RAA Conference Tuscon, USA 2006

SummaryThis paper introduces the concept of Ayurvedic Reflexology. This is a dynamic modality that the author believes illuminates the roots of contemporary reflexology.

Some of the history and philosophies of Ayurveda are discussed. Particular attention is paid to Padabhyanga. The principles associated with its application are discussed in some detail.

Techniques of Kasa bowl work and the dynamic Marma Therapy are discussed, as well as how these can be integrated into current reflexology practices. The author hopes this presentation will inspire many of you to investigate the possibilities that Ayurvedic Reflexology has to offer.

Ayurvedic Reflexology

By Sharon Stathis

I would like to introduce you to Ayurvedic Reflexology. It is a new term which describes a dynamic healing modality that successfully integrates traditional Ayurvedic bodywork techniques with the knowledge of contemporary Reflexology.

I’ve titled this presentation Ayurvedic Reflexology – ancient or new? The question I ask is this. Has the Reflexology that we practise today, emerged from the discipline of Ayurvedic medicine? 

Johari, when discussing reflex points on the feet, states  “A physician who studied these points while he was visiting India determined the connection of these points with internal organs and thus began foot reflexology as it is known in the West.” 1  I wonder if he was referring to Dr. William Fitzgerald? 
Of course, hand reflexology has an important place within our practice of reflexology, and is certainly not neglected in Ayurvedic Reflexology.  Ayurvedic Reflexology can be successfully applied to both  hands and feet. 

One of the most exciting aspects of my presentation involves vital energy centres located on the hands and feet called Marma Points. Once you are aware of theses points, you will begin looking at some of the reflex areas from a very different perspective.

So little is known about marma therapy in the West. According to Atreya Smith “Marmas are similar to the pressure points used in reflexology and acupressure.  In fact, it is the system of marmas that is the origins of these systems and acupuncture. Their use in the context of the Ayurvedic system greatly enhances their results.” 2

Historically, the knowledge of the marmas, which belongs to the ancient Ayurvedic system, pre-dated the Chinese system that uses energy meridians and vital energy centres, the acupuncture points. The Chinese have developed a wonderful system for health and healing that is well used throughout the Western world today. I believe the practice of Marma Therapy will experience major expansion and development in the near future, particularly among vibrational (energy-based) therapy practitioners such as reflexologists.

Ayurvedic Reflexology provides a significant addition to our knowledge base. This form of reflexology is dynamic. It is uncomplicated and easy to apply.  It is easily integrated into current practices. It is also safe, effective and feels wonderful. An added bonus – it is described as being “kinder to the hands”.
We all have a working knowledge of reflexology, but there are probably few here today that understand the complexities of Ayurvedic medicine. To have a greater understanding of Ayurvedic Reflexology, we need to take a brief look at the principles on which Ayurveda is based.            

What is Ayurveda?
History and Philosophy
Ayurveda means ‘the science of life”. It is the ancient, traditional healing system of India. Written records of Ayurvedic medicine date back approximately 4,000 years.  However, well before that time, the knowledge of Ayurveda was passed on through the spoken word and by observation. 

Ayurvedic medicine relies on Nature to provide all the necessary ingredients to heal a sick body, and then to keep it healthy. The healing and wellness programs of Ayurveda utilise plant oils, aromatic oils, herbs, minerals, gemstones, heat, cold, colour, sound and taste. The goals of Ayurveda embrace freedom from disease, personal happiness and fulfilment in all areas of life, and a harmonious and respectful relationship with nature.

Ayurveda is a truly comprehensive healing system. Ayurveda explains the totality of the relationship between the whole being (physical, mental, emotional and spiritual aspects) and the universe.  It views the human being as a microcosm of the macrocosm. That is, the human body is a small model of the universe, composed of the same five elements common to all of Nature. These elements are earth, water, fire, air and ether.

The body is composed of three bio-energetic principles called ‘doshas’. They are called Vata, Pitta and Kapha. The word Dosha means “that which changes”.  These dynamic energies are in a state of constant change and balance.  When in equilibrium, the doshas support healthy physiological and psychological function.

The major body constituents (dhatus) are influenced by the doshas. The doshas can be regarded as the supervisors and the dhatus, the workers. If the energetic balance of the doshas is disturbed, the dhatus will be affected, and disease will be the unwanted outcome.

Usually one or maybe two of the doshas will predominate in each of us at any given time, displaying specific physical, mental and emotional characteristics that relate to the dominant dosha(s). Each dosha consists of a pair of elements combined to form a dynamic life force with specific characteristics. 

The doshas and their associations are:
Vata is a combination of air & ether   
Vata is associated with dryness and wind dominance. 
Vata is responsible for movement occurring within the body.

Pitta is a combination of fire & water  
Pitta is associated with heat and bile dominance.
Pitta is responsible for heating processes occurring within the body.

Kapha is a combination of water & earth     
Kapha is associated with moisture and phlegm (mucus) dominance.
Kapha is responsible for lubrication and cohesion in the body.

Although the three doshas are active in all parts of the body, there are concentrations of each dosha in particular areas.  There are some variations regarding this information in different texts.  

The primary locations of each dosha are:
Vata  – colon 
Pitta  – small intestine and stomach
Kapha-  lungs (and respiratory passageways) and stomach

A healthy immune system is dependant upon the successful elimination of wastes (malas) and toxins (ama) from the body. The body produces three major wastes (faeces, urine & sweat) which must be effectively excreted to maintain wellness.

It is considered that an imbalance of Vata dosha is a major contributor to disease processes. An excess of Vata is often associated with poor elimination of faeces from the colon (the primary location of Vata).   When this occurs, toxins are reabsorbed through the lining of the bowel.  Appropriate detoxification procedures used in Ayurvedic medicine could include the use of herbal laxatives, massage and enemas. 

Each of the three doshas is divided into five subdivisions called subdoshas. Each subdosha influences specific body functions. Dr. Randolph Stone, of Polarity Therapy fame, related the five Vata subdoshas to the five longitudinal zone lines on the soles of the feet.  He said that physically working these lines would help to balance Vata and stimulate the flow of Prana in the body. 3  Prana refers to the vital life force circulating within the body. One of the techniques in the Ayurvedic Reflexology procedure involves working the individual zones of the foot from the heel to the toes to help facilitate this balance.

Ayurvedic philosophy views disease as a helpful message that some negative patterning in our life needs to be changed. An Ayurvedic principle is that a healthy, strong immune system will not allow disease to manifest in the body. Therefore considerable emphasis is placed upon the maintenance of the immune system i.e. upon disease prevention rather than cure.

Preventative measures include detoxification with regular internal cleansing. Pre-detoxification procedures are  carried out prior to purification. They include massage with herbalised oils followed by sweat therapy to remove accumulated toxins.

Prana refers to the energy or vital life force of the Universe. Within Ayurvedic philosophy, wellness and the ability to heal are dependant upon the unimpeded movement of this energy within the body.

There are several types of energy centres or pathways that facilitate the circulation of Prana throughout the body. They are primarily the chakras, the nadis and the marma points. These centres and pathways connect the physical body to the mind and to higher consciousness. 

Chakra is a Sanskrit word for ‘wheel’ or ‘disk’ and indicates movement. The chakras are interconnected energy centres.  Seven of these align with the midline of the body and are referred to as the major chakras. Due to their positioning along the spinal column, they have a considerable influence on the nervous system. They also have a strong influence on the endocrine system.

Nadis are fine energy pathways which form a network throughout the body. There are fourteen major nadis. They all emanate from the first chakra at the base of the spine, and distribute Prana from the chakras to the various body areas.  

“Two special nadis supply Prana to the right and left sides of the body including the arms and legs.  Many different marmas occur in the field of these two nadis, which are very important for marma therapy. They are connected to both the navel and heart chakras, which govern the hands and feet as motor organs and the flow of energy through them.” 4  These nadis primarily end at the tips of the thumbs and big toes. This is of special significance to reflexologists.

Marma points are sensitive, energy centres of varying size and function. They are located at the skin surface and within internal organs. They are connected to the nadis, and can be treated to influence the flow of Prana to the various body tissues. Marma points are discussed in detail below.

Massage is probably the oldest form of medical treatment. Ayurvedic massage improves the flow of Prana within the body. Massage is an integral part of the Ayurvedic system of healing. Sushruta (considered the father of modern surgery), an Ayurvedic surgeon from the classical period of Ayurveda, stated that the head, ears and feet are the most important areas to massage.     
Padabhyanga, as previously stated, is Ayurvedic massage of the feet. It has several components which are discussed below:
1  a combination of various massage techniques
2  kasa bowl work
3  Marma Therapy (Marma Chikitsa)

According to Dr. Avinash Lele (International Academy of Ayurved, Pune), Padabhyanga is used to pacify Vata
and support polarity (the energetic balance between the feet and head). He states that Padabhyanga works through the nervous system.  As the mind (governed by Vata) becomes agitated during the day, the doshas become unbalanced. This is why Padabhyanga is so effective when applied at night.
Padabhyanga can be used as a stand alone therapy, or in conjunction with full body massage. It lends itself well to professional clinical practice and for home use.  It is widely recommended that padabhyanga be performed in the home as a daily ritual, especially before retiring at night.

“According to the Indian scriptures, diseases do not go near one who massages his legs
and feet from knee to toes before sleeping, just as snakes do not approach eagles.” 5

Benefits of padabhyanga include:
• helps calm the mind
• promotes quality sleep
• promotes blood circulation in the feet and legs
• nourishes the skin on the feet and prevents cracking
• aids foot health (alleviates pain, improves muscle tone and strength)
• helps maintain eyesight and hearing
• helps prevent sciatica
• helps calm and maintain the vata dosha

Contraindications to Padabhyanga
According to Dr. Lele, the contraindications to Padabhyanga are: toxin induced coma, lymphatic infection, blood infection (e.g. septicaemia), thrombosis and thrombophlebitis.

Lubricants are used in Ayurvedic treatments to facilitate massage techniques and enhance the therapeutic effect. They include plant oils, ghee (clarified butter) and fine powders. Massage oil is always warmed before application, preferably over water.

Although the plant oils have their own therapeutic properties, they are also used as suitable vehicles for the addition of herbs and aromatic oils to help obtain the desired healing effect.

The most common oil used for Ayurvedic massage, including Padabhyanga, is sesame oil.  It is considered tri-doshic in quality i.e. suitable for Vata, Pitta and Kapha. Sesame oil is rich in fat soluble vitamins, has a high mineral content and excellent keeping qualities.  It is a powerful antioxidant and serves as a suitable base for making herbalised and medicated oils.

Padabhyanga and Ayurvedic Reflexology Techniques

1 Massage techniques
The hand techniques used in Padabhyanga are predominately friction movements such as rubbing and stroking. They are usually applied vigorously to stimulate local circulation and energy flow. 

Emphasis is placed on rubbing bony prominences and joint areas, as this is where Vata and Prana are stored. Overworking these areas is contraindicated if the joints are inflamed. Prana in the leg and arm circulates in a downward direction towards the toes and fingers. This energetic flow is reinforced by stroking the foot from the heel to the toes and the hand from the wrist to the fingers.

2 Kasa bowl
The kasa bowl that I use is composed of copper and tin. The rounded surface of the warmed and well oiled bowl is rubbed on the plantar surface of the foot and the palm of the hand in circular and stroking movements. Care needs to be taken over bony prominences. 

Using the bowl on these surfaces helps draw toxins from the body. It also helps regulate the heating processes that occur in the body. The kasa bowl adds an extra dynamic when used on depleted reflex areas and marma points. Last but not least, clients report that they really enjoy the unique sensation that kasa bowl work imparts.

3 Marma therapy (Marma Chikitsa)

Marma therapy
History and Philosophy
Marma means ‘sensitive’ or ‘vulnerable area’.  Marma points were commonly mentioned in ancient Ayurvedic texts.  Unfortunately, valuable information on marmas was lost as a result of foreign invasion. Today there is a resurgence of interest particularly in the West, probably due to the popularity of yoga and its related practices.

As with other Ayurvedic practices, there are regional differences within India regarding information about marma points. This includes the spelling, the location and the size of individual points and regions. There are also different philosophies regarding the methods of treating the marmas. Today the knowledge of marmas is used by professionals and lay people to address specific health issues and to help maintain health and wellbeing.

What are marmas?
In both ancient and modern texts, the definitions of marmas are many and varied. They (marmas) “are primarily ‘energetic centres’ where the life-force accumulates and flows. Treating them is more a means of treating Prana (the electricity running through the body) rather than simply working on physical tissues and organs (the light bulbs that carry the electricity)”. 6

The body contains 107 major (primary) marmas. The size of the marmas varies. Small sites are referred to as ‘points’ and the larger ones as ‘regions’. The specific influence on body function, and individual relationships with the internal organs, varies between marma points.

Why are marmas treated?
Marma therapy is used to detoxify, tonify and rejuvenate. The significance of marma therapy cannot be overestimated. Effective marma therapy impacts upon all factors associated with the chakras, including the nadis. 

“Treating them (marmas) can release negative emotions and remove mental blockages, including those of a subconscious nature (like addictions). This means that there is an important psychological side to their treatment.” 7  

To demonstrate how profound this therapy is, Frawley et al states that “Through working on marma points, we can control our Prana. Through Prana we can control our sensory and motor organs, and eventually our entire mind-body complex,” 8 
Benefits of marma therapy include:
•  removal of energy blockages that impact on all aspects of health
•  improving flow of energy
•  releasing and eliminating stored wastes and toxins
•  releasing stored negative emotions
•  helping with stress reduction (calming the mind and emotions)
•  treating specific health issues
•  maintaining health
•  aiding prophylaxis
•  assisting rejuvenation therapy
Methods of Marma treatment
Marma therapy is dynamic, and warrants respect and sensitivity during its application. If the therapist is focused, the healing process will be enhanced. It is recommended that a suitable lubricant is used when massaging marmas, as excessive friction can create imbalances within the doshas. As a general rule, an area is vigorously massaged before marma therapy to stimulate energy flow, and gently massaged afterwards to quieten and calm the area.
The methods for treating marmas are quite diverse. Commonly used methods include: holding, gentle massage, massaging with pressure , applications of vegetable oils , aromatic oils, medicated oils and herbal pastes. The use of yogic practices such as meditation, specific breathing techniques (Pranayama), and chanting of mantras can also help to clear and energise marmas.
 “Aromatherapy for marma points is both one of the most powerful forms of aromatherapy as well as one of the best forms of marma therapy.” 9 The oils can be used directly on the marma points without the administration of general massage to the surrounding area. I consider the use of essential oils to be invaluable in this work.
The fingers or palms of the hands are used for Pranic healing. As a general rule it is best to use the thumb when treating the marmas as the thumb projects the main pranic power of the hand. “A practitioner with good Prana can achieve good results even without a great deal of technical skill or much time spent in treating a marma point” 10
I was taught that a simple and safe way to work marmas, is to use light, brisk, circular rotations with a well oiled thumb. When using the left hand, the thumb works in a counterclockwise direction, and clockwise when using the right hand. I firstly work each point in a counterclockwise direction (left hand), followed by a clockwise direction (right hand). I augment my own marma work with essential oils, heat (kasa bowl), pranayama, mantras and visualised colour.
Atreya states “In general, clockwise movements give and stimulate a marma (or the body) and a counter clockwise movement liberates and dispels blocked or stagnant prana. Some practitioners use only clockwise movements.” 11 
Marmas occurring in the feet and hands
There are five marma points occurring in each foot and hand. These points are identical on both sides of the body. As a general rule, when treating foot or hand marmas, the corresponding marmas on both limbs are treated in the same session. Some of the points can be accessed from both the anterior and posterior surfaces.  

Frawley et al states that  “Therapeutic regions, like marmas on the arms and legs, are the most important for treatment purposes.” 12 Also, four of the five marmas occurring in each foot and hand, directly affect aspects of foot and hand function. This is of significance to reflexologists who are helping clients with problems in these areas.

To help maintain health, self-treatment is recommended. “Many marma points, particularly those on the extremities of the body, are easy to reach for self-treatment with massage, acupressure, massage oils or aromatic oils. You can do this on a daily or weekly basis to aid energy circulation or to counter chronic ailments.” 13  I encourage and train my clients to use Marma therapy at home as an adjunct to their clinical sessions with me.

To treat for a specific therapeutic result, it is recommended that “the duration of massage for marma points should be three to five minutes twice a day.” 14 It is traditional practice that no more than five marmas are treated at one time.
Ayurvedic Reflexology, the combination of ancient Ayurvedic wisdom with the knowledge of contemporary reflexology, is an exciting new concept for reflexologists today.
As I have researched the connections between Ayurveda and contemporary reflexology, I have been excited by the interface between these two disciplines.  It is with enthusiasm that I pass this knowledge on to fellow practitioners, knowing that they will be able to use this knowledge to further improve the therapeutic outcomes of their clinical practice.

1.       Johari, H. Ayurvedic Massage  Healing Arts Press, Vermont USA, 1996. p. 62.
2.       Atreya (Smith) Secrets of Ayurvedic Massage  Lotus Press, Twin Waters USA, 2000. p. 58.
3.       Morningstar, A. The Ayurvedic Guide to Polarity Therapy: Hands-on Healing Lotus Press,   Twin Waters USA, 2001. p. 121.
4.       Frawley, D., Ranade, S., Lele, A. Ayurveda and Marma Therapy: Energy Points in Yogic Healing Lotus Press, Twin Waters USA, 2003. p. 47.
5.       Johari, H. op.cit. p. 62.
6.       Frawley, D. et al. op.cit. p. 29.
7.       Frawley, D. et al. op.cit. p. 34.
8.       Frawley, D. et al. op.cit. p. 41.
9.       Frawley, D. et al. op.cit. p. 68.
10.    Frawley, D. et al. op.cit. p. 65.
11.    Atreya op.cit. p. 68.
12.    Frawley, D. et al. op.cit. p. 29
13.    Frawley, D. et al. op.cit. p. 85.
14.    Frawley, D. et al. op.cit. p. 66.
©Sharon Stathis 2006