Skip to content

19. Underlying Texture

Covered In This Chapter

Differing Textures

Many textures can be seen on the feet resulting from activity in the underlying tissues. They can be connected to medical conditions, some of which may be dangerous, such as cellulitis or DVT. So if there is a lot of puffiness on the feet or a painful and/or red swelling, and the client does not know the cause, they should be referred for a clinical diagnosis. 

But whether or not there is a medical condition present, variations in texture give us a lot of information about the client’s overall wellbeing or the health of the reflexes on which they appearSometimes these variations may be subtle, but like everything else in foot reading, the more you look, the more your eyes will start to discern. 

These textures may develop because of a loss of fat or collagen or multiple stress lines forming patterns, and many others appear as swollen or sunken areas. But all abnormal textures show either an excess or deficit of energy at the reflex, and reflexology helps to get this moving freely again to help the client achieve physical health and mental wellbeing

Rebalancing The Underlying Tissue

I will look at some of the most common textures and the imbalances in energy flow that they show us in the sections below. But in general, whenever there is swelling in an area, it shows an excess, and sinking shows a deficit. Signs of excess and deficiency can potentially be seen on the same foot and sometimes even over different areas of the same reflex, especially the larger ones


Depending on the function of the reflex and its role in the body, swelling can indicate different types of problems. Swelling in an endocrine gland, for example, means it is overactive and that the reflex needs to be calmed. But in the intestines, a swelling indicates sluggishness and stagnation, so the reflex needs to be stimulated. 

Regardless of its cause, first work to dissipate the swelling by using firm/hard, deep, and fast repetitive finger walking and massaging of the area. Then use calming techniques to sedate the reflex, such as gentle massage of the local lymph, linking, and simply holding an area to make it feel grounded again. Some say to stimulate, it is best to work in a clockwise direction and to sedate, work anticlockwise (video 1. following).


When you see a deficit, working the other way around with deep relaxation techniques before stimulation is better. This is because the depleted reflex needs to feel calm and supported to be receptive to the input of new energyAgain, assess throughout your treatment how things look and feel, and decide whether to carry on encouraging new energy into the area or not. It is still necessary to sedate the reflexes at the end, but not as much as where there has been detoxification.

Assessing Improvements

Looking for changes in the appearance of underlying textures between (and even sometimes during treatments) is one way of deciding how well the reflexes are responding to your work. Use this alongside palpation and communication with the client to reassess the current condition of the reflex. And whether a further round of stimulation can be supported by the body. This is very helpful, as there is no standard routine for how long and how deeply to stimulate or sedate a reflex, as each client needs to be allowed to let energy shifts occur at the right pace for them.  

I find that a client’s health with very sensitive ‘rapid’ feeling energy gets out of balance easily but also responds quickly to treatment. So I would work more carefully with them. But with a client whose energy is generally slower and ‘heavier’, it takes longer for them to get out of balance, but also longer to rebalance, and they are slower to respond. So with the latter, you may need to work much harder or at least for longer to have an effect. 

You will tend to sense what type of energy a person has in interactions with your clients. But regardless of this, there are still some general guidelines whilst working to rebalance the tissues. The most important is not to overwork if the client is rundown, elderly, has medical problems, or has intense emotional issues. This is especially the case when you are stimulating an organ to detoxify. To avoid an adverse reaction, ensure they are well hydrated and do not have low blood sugar levels because they are hungry or hungover, for example. 

Emotional Significance

Whether there is likely to be a deficit in some reflexes and excess in others is determined by how a client feels about different aspects of their life. Then the emotional connection with each organ or area of the body is relevant. I look at the various ways this can be seen at different reflexes in each section below, but it is possible to make some general observations. 

Both an excess and a deficit of energy are emotionally connected to fear. An excess accumulates because of holding on to old emotions due to a fear of letting go, and a deficiency is because of a fear of allowing new emotions in. Of course, there is an element of each in the other, and the two are interconnected. The client must release these fears to allow their emotions to flow freely and openly. 

As ever, all the different forms of energy manifest in similar ways, so with excess, the person needs to detox emotionally just as they do physically. They are holding on to a bad situation and unhappiness either because of fear of the unknown or worry that a new situation will be even worse. In either case, they feel that they would not be able to cope, and holding on to the old is a way of trying to protect against this. 

If there is a deficit, it shows that the person is not allowing themselves to be nourished emotionally and may not feel entitled to happiness and fulfilment because of a lack of self-worthOr they may feel too vulnerable to open up to new things because they already feel drained and jaded from previous or current experiences. 

In both these cases, they may lack support, either because they are too proud to accept it from others or think it is unavailable. The healing space provided by reflexology can help them realise their self-worth and inner strength to rebalance emotionally and seek help and assistance. 

Simply having a person listen while they express their fears may be all that is neededIf a client with a stagnation of toxic emotions feels calm and secure during a treatment, they may be able to let go of anger and resentment. Other clients may not need to talk but simply have anxiety alleviated for them to realise that they are more resilient than they think. If they felt emotionally weak and depleted, they might feel invigorated and strong enough to allow new, positive emotions to enter.

Sometimes when releasing emotions, a client will cry during a treatment. Interestingly, tears contain stress hormones and other toxins, which are part of the body’s natural emotional healing process. And if the client is sobbing, the deep breaths that happen as a result are also part of the body’s healing response. So just allow a client to let tears flow, do not try to stop them unless absolutely necessary, and lightly hold their feet until they finish crying.

Reflexology is perfect for the job it is meant to do, which is holistic bodywork, creating an environment where clients can experience mental and physical healing. But it is not counselling, and it is important not to overstep your boundaries as a therapist for your own psychic wellbeing as much as your clients. 

If you would like a quick recap on guidelines for reading the emotions on the feet during a reflexology session, go to this chapter.

Types of textures

Swollen Lymph Reflexes

Some serious conditions cause extreme swelling in the feet, including lymphoedema, which is connected to cancers such as leukaemia. If the client is unaware of the reason for excessive swelling, refer them for a medical diagnosis. But as we know, puffiness in the feet is more often simply a problem caused by sluggish lymph circulation because the person is overweight, pregnant, and/or stands a lot.

But whether or not there is a problem with the system generally, we can often see lymph pooling at very localised areas of the feet. This means that there is an excess of toxins in those reflexes, which the body is struggling to eliminate. The area affected is often relatively small; for example, the upper lymphatic reflexes at the base of the toes reflect immune problems with the head and neck, such as repeated sinus or throat infections. If the swelling continues, it is typical of clients prone to chest or lung problems such as bronchitis (photo 1b. following).

Swelling over the lymph reflexes to the intestines when there are problems with digestion is very common, as is puffiness over the fallopian tubes/vas deferens (photo 1a. following) when there are problems with the sexual or reproductive organs. Another less well-known area where lymph accumulates in these clients is behind the ankle bone, up from the testis/ovary reflex alongside the Achilles tendon (photo 1c. following). Because it is at the rear of the ankle, this is easy to miss, but look out for it, especially if you are doing work for reproductive or gynaecological issues. 

Whether the problem is due to a medical condition, poor circulation, or toxicity at a specific reflex area, lymph flow responds very well to reflexology, especially Reflexology Lymph Drainage. If lymph pooling indicates toxicity at a reflex, then naturally, pay close attention to the organs’ health – not only the lymph. And work to relax the surrounding joints to prevent muscle tension from impeding the lymph flow in the area. And always work the other detoxification organs, the liver, kidneys, and lungs. 

N.B. As I mentioned in the previous post, hard, dry skin can indicate a deficit in lymph reaching that area of the body. It is possible to see both dry skin on the plantar foot and a swollen puffiness on the dorsal. This still means that the lymph flow to the area has been impeded, but that which has reached it accumulates because there is toxicity at the reflex that is not effectively eliminated.

Poor lymph circulation is also greatly helped by exercise, particularly rebounding, which is worth mentioning to clients. But stress that you only suggest they look at the potential of rebounding, not telling them to take it up. They do not need to do jumps, especially if they have a weak pelvic floor; running on the spot is also good and will not affect their bladder. They should look at the website of a good brand, such as Bellicon, in the link above, which covers all the important questions before deciding whether it suits them

Note: It is usually safe even for those with medical issues, but make sure they check with their primary care provider first. Being overweight or having bad joints are not contraindications, as a good model can withstand heavier weights, and the springs absorb the impact on the joints. Nor is having low ceilings, as you will not bounce very high on a rebounder. (It may not be suitable for those with neighbours living beneath them, though.)  

photo 1a.

Here there is an accumulation of fluid over the reflexes of the fallopian tubes and intestines, most noticeably over the left foot.

photo 1b.

All right foot’s upper lymph and chest lymph reflexes are swollen. This is made more evident by comparing them to the upper lymph reflexes on the left foot, which are not puffy. So the tendons and dips between the metatarsals are visible.

photo 1c.

There is a build-up of lymph at the rear of the Achilles tendon at the lateral aspect of the ankle. The puffiness is spreading from the ovary and showing issues with toxicity causing lymph to pool there.


Oedema is when an area swells up because the capillaries leak fluid into the surrounding tissues to protect them. It can be a healthy acute response by the body to protect an area with recent trauma, such as a sprain or a bee sting. But oedema often occurs for no known reason or does not go down after the trauma has passed. When this happens, and the swelling becomes chronic, it is a sign of a problem with a weakened venous (not lymph) system. 

Oedema looks very similar to sluggish lymph circulation. Likewise, it can affect the whole foot or be restricted to only certain reflexes, making it very difficult to tell the difference between them. In fact, it is very common to have these conditions concurrently as blood and lymph circulation are so interconnected, and both are impaired by standing a lot and/or being overweight/pregnant. Would it not, therefore, be actually much more accurate to chart the lymph reflexes as also the reflexes to the circulatory system?

Just as swollen lymph over the whole foot shows a problem with the entire lymphatic system, oedema over the whole foot shows a problem with the functioning of the entire venous system. But sometimes, the swelling has a reddish tone (photo 2a. following), showing an inflammatory response of increased blood flow into the reflexes. In these cases, while there may also be lymph pooling, the redness is definitely a sign of oedema and indicates a problem with the cardiovascular system, specifically at those reflexes. (I will look at this in more detail in the upcoming chapter on ‘Reading Veins and Capillaries’.)

This is clearly evident in photo 2b. following, where there is lymph swelling in both feet. However, the redness over the reflexes on the distal left foot shows that, in addition, there is definitely cardiovascular inadequacy in that part of the bodyBut ultimately, without redness present, it can be hard to know which system is the root cause of the problem. So if you are unsure which is which, stimulate any swollen reflexes charted as those to the lymph, as this will boost blood and lymph circulation simultaneously. 

photo 2a.

There are no visible dips between the tendons of the toes, and the upper lymph and chest reflexes are quite puffy, so there may be lymph pooling and congestion here. But the puffiness is red, so there certainly is oedema here, showing venous inadequacy and an inflammatory response at the chest/lung reflexes.

photo 2b.

There is puffiness on each foot, so there is likely poor lymph circulation in both. But the swelling on the left foot is greater and red, indicating that there is also oedema here. The area it covers shows that the venous circulation is affected in the left upper body, including the chest and head.

Other Ankle swellings

Structurally the ankle is quite a complex joint, so it is common for swelling to build up at various points around it. But it is the gateway through which energy must pass to connect the body with the earth and also between the reflexes and the body, and any form of swelling in the ankle area is a barrier to this. So understanding their various causes helps us in our work to keep the gateway as open as possible.  

As we saw in the previous section, fluid retention is often seen at the ankle over the fallopian tube or vas deferens (photo 2b.) and up alongside the Achilles tendon (photo 1c.). However, other swellings are not necessarily related to lymph or venous circulation.

1. The most common is seen on the dorsal ankle at the dip in the lateral talus (photo 3a. following)It occurs to some degree in most women from their mid-twenties onwards, even in very slim women with slender feet, although it is interesting to note it is not seen in many menI was taught that this dip is the reflex to the sacroiliac joint, although it is also where the inguinal lymph node reflexes are placed. 

Anatomically, it would be natural for lymph to pool in this dip, but this swelling has a slightly different, denser texture, which is not like the texture of fatty tissue either. Although I am not sure, I think this swelling relates to the accumulation of cellulite in the body around the buttocks, hips and thighs of the client. 

The leading cause of cellulite is believed to be a breakdown in the fat cells’ structure triggered by hormonal changes specific to women, which is why men get it much less. It is also why cellulite appears in female clients increasingly as they age, regardless of whether they have an excess of normal fat in the body otherwise. This swelling also fits all these criteria exactly.

2. There is also another, much less common swelling that is sometimes seen in people who have hyperthyroidism, which because of its blueness, I covered previously in the post on colour (photo 3b. following). As it is over the small intestine’s lymphatic reflex, it would seem to relate to the digestive issues, which are connected to an overactive thyroid gland, specifically poor oxygenation of the area, which is indicated by the blueness of the swelling. 

3. There is another area around the ankle where lymph often pools, in the v-shaped gap between the fibula and tibia just up from the ankle joint (image 1a.). Sometimes this pooling will be visible, but it is possible to feel it even if it isn’t. It is just out of range of the reflexes, so it is not reflexology as such, but if your client has problems with lymph circulation in their leg, it is easy to add a quick massage to this area, as this will definitely help stimulate it. 

4. A ‘cuff’ type swelling just above the malleoli of the ankles is known as lipoedema, which I cover in the next section (photo 4a. following).

photo 3a.

This dip in the ankle joint is where swelling most commonly occurs, especially in women. It has a different texture to lymphatic swelling and may relate to the accumulation of cellulite in the body.

photo 3b.

This bluish swelling beneath the talus is seen in clients with hyperthyroidism. It seems to show a connection between the small intestine and thyroid malfunction.

image 1a.

The red circle is the area where lymph tends to pool between the fibula and tibia. Massaging this area will help clients with sluggish lymph circulation.


There is a widespread but under-recognised and under-diagnosed condition known as lipoedema, a distinguishing feature of which is a ‘cuff’ type swelling around the ankles. This is caused by a build-up of leg fat that does not spread into the feet (photo 4a. following).

However, this fatty tissue’s constitution differs from other body fat, is often painful to the touch, and does not reduce with exercise or diet. Its build-up in the legs can range from slight to extreme, but it causes a disproportionate leg-to-upper body size, and the person will tend to have much heavier legs and a slimmer upper body.

photo 4a.

The causes of lipoedema are not entirely known, but It is seen almost exclusively in women, and its development starts around times of significant hormonal changes. Unfortunately, it is frequently mistaken for an accumulation of normal fat, cellulite, or fluid. Indeed those conditions may also be present to confuse matters further; however, lipoedema is medically different from any of those things and needs to be treated as such.

If you see this ‘cuff’, or the client has other symptoms, of course, it is not for you to diagnose its presence, but to make them aware of the possibility they may have the condition and the need for it to be appropriately assessed and managed if they do. And to support them if they are having difficulty getting a medical professional to take their symptoms seriously. 

From a reflexology perspective, treating the relevant endocrine reflexes is very important because its development is connected to hormonal stress. Interestingly, the cuff area is over the fallopian tube and just above the uterus and ovary reflexes. 

Karen Windsor is a reflexologist who has had a lot of success using reflexology for lipoedema as an extension of RLD. She can be found on Instagram @kaztalks and on Facebook. She has recorded a podcast with Sally Kay about her work if you want to learn more.

Emotional Significance

When the swelling is due to water retention, it is a form of emotional protection and a sign of great sadness linked to unshed tears from past hurts. But its softness is a sign of vulnerability, an attempt to cushion against emotional blows rather than the defensive shield of hard skin. It shows a desire to be cared for and loved, but because of past experience, the person is very wary of opening up to receive this from others.

Where swelling is associated with changes in fat cells, such as cellulite or lipoedema, it is connected to hormonal changes in the female body. So is emotionally connected to the acceptance of femaleness and trauma around life changes associated with the stages of womanhood, from puberty to potential or actual motherhood, and to peri and post-menopause. 

The Base Of The Heels

Small round swellings at the base of the heels, known as piezogenic papules, are very common. They are found at both the medial and, less frequently, the lateral edges of the heel (photos 5a. & 5b. following). They are never found anywhere else on the foot, so if you see a similar swelling elsewhere, it may be a cyst, for example, but it is not one of these. They are considered benign and harmless; however, get them checked out if you are in any doubt, especially if they are painful. 

These papules are formed of fatty tissue herniated through weakened muscle fibre in the heels. They mainly occur because of a client’s lifestyle when there is excessive pressure on the feet, particularly the heels. This happens to clients who are overweight and/or have recently spent a lot of time walking or standing, especially in unsupportive footwear. For the same reason, they become more noticeable in pregnant women and less evident after the birth or weight loss. Sometimes this weakness is inherited and can even be seen in children.

In reflex terms, as usual, it is possible to directly correlate what is happening in the foot and what is happening to the corresponding part of the body. Therefore because they appear on the heels, if they are on the inner aspect, they indicate weakness in the connective tissue of either the pelvic floor/lower back muscles or, if they are on the outer aspect, those of the hip/lateral glutes. (And, of course, these muscle groups in the body would likewise be impacted by all the same factors such as standing a lot, excess weight bearing, etc.) 

Muscle weakness in the pelvic girdle can significantly contribute to any number of problems with organs found there, including the bladder, the colon, and particularly the reproductive system. And the density of the fatty tissue herniates through this weakness would also cause an impediment in the flow of energy to the area. 

They are most common in women, probably reflective of the complexities of the female reproductive organs and the added stresses of childbearing on the pelvic girdleAs a result, they are often seen in clients with problems such as endometriosis or fibroids. And if they are seen on the lateral heel, they will affect the ovary reflex (photo 5b. following). Besides its gynaecological function, this produces hormones that regulate women’s mood and mental wellbeing even after menopause. And in men, the presence of these papules can affect the prostate and/or testes glands, so likewise affect their fertility, moods, and energy levels. 

But bear in mind that they, or rather the weakness they represent at the reflex, are not the sole reason for any gynaecological or reproductive problem – holistically, there is never a single cause. They indicate the presence of just one of a combination of several contributing factors, all of which depend on the individual’s genetics, lifestyle, and medical history.

Working with piezogenic papules

Regarding working on these papules, getting the client to strengthen the weakened muscle groups through exercise, pilates, or yoga will be especially effective, combined with weight loss if necessary. And reflexology treatments that focus on the lower back and pelvic floor muscles will also help (video 1. following). If the muscle bands in the body are strengthened, and the weight bearing on them is reduced, the papules will appear much less evident at the reflexes.

photo 5a.

Multiple papules on the medial heel show great weakness in the pelvis and groin area. This can contribute to all manner of problems with the reproductive and/or other organs in the groin area.

photo 5b.

Here the papules are seen on the lateral heel. One of them is over the ovary reflex. The client is postmenopausal, but it would still affect endocrine function and emotional wellbeing.

There is also lymph swelling above the ovary going up behind the Achilles tendon and ‘cellulite’ puffiness in the talus dip (as in photo 3a.)

Emotional Significance

As mentioned above, if papules are seen on the ovary reflexes, consider their impact on emotional wellbeing, even post-menopause. This is just as important if they are on the testes reflexes, as the function of these glands greatly affects the emotional well being of men. But as male sex hormones fluctuate less obviously than women’s, unfortunately, they are discussed less and are often overlooked.  

Weakness in the lower back and pelvis relate to how much support, or lack thereof, we feel in our lives and how emotionally grounded we are. It is very connected to the person’s feelings about their family during their childhood, as well as their life at the moment, including their partner, or lack of one. The area also reflects sexual energy and reproductive issues, so choices and attitudes towards parenthood.

At The Pituitary Reflex

It is very common to see a swelling in the centre of the pad of the hallux in the reflex that usually is charted as the pituitary (photo 6a. following). Many reflexologists now consider this the reflex to the hypothalamus and place the pituitary reflex just above the pineal on the medial edge of both big toes. And some charts put this spot as the reflex to both, with the pituitary just below the hypothalamus, which perhaps would be more medically accurate.

However, it is not essential to agree on which reflex it is when using foot reading. A swelling indicates an excess, so whichever gland(s) it appears on is overactive and needs to be sedated. And as both glands work closely together as significant drivers in the endocrine system, all the reflexes in that system will need extra attention, with a focus on the HPA axis.  

You can use strong pressure in this swelling as long as it is followed by calming techniques. And as treatments progress, check how successfully things have been rebalanced by seeing if the swelling in the pad has reduced. 

N.B. During pregnancy, especially when the client is near to going into labour, it may be expected that this gland reflex is very swollen. This is a sign of a great amount of activity there, which is necessary at this time, rather than a sign that it is imbalanced.

If the client is on antidepressants of any type, the reflex to the pituitary/hypothalamus will often have little or no feeling in it and may even be numb. This presumably is because of the deadening effect of the medication on emotions. 

So with these clients, even if the reflex appears imbalanced because it is either swollen or sunken, it may not register any pain. But it is still worthwhile working on the gland in these cases. Feeling pain again when the person is ready would be a progression, as to heal the painful emotions, they need to be accessed first, not numbed. 

However, reducing antidepressants should be done carefully under medical supervision, so do not encourage a client to do so without this. But if they are planning to reduce or come off antidepressants, reflexology is a great therapy to support them whilst they are doing so.

When there is swelling at this reflex, it is also important to look for any misalignment between the cranium and neck. Because if the neck is not held upright, the head’s weight will compress the top vertebrae and the local muscles. This will impact the nerves and blood supply to the organs in the skull, particularly those nearby, like the hypothalamus and pituitary. This compression can be read on the hallux as a deep line at the reflex to the cranium base at the bottom of the toe pad. (I covered this previously in a section in the chapter ‘Reflex Specific Lines.)

Or if the person is prone to leaning their head, depending on whether it is to one side or from side to side, the swelling of the reflex can appear as pushed off to the side of the pad on one or both toes; this will show as a diagonal line at the reflex to the base of the cranium, or a broken diagonal then a straight line, with the swelling seen as ‘off centre’ (photo 6b. following). So, in addition to the overactivity at the gland, this shows another form of imbalance, this time between the left and right brain. 

When you see any of these misalignments, regardless of whether or not the client has any symptoms of current neck problems, still work to realign the cranium, especially when there are known endocrine problems such as fertility issues. And alongside reflexology treatments, a referral to an osteopath or chiropractor may help speed things up. I have referred several fertility clients to osteopaths for neck realignment to ease pressure on the gland and improve circulation and had successful outcomes. 

photo 6a.

The swelling at the pituitary/hypothalamus reflex is very evident. It is still in the correct position at the centre of the toe pad, though. All the small toe pads seem slightly bulbous, but there is no noticeable swelling in their centre at any sinus reflexes. (see the section below.)

photo 6b.

Here the swelling at the pituitary reflex is less noticeable, but this may be because the toe pad itself is quite bulbous. This shows there is a lot of mental build-up that is probably due to thoughts not being expressed. But we can see that the reflex is being pushed far off-centre. This seems to be due to the misalignment of the neck and head reflected in the lines at both hallux joints.

The line showing the alignment at the base of the cranium is not straight but wavy. It is heading up into the pituitary and looks like it is pressurising the gland. The line at the base of the neck is diagonal and reflects chronic lateral leaning of the neck, which is also pushing the gland out of alignment.

At The Sinus Reflexes

Swellings can often be seen on some or all of the pads on the small toes (photo 7a. & 7b. following) and show congestion in the sinus reflexes. This is to be expected when the client has a cold, virus, or allergy, such as hay fever. But there are many other conditions where the sinus function is impacted, but the symptoms may not be obviously connected. So, whenever the sinuses are swollen, it is a clear sign that they need to be worked on, along with those of the upper lymph and temporomandibular joint, regardless of the presenting symptoms or lack of. 

Reflexology is highly effective for clearing sinuses but can also be very painful. Holding the reflex and linking it to the same spot on the dorsal aspect of the toe can work very well to provide soothing relief after the pain or as an alternative for those who find deep pressure on them too much to bear.


Colds and viruses can often cause an infection in the sinuses and their reflexes to appear swollen for a long time after the initial problem has passed. Sinusitis can be symptom-free initially but slowly worsen until it becomes the cause of other issues, such as severe headaches around the eye socket or a blockage in the eustachian tube leading to an ear infection. The client will likely not be aware of the connection, so if they have these symptoms, always ask if they had a cold within the last month or so. 


If the swellings appear because the sinuses are aggravated in a client prone to allergies, it is essential to work the adrenal gland to reduce histamine production. And it is necessary to have a long-term plan to take care of digestion to avoid the overreactions of the immune system that cause allergies, as they are very much associated with Leaky gut syndrome. 

Post nasal drip & Mouth Breathing

This is commonly connected to sinus problems and can cause long-term and sometimes severe health problems, including respiratory diseases. There is also a direct connection that most people are unaware of between the ‘mouth breathing’ caused by chronically ‘bunged up’ sinuses and asthma. So it is important to decongest the sinus passages to help protect the lungs of these clients. 

Facial Skin

Although, to my knowledge, there is no proven medical connection between the sinuses and acne, in my experience, working on them really helps to clear up the skin.g

photo 7a.

The sinus reflexes are definitely swollen on toes 2-4 of the left foot. On the right, there is a barely perceptible swelling at the sinuses on toes 3 & 4. The whole pad on both toes 4 looks generally swollen. However, neither of the pituitary glands is evidently swollen. There are also yellow patches over both lungs zone 1-2, so congestion in the sinuses may contribute to post-nasal drip.

photo 7b.

Here there is congestion in all the sinus reflexes, but there is also overall swelling of the whole pad of both toe 3 and especially toe 4. (see the section below on swollen toe pads.)

This shows congestion and excess energy in the outer eye, and particularly in the inner ear and eustachian tube. There may be problems with these organs, including with balance. It also shows variations in energy flow through the different zones of the foot.

The swelling in the pad is accompanied by compression in the neck of the toe, showing tightness in the neck and shoulders in this zone.

Pituitary And Sinus Reflexes

It is very common to see all or most of the small toes, along with those of the hallux, to have swellings on their pads (photo 8a. following) or to see the opposite where the pads are sunken (photo 8b. following)Sunken pads are seen less often than swollen, but you are not likely to see a mix of swollen and sunken on an individual.

In these cases, there may be separate but contingent issues present in these reflexes. But it is just as likely there is some form of a connection between the function of the sinuses and that of the pituitary/hypothalamus. 

This medical article looks at how the sinuses may regulate brain temperature, which would certainly make sense. In fact, the famous reflexologist and cranial osteopath Dr. Martine Faure Alderson, who devised cranial-sacral reflexology, taught this to be the case. And there may well be further connections between the sinuses and brain function that are yet to be discovered. 

But even if we do not fully understand precisely how these reflexes may work with each other, we know that swelling indicates an excess and sinking deficit. So we should work accordingly when the health of the sinuses and the gland appears to be connected and try to rebalance all the reflexes in unison. 


When some or all of the sinus and pituitary/hypothalamus reflexes appear swollen (photo 8a. following), it indicates an excess of energy in the brain and sinuses connected to overactivity. So the reflexes first need to be stimulated to encourage the body to get rid of the excess, then sedated afterwards to recover.  

It also shows that the toes are dorsiflexing and rising up as if they were flat; there would not be a space for the swellings to develop. And posture-wise dorsiflexing means that the head, neck, and upper shoulders pull forward. Working to plantarflex the toes and bring them back into proper contact with the ground is important for their weight-bearing and counterbalancing roles for the body’s head, neck, and upper shoulders


When some or all of the sinus and pituitary/hypothalamus reflexes appear sunken (photo 8b. following), it indicates a depletion indicating underactivity and a lack of energy. The reflexes are exhausted; first, they need to feel supported and for any anxiety stored in them to be calmed. Then they may feel strong enough to receive some stimulation and be re-energised by the treatment.

The sunken texture is caused by the toes plantarflexing and their pads pushing downwards flat against the ground. It is due to a ‘clawing’ type alignment of the toes that give the impression of someone trying desperately to hold on. Regarding posture, the upper chest and clavicle pull forward, but the head and shoulders are held upright. 

So, stretching and straightening out the joints and releasing the tension in them will help get the energy back into the pad of the toe and the affected organs. It will also help the person to ‘think straight’ again and improve the posture of their upper body, head and shoulders.

photo 8a.

In this foot, all the toe pads are swollen, showing an excess of activity and energy. These toes are dorsiflexed, so raising up from the ground.

photo 8b.

Here all the toe pads are sunken and flat, showing that they are depleted and lacking in energy.

The pads have been flattened from constantly being pressed down into the ground in a bunched-up clawing position.

Swollen 'Bulbous' Toe Pads

Sometimes the whole distal joint of a toe appears swollen and bulbous, often accompanied by a compression in the neck of the toes (photo 7b.). This shows congestion in the reflex of the eye/ear or the whole head in the case of the hallux toe. It also shows an imbalance and lack of connectivity between the toes that are swollen and those that aren’t

And because the toes are at the head of each zone, it also indicates an energy blockage that impacts the whole zone. Similarly, if there are any meridian points on the toe, this can mean that there is a problem elsewhere in the meridian. (I will look at foot reading and the meridians in an upcoming chapter with Chi Medics.) So it is important to work on any bulbous toes, not just to get the energy moving down through the local reflexes, but also the entire zone which it heads and/or the meridian it is on.

It is necessary to stretch out the whole toe and work at the base of the distal joint to ease the congestion. It is a good idea to work up and down the zone from the toe to get the energy flowing freely and to feel whether there are any blockages in it further down the foot. The Brazilian Toe Hold, which I covered in a previous post, is very useful for balancing energy in individual toes and for all of them in unison. 

Emotional Significance

Swelling in the toe pads

When swellings are in the centre of the pads, they can form because the toes are dorsiflexed, rising up and pulling away from contact with the earth. They show a person who is not grounded may be prone to wishful thinking, detached from reality, and honest interaction with others. 

It is also a sign of excessive energy in the brain and, when on the hallux, overactive hormonal activity, which could lead to mood swings. Energetically, if the swelling is away from the centre of the pad, especially if on both toes, it means the person is ‘not centred’. There is a gap in the connection between the two lobes of the brain, which will contribute to mental and emotional disharmony.

Sinking in the toe pads

When the centre of a pad is sunken, it shows a deficit of emotional energy, someone who is overly grounded with a fear of losing control if they let go and follow their dreams. There is emotional exhaustion and someone who lacks the energy to deal with life and take on new things. The toes are in a ‘clawing’ position and desperate to hold on to something. Posturally, this means that the head is being held upright even though the chest is slumping as if they are feeling defeated but trying to keep their head above water. 

Bulbous toe pads

When the whole distal toe is swollen, there is a build-up of energy in that zone of the brain connected with the sense that the toe relates to, either sight or sound. Something they are seeing or hearing makes the person angry or full of emotion, but there is no outlet for it. And the bulbous swelling means that the neck of the toe will be compressed, so the throat area is being prevented from voicing their thoughts on the matter.

Whorls of the toe pads

As a separate observation, the patterns made by the whorls on our toe pads are formed the same way as those on our finger pads and, like our fingerprints, are unique to each of us. 

So it is fascinating that the reflex to the hypothalamus/pituitary gland, which is the coordinating centre of many hormones that regulate moods, determine our personality type, and make us all individuals, is found right at the centre of the whorls of the big toe.

Bladder Swelling

The bladder reflex is normally slightly swollen but can appear noticeably puffier in some clients. This is not because the bladder is full, nor that there is an inherent problem with it. It is more likely because of how the muscles and joints of the pelvic girdle are aligned in that particular client, which will be reflected in the feet and cause the bladder reflex to appear more or less prominently.

The alignment may just reflect the natural shape of the client’s pelvis. However, if a misalignment is present, it will put undue stress on the area, including the bladder. So look for indications that this may be the case, such as if the puffiness is very pronounced or only appears on one side. Also, whether the lower vertebrae have stress lines exiting from them that run across the bladder (photo 9a. following)This can be connected to overly frequent urination associated with overactive bladder condition, which is just as prevalent as IBS but not as well known. 

If a pronounced swelling is due to misalignment, work to relax and strengthen the local muscles, especially those of the pelvic floor (video 1. following)There may be indications of other health issues around the bladder, such as broken capillaries, swollen veins or inflammation, but I cover these in other chapters.

video 1.

I showed the video below in a previous chapter. I’m reposting it here because it shows a way to work the reflex to the pelvic floor muscles and is good for when the bladder area seems very pronounced. Because of the positioning and role of the pelvic floor muscles, this works for any lower back or groin area problems. There is often tightness in the band of the muscle in the foot here, especially if the lumbar spine reflex is tight. In these cases, clients tend to find this technique painful but call it a ‘good pain’.

Foetal Swelling

When a woman is pregnant, as the foetus grows, the swelling at the bladder reflex tends to appear more and more pronounced and is more noticeable on the foot of the side of the body on which the baby is lying. It is fascinating that it is often possible to look at feet in the later stages of pregnancy and to make out the shape of a baby there (photo 9b. following)

And as the size and shape of each woman’s bump will vary a lot depending on abdominal fat, the pelvic and uterine muscles, and previous pregnancies, the swelling in her feet reflects this too. But a misalignment of the pelvis also makes the bladder swelling in the foot more prominent, and it is easy at times to mistake this for a ‘baby bump’ (photo 9a. following)I will look into all this again in more detail the upcoming chapter on ‘Fertility and Pregnancy‘. 

photo 9a.

The swelling on the left foot at the bladder is much more pronounced than on the right. However, this person is not pregnant, so it is connected to their pelvic alignment.

There are markers of lower back and pelvic issues. Firstly, the great asymmetry of the swelling, then the deep horizontal lines from the Achilles tendon that show tightness in the lower back and a posterior tilt on this side.

 Also, the line running diagonally across the base of the bladder indicates stress there and in the pelvic floor muscles. The line exits from between the vertebrae; therefore, there is also pressure on local nerves in the CNS.

photo 9b.

As in the previous photo, there is also a swelling over the bladder area (this time, it is noticeable mainly over the right foot. swelling on the right foot). But in this case, the client was in the later stages of pregnancy.

The swelling here reaches further down – as far as the uterus reflex. If you look carefully, it seems to have the shape of the outline of a baby with its head down near the cervix reflex. It is a tiny but discernible difference; a non-pregnant bladder swelling will never reach as far as the uterus, but when the baby is engaged, a foetal swelling will.

At The Liver And Spleen

It is common to see a distinct area of congestion at either the liver (photo 10a. following) or spleen reflex, often spreading downward to impact the associated flexure. Or there may be dips in one or both organs (photo 10c. following), indicating a deficit of energy. And as the spleen supports the liver by cleansing the blood, it is typical for both of them to be simultaneously affected (photo 10b. following).

The spleen also plays a vital role in the immune system, so any abnormal underlying textures there may reflect that the client is run down and may be fighting off an infection. But in the case of the liver, it has so many functions and carries out so many processes; it is not always easy to say why congestion or depletion has appeared there. 

If the client has not mentioned any possible physical or emotional causes, dig a little deeper with your questioning, as there may be things they have omitted to mention. And bear in mind that as the liver also has to process prescription medications, they may cause toxins to accumulate. But generally speaking, when either texture is present in one or both of these organs, it would be expected for the client to feel quite sluggish and lacking in energy.

If there is swelling, work firmly (within the client’s pain threshold) to stimulate the elimination of toxins, and if it carries on down into the flexure, then work on that as well. But if you feel it is more appropriate because the person is ill or very rundown, you can use lighter pressure and work slowly over a more extended period. However you work, after detoxification, always focus on the lymph reflexes, especially those local to the liver and spleen. 

If there is a dip in the organ’s appearance (photo 10c, following), use calming techniques to sedate it, then work to stimulate and re-energise it. And especially in the case of the spleen, work a lot on the rest of the immune system through the lymphatic reflexes.

photo 10a.

There is a very noticeable swelling over zones 4 & 5 of the liver. If possible, this should be worked quite deeply to eliminate the toxic congestion building up here.

photo 10b.

Here there are swellings showing congestion in both the liver and the spleen. This is very common because of how closely they work together. The swellings impinge on both flexures, especially the splenic, so work on them as a continuation of your work on the two organs.

photo 10c.

There is a sunken dip over the spleen reflex. This shows a depletion, and the organ needs to be stimulated in a way that will increase energy there.


Emotional Significance

The two organs also work in tandem emotionally and replicate their physical actions. The liver is responsible for many processes in the body, including metabolising food and turning it into energy; hence it is also responsible for processing emotions. 

When it is congested, the person is not working through their feelings satisfactorily and is not good at expelling negativity and anger. When there is a sunken area, they are not good at getting the emotional support they need from their relationships and using it to nourish themselves.

The spleen supports and cleanses the liver, so if the person is tired and emotionally fatigued from having to process a lot of emotional upheavals and/or negativity, the spleen is involved in this. This is why it is traditionally associated with the way anger is released. In an old expression, ‘vent your spleen’ or ‘anger management’ in modern terminology.

Swelling In The Colon

The cause of swelling in the colon is more straightforward, as it shows a build-up of old waste matter. It is most common for this to accumulate in the flexures as it is more difficult for peristalsis to move the waste through the bends (photo 11a. & 11b. following)The swelling at the flexure can often be seen carrying on into the liver or spleen. In this case, it shows that the waste matter is so large that its size directly impacts the working of the organ (photo 11a. following)

Congestion can also be seen along other sections of the colon reflex (photo 11c. following), and the compacted waste can cause pain in that area of the body. It is common for these swellings to be red, showing inflammation in the bowel connected to the congestion.

Despite everything, the client may think their bowel movements are fine and may not actually suffer from constipation. This is because more easily digested fibrous waste will still pass through the centre of the colonic tube and be passed as stools. However, other types of waste that are more difficult for the body to process can adhere to the colon walls and remain there, even for years. 

There are various reasons for this, including certain medications and hormonal imbalances. But the most common is dehydration. Low water content makes the waste more compacted and makes the intestine’s lining dry and poorly lubricated, so peristalsis is inefficient. Other common causes include a poor desk sitting position, where the person is slumping forward, which can push the diaphragm and rib cage down into the flexures and horizontal colon impeding peristalsis. 

The health of the gall bladder may be a contributing factor; if it is not functioning well and producing the requisite digestive juices, this can prohibit bowel movements and cause a waste build-up. So study and palpate this organ carefully to check for problems here.

photo 11a.

The centre of the congestion here is at the hepatic flexure. It also spreads downwards into the ascending colon, across into the horizontal colon, and up into the liver.

photo 11b.

The congestion at the splenic flexure is quite evident. But it has not spread as much as in the previous photo. 

There are several other round swellings  over the stomach/pancreas area. I cannot say what these relate to specifically.


photo 11c.

The congestion in the bowel here looks as if it is further along, in the descending colon.


The other thing to note is that the two flexures are over the metatarsal protuberances, which also relate to the knees on the lateral edge. This is interesting as tension in the upper legs passes through the thighs into the abdominal muscles, hindering the effective movement of waste through the ascending and descending colon. 

So when there is swelling at the flexures, I always pay a lot of attention to the leg and knee reflexes. Video 2. following shows a very effective way to work a colon that looks very congested at the ascending or descending reflexes. 

Seeing and feeling individual bumps of faecal matter in the intestines is one of the stranger experiences of reflexology. Then, feeling and seeing them be moved along the colon during a treatment as they are pushed through is bizarre. Why the body replicates all these things in the feet is a mystery; however, if it helps the client, it’s all fine.

video 2.

And here is another video showing a reverse technique for working the colon, which is very powerful. It is from Touchpoint’s excellent collection of YouTube videos, which is well worth checking out.

Emotional Significance

Sluggish movement and waste congestion are associated with holding on to old matters in the person’s life. It can be specifically associated with a fear of letting go because of a need to control one’s actions and emotional responses and, by extension, the reactions of those around you. But as long as the person is not processing and letting go of old emotions, they cannot move on to new things healthily.

Problems with processing waste can also have deep emotional connections to early childhood, regarding embarrassment or shame at this natural bodily function. This can be tied in with adult feelings of self-loathing and disgust.

At Other Organs

Swellings and dips can also be seen at the reflexes to other organs and glands on the foot. It is not always evident why they are there or what they relate to (photo 11b.), but regardless, work accordingly. Either stimulate detoxification/decongestion or support then encourage energy into a depleted area.

Sometimes though, it is possible to understand what they relate to. For example, it is very common to see a small pea-shaped swelling just above the kidney reflex, approximate to the adrenal reflex (photo 12a. following). This occurs when the adrenal gland is overactive and produces excessive adrenaline, cortisol, or other hormones. Either way, it is likely to be connected to constant high-stress levels in the body. 

In contrast, a dip can occasionally be seen in the same place (photo 12b. following). This indicates that the gland has been under stress for a long time and is now so depleted and exhausted that adrenal fatigue has set in. Because of its proximity to the kidney and the close connection between the workings of the two, both should be worked together. (As an aside, it is fascinating to see that there appears to be an outline of a kidney in the foot at the reflex in photo 12b. following.)

Another example is the distinct round red swelling in the plantar heel in photo 12c. following. It probably shows congestion in the sigmoid colon, but it is also near the area of the helper reflex to the ovary/testis. We can try to find more information about which organ the reflex relates to, but it is not essential. It is still congestion that is interfering with the free flow of energy, and we need to break it down and encourage the body to expel it, whatever the reflex is.

photo 12a.

A small pea-shaped swelling is seen at the top of the kidney over the adrenal gland. This shows the gland is overactive and needs to be sedated.

But the dip between it and the top of the kidney shows a depletion. So there may be an energetic gap between the functioning of the two.

photo 12b.

It is possible to see a swollen area that looks like the outline of a kidney here. Also, there is a sunken area just above the top of the kidney where the adrenal gland reflex is. This shows adrenal fatigue.

photo 12c.

There is a round inflamed swelling over the gluteal area. It may show congestion in the sigmoid colon or the helper reflex to the ovary/testis.

In contrast, there is also a multitude of lines cutting across the area, giving this a rippled texture.

Lingering Sunken Texture

After pressing down into a reflex, when you remove your finger, a dip remains; this indicates that the energy level or ‘resistance’ at that reflex is poor. It tells you to pay a lot of attention to palpating the reflex and get more information from the client and other visual clues (e.g. inflammation) as to the cause of the weakness.

If we look carefully at the following photos, we can see that after the gall bladder reflex has been pressed (photo 13a. following), an indent remains after the thumb is removed (photo 13b. following). This lingering indent shows a definite need for extra support of the reflex and the digestive system as a whole.

photo 13a.

photo 13b.

Other Textures

Not all textures are directly due to depletion or excess. Many are caused by patterns made by the position of adjoining or crossing lines on the feet. But all lines equate to stress in the body, and the development of multiple lines in an area shows that there has been a distinct erosion of energy there.

Bumpy Texture

A ‘crosshatching’ type texture is formed by multiple parallel lines running in opposing directions and crisscrossing each other. As covered in a previous chapter, these particular lines that run parallel to each other in a track formation show the paths taken through the organs by pathogens and indicate an imbalance in the gut biome (photo 14a. following)When enough lines crisscross each other, that area of the foot takes on the texture of small diamond or oval shapes (photos 14b. following)

But the tracks made by parasites in an organ are narrower than those made by bacteria, and when there are lots of them crossing over each other, they create a different texture that has the impression of multiple small raised dots known as stippling. Like crosshatching, this frequently develops over the reflexes to the stomach (photo 14c. following) and small intestines.

The two textures are often seen side by side and even overlapping, showing where there have been overgrowths of both types of pathogensPresumably, it is because they mainly affect the gut that they occur over reflexes involved in the digestive processes.

If you press firmly on an area with these textures, it will feel tender, but the client is often unaware of a problem with their digestion. This is especially true in the case of the small intestines, as they do not always produce noticeable symptoms. But if the gut is not metabolising food properly, it will not provide optimum fuel for the rest of the body, so it will directly cause or exacerbate problems in any areas of weakness. 

But crosshatching and stippling are not restricted to specific reflexes, often running into others, especially those adjoining the intestines, showing that pathogens can invade multiple organs. So they are a reminder that we need to look at the feet in relation to the health of areas of the body. For example, photo 14b. following shows wider track lines over both the ascending colon and small intestine in zones 3-5. And much narrower ones run over the kidney and small intestine zones 1-3.

These textures can also be formed when pathogen track lines cross stress lines that develop due to muscle tension in the back or thigh muscles (photo 15b. following). I will look at this in the next section.

photo 14a.

These parallel track lines show pathways that pathogens have taken through the small intestines. They are slightly wider track lines, so they  probably show bacteria rather than the narrower lines of parasites.

photo 14b.

There is a ‘crosshatched’ texture over the ascending colon here and over the small intestine in zones 3 & 4. It shows where multiple track lines of bacterial overgrowth running in different directions have crossed over each other.

There are also narrower track lines, probably caused by parasites, over the kidney area.

photo 14c.

Here there is a ‘stippling’ bumpy kind of texture over the stomach reflex. This was formed when multiple narrow track lines associated with parasitic overgrowth crossed each other. It contrasts the area over the liver zone 4-5, which looks sunken and depleted.

Rippling Texture

Horizontal Rippling 

‘Rippling’ type textures result from multiple stress lines that I covered in a previous chapter, running in rapid succession across the foot; they primarily emanate from the spine and show where tightness in the back muscles is causing compression in the vertebrae and give the area a kind of ‘concertina’ type texture. How far across the foot the lines reach shows how much muscle tension reaches across the body (photo 15a. following).

It is also very common for lines to come from the lateral edge of the foot showing tension in the relevant limb, usually the hip/thigh (photos 15a. & 15b. following). If they run across the heel, they show tension in the gluteal muscles and sciatic nerve reflexes. The lines from each side often join up and run right across the foot. And the narrower gap between the lines, the more they show that the tension in the back muscles also impacts the nervous system causing emotional stress and anxiety (photo 15b. following)

The best technique for compression is to do a lot of lengthways stretching of the foot. This is the equivalent in the body of stretching out the spine and back muscles, easing the compression, and as this is done, the ripples will temporarily lessen or disappear. The ripples reappear when the stretch is released because the spine and back muscles have returned to their chronically tight compressed state.

photo 15a.

This ‘rippling’ texture is caused by multiple stress lines running horizontally across the foot one after another. And the looser the skin, the more evident the texture is.

Some lines leaving the mid spine only go partially across the foot, showing the stress extends this far across the body. But the ones in the lumbar region show tension impacting further across the body. And they meet up with the stress lines from the hip and thigh muscles on the lateral edge.

The multiple lines crossing the gluteal area reflexes on the heel show that these muscles are impacted by stress from the lower back, pelvic floor, and hip.

photo 15b.

Here the rippling texture also shows compression in the vertebrae. But because it is very fine, it shows not only muscular tension but also that emotional stress in the central nervous system impacts the intestines.

Wider ripples emanate from the lateral edge of the foot, showing tension from the hip across into the gluteal muscles and sciatic nerve reflexes in the heel.

And at the lower small intestine area, down towards the heel, diagonal pathogen track lines have crossed the muscular stress lines, creating a stippling texture.

Vertical rippling

This texture is more evident when the foot is stretched back for some reason and seems to be created by the narrow parallel track lines caused by parasites crossing the internal organs. As we have seen before, they indicate the path of least resistance they have taken as they spread through the organs. And are usually seen in the body’s core running over the digestive reflexes.

However, a softer and broader vertical rippling texture is sometimes seen across the upper third of the foot. This reflects a narrowing of the diaphragm area that may be caused by shoes that are too narrow, squeezing the metatarsals together. Or it may be due to the arms being held too tightly into the body. Either way, it indicates chronic muscular tension and means functions of the organs in the chest cavity, the lungs, the heart, etc., are also being affected (photo 16b. following)

Working to open up the metatarsals using stretching techniques will help alleviate the rippling effect.

photo 16a.

These long flowing parallel track lines seem to follow the path pathogens have taken through the body. They become more visible when the foot is dorsiflexed either by the client or the therapist. 

photo 16b.

This kind of vertical rippling is due to chronic lateral-medial compression on the metatarsal area. It can be caused by ill-fitting shoes, but in the body is caused by chronic tension in the shoulder joints and arms pressing into the side of the upper body/diaphragm. (Such as may happen when driving or using a computer, for example.) 

Emotional Significance

All lines are evidence of stress; as such, the more there are, the more the person has been under emotional and physical pressure. Lines also form a partition, interrupting the free flow of energy, so they emotionally show many barriers and conflicts around the organs on which they are seen. The rippling textures formed by multiple horizontal lines are usually seen on the digestive organs and show conflict around food and nourishment. 

Feelings connected to food are elemental as they are one of the first emotions to develop in an infant. As such, they are associated with how we bonded with the caregiver who responded to our primary needs, usually our mother. Modern day media pressures on women and, increasingly, men to look a certain way also play a role in causing anxiety and emotional conflict around food, confidence, and appearance.

The lines can also run across the kidneys, which as the deepest organ at the core of the body, represent the core person and inner child. So stress lines show the person has conflict around connecting with their most profound and fundamental needs and self-acceptance. 

When the rippling texture caused by the lines is very fine, they tend to be found in those with a high level of sensitivity towards their emotions and those of others. This sensitivity can be good as it can make high levels of creativity or very intuitive and empathetic healers. But this sensitivity can become imbalanced, and then the person can become overly sensitive and susceptible to the negative emotions of others. The deeper and more apparent these lines are, the more this is the case.

The crosshatched and stippling textures caused by pathogens show a weakness in the organs they have been able to exploit. So will show an area already weakened by anxiety and over-sensitivity.

Loose Skin

Loose skin overall, or most of the feet, is expected in older clients as the collagen beneath the dermis lessens with age (photo 17a. following), and the way the skin sags shows the pattern formed by stress lines very clearly. In younger people, loose skin may well be due to a recent rapid weight loss, and if so, it is important to try to find out from the client what brought this about. 

Knowing what triggered the weight loss is the key to how you support the client. It may be because of dieting and exercise, but check this has not been done too quickly on a crash diet but is part of an ongoing healthy lifestyle choice. Rapid weight loss can also be caused by an illness, medication, or emotional trauma, all of which would require a different approach and treatment plan.

But sometimes, it only appears over certain reflexes, so it seems that the organ has had a significant energy loss and is significantly depleted (photo 17b. following). Try to get an idea of what this might be related to, but even if you don’t know, you will need to work to encourage energy into the organ. So firstly, use calming and anxiety-reducing techniques to make it feel secure and supported. Once you have done this, use stimulation to encourage energy into the area, so it can resume normal function.

Emotional Significance

Loose skin is associated with emotional exhaustion and a lack of confidence, leading to a lack of enthusiasm for life.

photo 17a.

This is the foot of an older person. The skin is very loose due to the loss of collagen in the dermis. The looseness shows the rippling type texture caused by stress and pathogen lines very evidently. 

photo 17b.

Here the skin over the stomach reflex is loose over both feet. There is a definite ’emptiness’ indicating a great lack of energy in the organ.


In the foot, gout usually affects the toes, especially the ball of the hallux (photo 18a. following), but sometimes can attack the heels. It is a form of inflammatory arthritis where the tissues are attacked by high uric acid levels in the blood. Hardened uric acid crystals known as tophi can form, causing joint disfigurement. 

Whether the gout is in the feet or another part of the body, reflexology is very helpful in preventing attacks from flaring up. But a full-on attack is incredibly painful, and working on the foot is not usually possible, so the hand should be worked instead. 

photo 18a.

The most critical reflexes to work on are those of the kidneys, firstly to stimulate the excretion of uric acid and also because gout is usually accompanied by high blood pressure. Along with the kidneys work the adrenal glands to reduce stress levels. And as there is extreme inflammation, focusing on the local lymphatic system is important. 

Also, work all the musculoskeletal reflexes of the upper body (or the pelvis if the heel is affected) and especially those of the central chest and upper thoracic spine to relax them and de-traumatize them if there is currently or has recently been an attack. (As with any form of arthritis, only flex the joint within the levels acceptable to the client.) We should also work the whole of the affected zone – usually zone 1 – in the foot to keep the energy flowing up and down there.

As well as benefiting from the work you will do on the relevant reflexes, you can also explain to clients that a reflexology treatment will inherently include the same benefits as a foot massage in boosting circulation, etc. This massage website explains why foot massage is beneficial for preventing gout.  

Emotional Significance

Gout is connected with significant irritation or anger and an increasingly inflexible attitude to the problems causing those feelings. If it is in the hallux, then consider chronic hurt that the client has never been able to ‘get off their chest’ properly due to pride or an emotional inability to talk openly about it. If it is the heel, consider feelings around family, security, and lack of support.


If you see a round or oval swelling on the feet, it is probably a cyst. Different types of cysts are seen on the foot, usually benign and painless. However, this is not always the case, and they should be checked by a doctor. 

Ganglion cysts can be found anywhere on the foot and have a soft jelly-like texture. But do not confuse them with piezogenic papules, covered previously in this chapter, which are smaller and are always found around the sides of the heel. It is not always known why cysts develop, but they can be caused by infection, trauma, inflammation, or clogged oil glands

Energetically they indicate a blockage, so consider if this has impacted the health of the reflex on which they are sited. However, the blockage may cause a problem to manifest elsewhere on the zone of the foot or maybe on a Chinese meridian that runs through the place where the cyst is found. (I will look at foot reading and the meridians in a later chapter.)

photo 19a.

Cysts found on the sole of the foot may be plantar fibroma (photo 19a.), which are hard nodules that develop on the fascia of the tendon. They are not always visible but can cause pain and be confused with plantar fasciitis, so make sure they have been diagnosed medically. As the tendon is affected, consider the related muscle area in the body, although the client may not be aware of any symptoms in the area. But as with a ganglion cyst, the problem may be referred to elsewhere in the zone or on a meridian.

Main Tendon

The bump in photo 20. following is the pronounced outline of the flexor digitorum brevis (image 2. following), the large tendon that runs down the centre of the foot. This tendon is overlaid by the plantar fascia and needs to be kept loose and flexible to avoid issues such as plantar fasciitis developing.

Here it has become very tight, so it needs to be stretched and massaged to release the tightness. This will also reduce the equivalent tension that will be found in the corresponding muscles in this reflex area in the body and help keep them flexible.

photo 20.

image 2

Feet Reading Assessment

As the book progresses and we cover more ground, these assessments will get longer. But of course, the in-depth noting of multiple physical and emotional issues does not mean the person is or has been very ill, nor has serious mental health issues. 

It only means that the appearance of the feet provides us with an amazing picture of the unique and complex history of the health and wellbeing of that individual. Their multiple visual indicators give a record of every physical and emotional challenge the person has faced throughout their life as a human being and constantly changing living organism.

photo 21.


The ankles are a good width apart, but the upper feet present too closely together. This may be a chronic posture showing long-term tension up the legs or a temporary position adopted at the treatment.

We can look for clues as to other indicators for which it is. But regardless of the cause, we will need to get the feet a little more relaxed and roll slightly outwards to work them properly.

However, the feet do appear fairly symmetrical. The right one is slightly wider than the left, but otherwise, they are without significant size or shape disparities. This shows some balance between the two sides of the body.


There are noticeable bumps at ascending and descending colon reflexes over both metatarsal tuberosities. The bumps are also bulging out onto the knee reflexes, which in terms of the musculoskeletal system, would equate to great pressure on the knee joints and tension in the attached muscles of the legs. This means that the unrelaxed presentation of the feet is at least partially due to leg tension and a chronic, not temporary, condition. The shoulder joint reflexes at the heads of the 5th metatarsal toes also look very pronounced and indicate tension in the shoulder joints which will carry on down into the arm muscles. Overall, the length of the lateral edge of the feet/body looks very tense. The bumps on both the knees and shoulders look like they are due to bone protuberance due to a lack of fat pad cushioning and some tissue swelling on top (see section lower down on tissue). Palpating them to feel their textures would confirm this.


The most obvious anomaly is the distorted and bent shape of both toes 2, which shows extreme tension in the head and shoulders in zone 2. It also forms a barrier to energy flow between the head and the rest of the body in this zone. Toes 2 are also very separate from the toes on either side, showing a wide gap in connectivity with those zones and a great deal of disjointed thinking.

Otherwise, the proximal joint of both halluces is fairly well aligned with the metatarsal, so the neck is fairly straightly aligned with the shoulders. But the distal joints of the halluces both deviate laterally, showing that although the neck is straight, the client is prone to leaning their head from side to side. This means the cranium is weighing down into both of the TM Joints and compressing the top of the neck on either side as they do this.

The smaller toes, 3, 4, & 5, on both feet are bunched up, and the necks are not visible. This shows the shoulder girdle here is hunching up towards the head, and the tension is also going up into the neck and face in those zones.


A mass of lines is evident over these feet, which look dehydrated. There are also short but defined lines across at the base of the distal joint in both toes 2, especially the right. This would indicate stress at the eye/eye sinus, which along with all the other indicators of problems with this toe, would definitely show issues here.

Short stress lines on the lower cervical spine show compressed vertebrae. They appear on the vertebrae that supply nerves to the organs in the neck and throat, including C7. This is the vertebra from which the nerve that supplies the thyroid leaves the central nervous system. And there are lots of lines over the heart reflex in left foot zone 2.

The most noticeable lines are a great deal of very narrow track lines running over both kidney reflexes showing continuous pathogenic overgrowths, possibly indicating infections. There is also a long vertical connector line running down zone 2 over both kidney reflexes, especially noticeable on the left one. All these lines show a great deal of pressure on the functioning of those organs.

Many stress lines are coming into both heels emanating from the lateral edge of the feet. These lines are another indication of tension in the hip & leg muscles and that the very upright presentation of the feet may be chronic. And as they run over both heels, it also means there is tension in the gluteal muscles and pressure on the sciatic nerve and the helper reflex for the ovary/testes, which is found here. 


There is obvious inflammation over the hepatic and splenic flexures and over the heels/gluteal muscles, where the red is more like crimson, so the inflammation may be quite acute. This redness at the flexures has a yellow undertone, so there is also toxicity. There is also some lesser inflammation at the shoulder joints. All the toes look slightly inflamed, but the redness is most noticeable over the medial edge of the toe pad and the ball of the halluces.

The area over and surrounding both kidneys has a slightly yellowish tinge, indicating toxicity.


The abundance of very evident lines shows these feet to be dehydrated. And the hard skin, especially at the flexures, shows impacted matter there, and dehydration affects the lubrication of the colon and movement of waste through the large intestine. The build-up of hard skin would also indicate a lot of pressure on the bones here through loss of fat rather than tissue swelling.

There is also hard skin at the medial edges of the halluces at the base of the cranium, caused by leaning the head from one side to another. This impacts the cerebellum area of the brain and means that there is an energetic block between putting thought into physical action and the brain’s two hemispheres.

Underlying texture

All the areas of congestion are made more evident because the feet are dehydrated. But there may also be a general age-related problem with the fat layer of the epidermis shrinking and collagen depletion, which makes variations in the underlying textures much more evident than they would be otherwise. 

The centre of the pads on toes 3 & 4 on both feet look slightly pronounced, so there is an issue with congestion at these sinus reflexes, which may also affect the outer eyes, inner ears, and eustachian tubes. The pituitary/hypothalamus glands are slightly swollen and off-centre, so there are endocrine imbalances.

Two areas over the spleen and liver look quite sunken and low in energy. And there is quite a bit of loose, sagging skin over the left foot zone 2 of the heart reflex, which is quite concerning.

There is obvious congestion at the hepatic and splenic flexures, which has already been mentioned. There is a lot of stippling texture over the small intestines caused by track lines from pathogens. These lines meet up with the rippling caused by the stress lines coming from the leg reflexes, and both together put massive pressure on the intestines. A smooth-looking area around zone 1-2 of the right gluteal/abdominal area may show congestion toward the lower small intestine.

photo 21. (repeated for ease of study)


The feet are presented very straight and upright, giving me the impression of someone who would take this stance as a person and that they are very concerned about being seen behaving correctly. However, the lack of cushioning of the feet shows that because of this, the person is very hard on themselves. But the symmetrical size and shape of both feet indicate someone well balanced and has dealt with significant changes or upheavals. 

But there are clear gaps between the toes showing quite a lot of mental dissonance and lack of joined-up thinking. The shape and isolation of the eye toes show concern over what they see and/or what they choose to see, causing tension. The three smaller toes are bunched up, so there is an element of not wanting to hear something and hunching up their shoulders around their neck defensively. The bunching up also means these toes’ neck/throat reflexes are compressed, which means an inability to speak out or tell the truth about what they are hearing.

There is also a blockage between mind/body and thought/action, shown by the hard skin at the base of the cranium/cerebellum reflex on the medial edges of both halluces. This reflects an element of ‘overthinking’ due to a lack of confidence in putting their thoughts into action. The pituitary reflex is slightly pronounced, showing an overactive gland which may result in mood swings. And it is definitely off-centre on both halluces, so there is an element of emotional conflict demonstrated by this and lack of ‘centring’ of their thoughts.

The area around the heart zone 2 left foot has very loose skin giving the impression of a dearth of energy there. But this is not due to cynicism or loss of interest but because it has been completely emptied out emotionally. And very noticeable sunken areas show depletion in the liver and spleen, so they are not good at getting what they need to nourish themselves emotionally. This is also reflected in the stippling texture of the intestines. It shows multiple challenges regarding nourishing themselves and self-worth related to feelings about their primary carer as a child.

There are a lot of lines, showing many stresses in their life, but a lack of cushioning shows they are not good at protecting themselves. They are not kind to themselves and prone to choosing the hard rather than easy options. The lines over the kidneys, especially, show the innermost core person; their inner child has been subject to many stresses and had to fight off many challenges. The yellowish tinge over the kidneys indicates a lot of residual emotional toxicity around this.

This is also shown by the evident accumulation of waste at the flexures, which shows someone hanging on to old emotions and resentments for a long time. Anger is associated with this holding on as the swollen area is quite red, so these feelings are toxic and cause a significant emotional blockage.

But the most inflamed area is the deeply red heels, showing the anger is long term but still felt acutely in the present time. The area’s stress lines show family and/or reproductive or sexual issues. And the upright presentation of the feet means a lot of tension in the pelvic area and their feelings around this area of life are not relaxed.

This is the Q&A section, so please go ahead and comment on this chapter if you wish. If you want to ask me something privately so only I can view it, make a note and I will not make it visible to others. 

Unfortunately, it isn’t possible to notify you when your comment has been approved, so you will need to check, but I aim to approve them all within 48 hours. You can also scroll down to go directly to the next chapter.

Leave a Reply

Your email address will not be published. Required fields are marked *