RAoA Conference Launceston, Australia 2012

Ayurveda is the ancient, traditional health system of India. Ayurvedic Reflexology provides a unique and dynamic approach to healing by bringing together the principles of Ayurveda with contemporary Western Reflexology.

Ayurvedic Reflexology encourages homeostasis by helping to balance the flow of subtle energy (prana) in the body. New opportunities emerge for therapists as they become familiar with the locations and characteristics of powerful energy points (marmas) on the hands and feet.

The techniques that are used in the application of Ayurvedic Reflexology, are considered by many reflexologists to be much easier on the hands than the standard thumb and finger walking techniques.

Ayurvedic Reflexology, a synthesis between Eastern and Western knowledge, provides reflexologists with an exciting and innovative approach to wellness, for themselves and their clients.

Ayurvedic Reflexology

By Sharon Stathis

For many years I travelled the globe training reflexologists in Ayurvedic Reflexology. It was exciting to introduce new and dynamic concepts that could be incorporated into more conventional foot and hand routines. Reflexologists with sore thumbs, fingers and wrists learnt new techniques that were kinder to their hands. The ongoing feedback from workshop attendees continues to be enormously encouraging.

Like any ‘good’ reflexologist, some hand and foot work were part of my personal daily health regimes. In early 2009 I became aware of the difficulty I was experiencing in performing my foot reflexology. I thought it was just ‘middle-age spread’. I new my reflexology routine had to change when reaching my feet became all but impossible.

As my abdomen continued to swell with cancer, hand work became my focus. It was at this time I realised the true benefits of hand reflexology, especially when incorporated with the principles of Ayurvedic medicine. My professional reflexologist continued with my regular foot sessions. I was responsible for daily hand work. We both used Ayurvedic Reflexology.

Ayurvedic Medicine
Ayurveda provides us with the oldest recorded system of medicine. The original principles of Ayurveda were developed by the great Indian sages (rishis) many thousands of years ago. Ayur (or ayus) means ‘life’ and veda and means ‘knowledge’. So, Ayurveda is the study of the knowledge of life.
The philosophy of Ayurveda states that there is no separation between the physical body and the mind. The Ayurvedic approach to health and wellbeing is based on the concept that there is a deep connection between mind, body and spirit. Ayurveda has a spiritual basis, and encourages individuals to embrace healthy spiritual practices.

Ayurveda strongly advocates that we embrace a harmonious and respectful relationship with Nature. Ayurvedic medicine is based on the Laws of Nature and utilises naturally occurring substances for healing purposes. These include herbs, vegetable oils, essential oils, minerals and gemstones.
Ayurveda has made significant contributions to other major medical systems such as Greek (Unani), Tibetan and Chinese Medicine. They share many similarities. In Ayurveda, the energy or life force that is present within every living thing is known as prana. In Chinese medicine this vital energy is referred to as chi (or qi). Health and wellbeing on all levels are dependent on prana.

Prana flows within the body through micro energy channels called nadis (similar to the Chinese meridians). These thousands of channels permeate the energy fields, including the dense physical form – the body. The nadis facilitate the flow of prana through the major energy centres, the chakras, and to all body areas. If the flow of prana is sluggish or blocked, the inevitable outcome will be an absence of health (dis-ease) within the organism.
Prana naturally flows, via major nadis, down through the limbs towards the fingers and toes. Ayurvedic Reflexology techniques support and reinforce this directional flow of pranic energy.

Ayurveda and health
The basic theoretical concept of Ayurvedic medicine involves three bioenergetic principles (doshas) that are involved with the regulation of all natural processes within the organism. Many readers will be familiar with the terms vata, pitta and kapha. These are the three doshas of Ayurveda.
In a similar fashion to the Chinese system of medicine, Ayurveda is based on a five element theory. Each dosha contains the five essential elements within it. The five elements of Ayurveda are earth, water, fire, air and space. Everything in the universe is comprised of these elements. This includes all animals – even us.

Practitioners of Ayurvedic medicine recognise and honour the uniqueness of each individual. It naturally follows that unique constitutional differences require individualised health management plans.

Ayurveda’s holistic approach to wellness is very different to the reductionist method of medicine that we are familiar with in the West. Usually, with the Western approach, people exhibiting the same outward symptoms are all treated in a similar manner.

Western medicine focuses on treating illness. With Ayurveda the emphasis is on prevention of illness rather than cure. As part of the preventative strategy, Ayurveda provides guidelines for wholesome daily living practices that will support an individual’s unique constitution, and help them maintain homeostasis. These practices include dietary regimes, exercise (usually yoga), meditation and self-massage.

Ayurvedic massage
Body massage is an integral part of the Ayurvedic system of healing. Massage promotes healthy growth in the young, helps adults maintain health and vigour, and is an aid in preventing the onset of degenerative diseases in the aged. Various forms of massage play a significant role in Ayurvedic treatments and in self-maintenance regimes.

Daily, self-massage is strongly encouraged to help an individual maintain health. Self-massage is usually recommended in the morning, before breakfast. A ten to twenty minute all over body massage with oil (usually sesame) is followed by a warm (not too hot) shower.

Shortcuts can be taken if time doesn’t allow for total body massage. Usually the head and several important, vital energy centres are a must. The areas of interest here that resonate with Western reflexologists are, of course, massage of the extremities.

Ayurveda encourages daily massage of the hands (hasta-abhyanga) and feet (padabhyanga) as an essential part of healthy living. Hand massage is usually applied in the morning. Alternatively, foot massage is often recommended at night, to calm the mind in preparation for sound sleep.

India is a country of great diversity. This diversity is reflected in the many and varied interpretations of hasta-abhyanga and padabhyanga techniques. Hand and foot massage can generally be summarised into three major components – applied hand techniques, kasa bowl work and marma therapy. These are the exciting additions to the Western reflexology regimes that make Ayurvedic Reflexology so special.

Applied hand techniques
Ayurvedic hand techniques will be familiar to exponents of Western style massage. They include lots of friction movements like rubbing and stroking, which stimulate the local cardiovascular and lymphatic circulations, and the flow of prana.

Friction movements can be applied in a variety of ways. Therapists can use the pads and sides of fingers and thumbs, the knuckles, the palms and the heels of the hands. Movements are usually applied briskly to stimulate local & systemic circulations, and can be helpful when applied with care over bony prominences e.g. bony joints of the hands and feet.
Rubbing and stroking techniques provide Reflexologists with effective and alternative ways to work reflex areas on the hands and feet. These movements might be a little challenging for those who have only used contemporary thumb and finger ‘walking’ techniques. I have used these alternative ways of working for many years, and found them to be fabulous!

I’ve come across so many reflexologists who reluctantly have given up or at least reduced their clinical practice due to the development of repetitive strain injuries (over-use syndrome) in their wrists and hands. The Ayurvedic Reflexology way of applying reflexology has brought relief and hope to many practitioners.

Ghee (clarified butter) is cheap and readily available in India, and used as a lubricant by some people for hand and foot massage. Sesame oil is traditionally the most commonly used lubricant for Ayurvedic massage. Care needs to be taken when purchasing sesame oil. Cold pressed and organic is best. The oil should be a straw colour and have a slightly sweet and ‘nutty’ smell..
Although it has its own therapeutic properties, sesame oil provides an excellent base for the addition of herbs and essential oils when a specific healing effect is required. Importantly, sesame oil provides just the right amount of ‘slip’ for friction work. Sesame oil is the perfect lubricant for Ayurvedic Reflexology.

Kasa bowl work
Metals are extensively used in Ayurvedic treatments. The Kasa bowl is an authentic Indian bowl manufactured at a cottage industry level in India. The bronze bowl is composed mainly of two metals, copper being the major metal component and tin the minor metal.

The Kasa bowl is traditionally used for massaging the soles of the feet and the palms of the hands. The conductivity of the metal interacts with the energy field of the body to aid homeostasis and help the body to function more effectively.

A well oiled kasa bowl is rubbed briskly on the palm of your hand to warm it. It is then applied to the skin of the client’s hand or foot with light, fast, stroking and circular movements. There is no need to hold the bowl tightly. If the bowl is well oiled, it can be held loosely, and easily guided over the skin.

Contact with the skin is not interrupted until the massage with the bowl has been completed. I know of no rules regarding the length of time the bowl can be used in a session. I would suggest starting with around three minutes. More or less time could be appropriate.

The kasa bowl plays a small but very important role in the Ayurvedic Reflexology routine. The action of the bowl is profoundly relaxing and adds an extra dimension to the Ayurvedic Reflexology procedure. The kasa bowl has been such an important and exciting discovery for me. I believe it has significantly added to the efficacy of my therapeutic work.

It is very important to clean the bowl well (physically & energetically) between clients.

Marma therapy
Marma means ‘sensitive’ or ‘vulnerable area’. Marma points were commonly mentioned in ancient Ayurvedic texts. However, valuable information on marmas may have been lost over time as a result of foreign invasions.

Today there is a resurgence of interest in marma therapy, particularly in the West. This is probably due to the popularity of yoga and its associated practices. One of the most interesting parts of my Ayurvedic journey has involved my research into marma therapy.

The marmas are the Ayurvedic equivalent of the Chinese acupuncture points. When comparing the two systems, there are similarities as well as many differences regarding the location, size and functions of these points. Marma points are larger than most acupuncture points and consequently much easier to locate.

There is considerable variation in the size of individual marmas. Small sites are referred to as ‘points’ and the large ones as ‘regions’. The average finger width of the person receiving the marma treatment is used as the unit of measurement (anguli) to locate the individual marma points and describe their size. The equivalent in the Chinese system is ‘cun’.

Marma points vary in size from half of one anguli to four anguli. Because of individual differences, the precise location of a marma point can vary from person to person. It is thought that the body contains over 200 marma points. Of these, 107 (some say 108) are considered to be major (or primary) marmas.
As with other Ayurvedic practices, there are regional differences within India regarding information about marma points. I found it difficult when sourcing information on marma therapy, as some of the factual information regarding marma points was contradictory, or at least, confusing.
Much of the information regarding marmas is still cloaked in secrecy. As a general rule, teachers of this ancient art will often only share the knowledge of the vital spots with senior, trusted students. So powerful are these points, that even today, Ayurvedic surgeons will avoid incising them.

Marma points act as ‘relay stations’ along the body’s subtle energy circuitry. If the marma points are functioning well, prana will flow along the nadis without interference. However, if they are not, energy will become sluggish or stagnant at the site of a marma point.

Traditionally, marma therapy is used to detoxify, tonify and rejuvenate. Currently the knowledge of these vital energy centres is used for diagnosing and healing energy imbalances. This is where marma therapy plays a vital role in health maintenance. Marma therapy incorporates the stimulation of these points to help maintain the optimum flow of prana.

Main benefits of Marma therapy:
• removes energy blockages and improves energy flow
• releases and eliminates stored wastes and toxins
• helps release stored negative emotions
• helps with stress reduction (calms the mind and emotions)
• eases fatigue and helps energise
• helps restore doshic balance
• treats specific health issues
• maintains health and aids prophylaxis
• assists rejuvenation therapy
• gives pain relief

I’m sure this list will be of great interest to reflexologists, as the benefits of both therapies are very similar. It is in the area of marma points (particularly location and function) that I draw comparisons with our contemporary reflexology.

Marma therapy techniques
As previously mentioned, there are varying points of view regarding the application of marma therapy. As a general rule it is best to use the thumb when working the marmas, as the thumb projects the main pranic power of the hand.

The marmas are massaged with gentle, brisk, circular movements. If using the right hand, the direction is clockwise. Conversely the left hand works in a counter-clockwise direction. (Some practitioners use only clockwise movements with either hand.) When appropriate, the thumb can be used to press or hold the marma point.

Essential oils can be used on the marmas to enhance the effect of the treatment. Herbalised oils can be applied to the marmas to treat specific doshic imbalances. The marmas can be treated with various forms of heat applications.

Yogic breathing techniques (pranayama) can also influence the therapeutic effect. Chanting of mantra (mantra chikitsa) can help to clear and energise marmas. Visualisation of specific colours can be effective. Colour visualisation can be used with mantra. Crystals can be used.

These powerful points need to be treated with care and respect. It is important to have appropriate knowledge before applying specific healing techniques to the marma points. As in other powerful natural therapies there are also the mandatory ‘do’s’ and ‘don’ts’ associated with marma therapy.

Suggested guidelines for energising marma points
I would like to begin by sharing with you that both Dr. Avinash Lele and Dr. Subhash Ranade (co-authors of Ayurveda and Marma Therapy) have confirmed with me that working each individual marma point on the hands or feet during a reflexology session will not do any harm to the recipient. In fact it will be beneficial in helping to direct the prana. They have suggested each point be worked for approximately thirty seconds.

The following guidelines have been complied from information received in a study session I had with Dr. Subhash Ranade in Pune, India in December 2005. They are in reference to working an individual marma point for specific therapeutic purposes.
• Never use force on a marma point. (A marma point can be held or massaged.)
• Use an appropriate skin lubricant when working marma points.
• Always work marma points with the same name on both limbs, in the same session.
• Use the thumb to massage each point in a clockwise direction.
• Begin by massaging each point for 30 seconds per day.
• Slowly build up to a maximum of 3-5 minutes per point daily (by the end of the first week).
• Stop working a marma point after 3 continuous weeks.

Here are a few more guidelines and some further information. The reason for using a suitable lubricant when massaging marmas is because excessive friction may be caused if the skin is too dry. Excessive friction can aggravate (vitiate) the doshas and create energy imbalances.

Marma therapy will be more effective if the hands or feet are massaged first, before working the marmas. Massage opens the energy in the local area, causing it to be more receptive to marma work. In short, an area is vigorously massaged before marma therapy to stimulate energy flow. It can be briefly and gently massaged afterwards, if required, to quieten and calm the area.

According to Dr. Avinash Lele, it is traditional practice that no more than five marmas are treated at one time. Isn’t it fortunate that there are five primary marma points on each hand and foot! Dr. Lele has asked me to reinforce amongst reflexologists that they remain aware of their current limitations. He is confident that in the 21st century, more information about the nadis and the marma points will become available, and then the work will become more popular. I eagerly await the arrival of new information!

Marmas and reflexology today
Reflexologists and massage therapists are already working marma points every time they work the hands or feet. Unfortunately, most don’t know they are doing it. Knowledge of marma therapy can greatly enhance therapeutic outcomes for clients.

Having knowledge of these vital energy centres was invaluable for me when I was very ill with cancer. I was able to work the points on my hands to improve the flow of prana in my body, and to help reinforce my severely compromised immune system.

Ayurvedic physicians palpate marma points at the skin surface for diagnostic purposes. Signs of energy imbalances at the site of marmas can include characteristics such as heat, cold, dryness, dampness, redness, pallor, swelling, and various forms of touch sensitivity, which range from dull ache to sharp pain.

Reflexologists routinely attribute such symptoms and observations on the hands and feet to localised problems, or maybe some form of dysfunction in related reflex areas. Now there can be another explanation. Congestion at marma points may indicate energy imbalances.

There are many techniques for working the marmas, and all involve working with care and sensitivity. Marma therapy is powerful and is best learnt from an experienced professional. I agree with Dr. Lele that the practice of marma therapy will expand and develop in the near future, particularly amongst energy-based therapists.

Marma points on the hands and feet
There are five (some say more) marma points occurring in each hand and foot. Identical points are located on opposing limbs. Many of these marmas influence peripheral circulation as well as hand and foot function.

This information is invaluable for reflexologists and massage therapists who are working with clientele who may be experiencing problems in these areas. The incorporation of appropriate marma point work into reflexology and massage sessions adds an exciting dynamic when therapeutic outcomes are being considered.

Marma points on the hands
The above diagrammatic representations of the marma points on the hands include additional locations for the Kurchashira marma points on the ulna side of the wrists, according to an eminent Ayurvedic body-worker, Harish Johari (author of Ayurvedic Massage).

Limited space permits me to describe the characteristics of the hand points only. The marma points of the feet are very similar. I have provided phonetic pronunciations and a brief overview here of the location and size of the points, plus the benefits of massaging them.

Manibandha (mah-nee-bahn-dah) marma
locations (anterior & posterior): immediately proximal to the wrist crease, approximately half way across the wrist
size 2 anguli
• energises the reproductive system
• helps reduce excess fat deposits
• promotes healthy joints and bone growth
• helps relieve skeletal pain
• assists the flow of prana to the hands
• maintains functional movement of the hands by influencing the health of the hand joints

Kurchashira (koorr-chah-shee-rrah) marma
locations (anterior & posterior): 1 anguli distal to the wrist joint, between manibandha & kurcha (Johari identifies additional sites on the ulna side of the wrist crease)
size 1 anguli
• helpful for digestion
• helpful for reproductive function
• promotes visual acuity
• calms the nervous system and the vata dosha
• promotes a healthy muscular system
• has considerable influence on the muscles of the hands

Kurcha (koorr-chah) marma
locations (anterior & posterior): palmar and dorsal surfaces, extending across the hand; main site is beside head of 1st metacarpal, approximately one anguli proximal to Kshipra
size 4 anguli (main point as marked)
• aids digestive processes
• improves flow of Prana, particularly to the head
• helpful for overall sensory acuity
• promotes visual acuity
• helps relieve mental stress
• aids mental acuity

Kshipra (ksheep-rrah) marma
locations (anterior & posterior): distal webbing between first and second fingers (the webbing between the other fingers is also important)
size 1/2 anguli
• supports heart function
• provides lubrication for the heart
• supports lung function
• provides lubrication for the lungs
• stimulates the lymphatic system
• improves the flow of prana to the whole body

Talahridaya (tah-lah-hrree-die-ah) marma
location: the centre of the palm of the hand
size 1/2 anguli
• supports heart and lung function
• helps strengthen the immune system
• aids circulation in the upper half of the body
• good for giving and receiving healing energy
• is calming
• controls the motor function of the hands

Ayurvedic Reflexology
We have already established that Ayurvedic Reflexology is the dynamic combination of traditional Indian hand and foot massage philosophy and techniques, with that of contemporary reflexology. The natural integration of these two powerful therapies provides therapists with new perspectives and new opportunities to enhance their current regimes.

Let’s look now at specifically combining Ayurvedic techniques with reflexology. Ayurvedic Reflexology is not a complicated procedure. The benefits, special care and contraindications associated with Ayurvedic Reflexology, are the sum total of those relating to Ayurvedic hand and foot techniques, and those relating to contemporary reflexology.

Contraindications and special care
Western trained reflexologists are already familiar with special needs and contraindications associated with their therapy. After an extensive literature search, I was unable to find any contraindications to padabhyanga or hasta-abhyanga.

The following list of contraindications to padabhyanga was sourced from a teleconference I had with Dr. Lele in January 2006. Most of these contraindications are similar to those associated with reflexology. According to Dr. Lele, the contraindications to padabhyanga are: toxin induced coma, lymphatic infection, blood infection (e.g. septicaemia), thrombosis, thrombophlebitis. Contraindications to hasta-abhyanga are similar.

The benefits of padabhyanga, hasta-abhyanga and reflexology are almost identical. They are also similar to the benefits of marma therapy (listed under the heading “Main benefits of marma therapy”.) The benefits of Ayurvedic Reflexology are the combination of all of these.

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

The benefits of hasta-abhyanga are the same as the above if “hands” and “arms” are substituted for “feet” and “legs” respectively. The only exception is the last bullet point “ helps prevent sciatica”. It is my personal experience that footwork is the most effective here.
Ayurvedic Reflexology procedure guidelines
In all forms of Ayurvedic massage, emphasis is placed upon the preparation of the massage therapist. If the therapist has a pure heart, is well prepared (mentally, emotionally, physically and spiritually) and is focused, the healing process will be enhanced. This principle also applies to Western bodywork.

I have included below, general principles that are usually observed during the application of Ayurvedic massage. There are many different forms of massage, and many and varied interpretations of those forms. This list provides you with a general guide only. I am guided by these principles during the application of Ayurvedic Reflexology.

• In India it is preferred that the professional therapist and the client are the same sex – for psychological comfort. (In the West this is not usually practical for Ayurvedic Reflexology.)

• At the commencement of the massage, the practitioner energises his/her hands. This is repeated, as required, during the session.

• Ayurvedic massage is generally brisk and stimulating, especially when used for prophylaxis.

• When massaging a male, the right (solar side) hand or foot is massaged before the left. When massaging a female, the left (lunar side) hand or foot is massaged first. The lateral side of the hand or foot is massaged before the medial side.

• Prana naturally circulates along the limbs in the direction of the fingers and toes, through the hands or feet to the tips of the digits. This directional flow is reinforced during massage.

• Skin areas over joints are usually worked firmly (unless inflamed) with circular movements to improve the local circulation and to release any stagnant prana or vata.

• Massage oil is always warmed before application, preferably over water.

• Traditionally a bowl of salty water is placed near the massage table to absorb any negative energy that might be ‘flicked’ towards it.

Procedure Summary
The hands-on component of my clinical Ayurvedic Reflexology sessions usually lasts from forty to forty-five minutes. I complete one hand (or foot) before moving to the next, and work the two hands (or feet) in their entirety. This includes meaningful work on the dorsal surfaces, ulna sides of the hands and the lateral sides of the feet. During my travels, I have observed that these areas are sometimes neglected by Western reflexologists.

The Ayurvedic Reflexology routine, applied to the hands or feet, can be summarised into four areas of action applied in the following order: mobilise, stimulate, energise, finish. I will provide here a brief overview of the techniques that are used, with some of their localised and systemic effects.

1. Mobilise
Techniques include shaking, stretching, pushing, kneading and rotating. Mobilisation loosens muscles, tendons and ligaments. Joint mobilisation helps mobilise stagnant vata dosha and prana that may have accumulated in the joint spaces. I recommend using minimal oil with these techniques.

2. Stimulate
Techniques include friction movements that can be applied with the pads and sides of fingers and thumbs, the knuckles, and the palms or heels of the hands. Direct thumb or finger pressure can also be used here. Stimulating techniques have a direct affect on the circulation of blood, lymph and prana and offer reflexologists alternative ways to work reflex areas.

3. Energise
Energising work is done with the kasa bowl and by working the marma points. The specific benefits and application techniques of kasa bowl work and marma therapy have already been discussed. In summary, the goal of these two wonderful techniques is to enhance the flow of prana and help balance the doshas.

The kasa bowl plays a small but very important role in the Ayurvedic Reflexology routine. The action of the bowl is profoundly relaxing and adds an extra dimension to the reflexology procedure. Clients really enjoy the warm, soothing feeling of kasa bowl work. I regularly use the kasa bowl on my own feet, and it really does feel fabulous.

On any given surface of the hands or feet, the marma points are worked after all the mobilisation, stimulating techniques and kasa bowl work have been completed. Marma point work is subtle, and further work in the area could cause energy disruption. The majority of marma points can be worked from more than one aspect i.e. medial &lateral;, anterior & posterior. I routinely work each aspect of a point for thirty seconds (as recommended by Drs. Lele & Ranade) during a session.

4. Finish
The finishing movements are slow and gentle in comparison to the stimulating techniques. Long, slow effleurage movements work well here. They help to consolidate the procedure, and leave the receiver feeling nurtured and relaxed.

Out of respect for yourself and for the person you have been working with, I strongly encourage the use of techniques that formerly separate the energy fields of giver and receiver. This is usually done after the last point of contact, and leaves both energy fields separate and intact.

Whether applying Ayurvedic Reflexology to others or yourself, the order still remains the same – mobilise, stimulate, energise, finish. Obviously, techniques will need to be modified when doing your own foot or hand work.

The above techniques are the dynamic additions that I combine with my knowledge of the reflex areas of Western reflexology. This amalgamation of Eastern and Western healing traditions is the cornerstone of Ayurvedic Reflexology. I hope you will be inspired to explore and discover this new approach to healing for yourself.
©Sharon Stathis 2012