is supplied mainly by branches of the tibial nerve. At the inner ankle, this nerve divides into the medial and lateral plantar nerves.
The sole is hairless skin. Kennedy and Inglis, writing in 2002, recorded 104 touch receptors in the soles of 13 healthy people and found them spread widely across the sole, not bunched in the toes. The receptors were silent while the foot rested unloaded and fired only when the skin was touched. The authors suggest these receptors play a part in controlling standing and movement.
Hairy skin, unlike the sole, contains slow-conducting touch nerves called C-tactile afferents. They respond most to slow, gentle stroking.
In the room
The Association of Reflexologists says a full medical history and a signed consent form are usual on a first visit, and that usually only shoes and socks come off.
Reflexology training includes a check of the feet before starting, for local reasons not to go ahead.
Reflexology training teaches a routine that starts and ends with foot massage, with systematic work over both feet between.
Massage professional bodies, among them the FHT and the CNHC, say you may ask for lighter or firmer pressure, or stop, at any time.
How it feels, and afterwards
Pressure varies between practitioners, and there is no standard scale for it. Words like light, moderate and firm are not defined in measured force. The Association of Reflexologists suggests asking a practitioner whether they use a gentle or a deeper pressure.
Reflexology training treats a massage medium as optional, so the feet may be worked with one or with nothing on the skin.
The Association of Reflexologists says some people report feeling lethargic, nauseous or tearful afterwards.
Many people find it deeply relaxing.
Where it comes from
Reliefs in the tomb of Ankhmahor at Saqqara, Egypt, from the Sixth Dynasty, show attendants working on people's feet and hands.
You may read that foot reflexology is a 5,000-year-old Chinese practice. We found no historical source for it.
William H. Fitzgerald and Edwin F. Bowers published a book called Zone Therapy in Columbus, Ohio, in 1917. Zone Therapy describes Fitzgerald as senior nose and throat surgeon at St Francis Hospital in Hartford, Connecticut.
Zone Therapy divides the body lengthwise into ten zones, five on each side, running between the toes and the fingers. Reflexologists believe areas of the foot correspond to other parts of the body. No study has shown this.
Eunice D. Ingham's book Stories the Feet Can Tell was published in 1938, in St. Petersburg, Florida.
Hanne Marquardt, a German nurse, says on her own site that she heard of Eunice Ingham's work in 1958. She says that in 1967 the idea arose to teach her Reflexotherapy of the Feet to other medical and therapeutic professionals.
The Bayly School of Reflexology says Doreen Bayly introduced reflexology to the UK in the 1960s, on behalf of Eunice Ingham. The school says it was founded in 1978.
In the 1970s, Hedi Masafret, a Swiss nurse, wrote a foot reflexology book, Good Health for the Future.