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What is reflexology and how do you become a reflexologist?

a reflexologist massaging their clients left foot during a session

Reflexology careers have gained popularity over the past few decades as people continue to seek out complementary and alternative medicine (CAM) options beyond the traditional medical system.

Manual therapies like reflexology are expected to maintain their upward popularity trend as the global CAM market is projected to grow substantially in the next few years and beyond.

In This Article

Today, practitioners of reflexology have the opportunity to make this rewarding field their full-time career. They may run private practices in their own homes, travel to client homes, or perform hands-on work in a chiropractic office or massage spas where they deliver treatment and work on building a solid client base.


What is reflexology?

Reflexology, also called zone therapy, is a manual therapy technique that posits that certain pressure points in the feet correspond to other areas or organs in the body. By applying pressure to these points, you can relieve tension and pain, and promote healing in the corresponding area.

It stimulates your nervous system

“Reflexology helps the body to balance itself,” Frank said. “Thanks to the work of [Dr. Manzanares] who has used reflexology in his medical practice for 45 years or more, we now know we are working through the nervous system. Dr. Manzanares took biopsies of foot tissue and found there’s an acceleration of nerve fiber in what we call deposits.

They can be globular and sometimes feel like a pellet or like grains of sand. It’s the body laying down extra nerve fibers. We send a stimulus up from that area on the reflex map and the nervous system responds—thereby ‘converse’ with glands, muscles, brain structures—every part of the body.”

A reflexologist explains reflexology massage

“In general, we say reflexology helps the mind and body normalize function. It increases circulation and soothes the nervous system, helping people go from fight-or-flight into what we call rest-and-digest,” said Linda Frank, a nationally board-certified reflexologist and instructor.

“We are engaging the parasympathetic nervous system. It’s predicted that up to 90% of doctor visits are stress related, so it’s not an insignificant thing that reflexology can really promote deep relaxation where the body can just do what it needs to do.”

Reflexology and your feet

Frank said that reflexology can be especially beneficial to us today because our feet don’t get the amount of stimulation that they were built to receive.

“We used to walk barefoot and essentially reflex our own feet over sticks and stones, but we don’t do that anymore. We stuff them in shoes, largely starving them of the opportunity to perform one of their vital functions as a sensory organ,” Frank said. “Feet are meant to give us feedback.”

Note: Reflexology is sometimes also referred to as footology because of its primary focus on feet. However, it also encompasses the manipulation of the hands, outer ears, and face as a means to potentially impact other areas of the body.


Benefits of reflexology

Reflexology has earned a place at the forefront of complementary therapies for its effectiveness in reducing stress and providing relief for common health problems like chronic pain and digestive issues.

Studies show, for example, that:

The benefits don’t end there either. Some common ailments that people seek out reflexologists for include:

  • Structural pain in areas such as the neck, back, hips, abdomen, and more
  • Foot pain
  • Headache, migraines, and insomnia
  • Digestive dysfunction
  • Sinus congestion and chronic sinus issues
  • Circulation problems
  • Respiratory system issues like chronic cough, asthma, and environmental allergies
  • Energetic blockages and trauma held in the body

Frank said that one of the reasons she loves her job is because she feels like she receives benefits as a reflexologist as well.

“I love it because I feel like I’ve gotten work when I’m giving work, and most of my students report that as well. They get energized and they feel better after they’ve been given a session.”


What does a reflexologist do?

Reflexologists often refer to foot reflexology charts to apply unique manual techniques to the client’s feet. These sessions typically last between 30 minutes to an hour and a half, depending on the services the reflexologist offers.

Many massage therapists choose to learn and get certified in reflexology so that they may offer this additional service to their clients. A reflexologist listens to the client’s health concerns and takes that into account in their session plan.

A firsthand account of on-the-job duties

“It’s incredibly easy to fill an hour. We do something called thumb and finger walking and what we’re doing is palpating for deposits, for areas of tension that we want to come back and spend some time on. Because where you have tension, you have reduced circulation,” Frank said.

“We are sending an impulse through the feet—oftentimes where there’s tenderness but we work the entire foot—so that any place that needs help, the nervous system can send a response back and help to normalize the function of that area.”


Reflexology schooling

If a reflexology career interests you, finding the right program can make all the difference to your success. A reflexology program should provide not only the technical training you will need to do the job, but also teach you fundamental business concepts to foster a thriving career.

Your reflexology courses should cover the following subjects:

  • History, theory, and techniques of the trade
  • Reflexology maps of the feet
  • Anatomy and physiology
  • How to customize sessions based on client-specific issues
  • Ethics and professionalism
  • Relevant business practices and marketing
  • Supervised classroom or clinical work

Tuition and length of study

Reflexology school programs generally take between six and twelve months to complete and involve approximately 150 to 300 hours of study combined with hands-on practice. You can expect tuition for a reflexology education program to cost approximately $3,000 to $6,000.

Reflexology specializations

Regardless of whether you are a full-time reflexologist or you include reflexology in another modality, Frank says there are many different massage specializations out there to learn and offer your clients. Some specializations include: 

  • Fertility
  • Children
  • Eldercare
  • Mental health
  • Vertical reflexology

“There are all these specialties now. The sky’s the limit,” Frank said.

To learn these specialties, you can take training courses instructed by professionals and receive a certificate of completion to add to your resume. For example, you can receive training in Sally Kay’s Reflexology Lymph Drainage (RLD) method or the Dr. Manzanares Reflexology Method (MRM).

Can I earn my reflexologist certification online?

Many reflexology programs consist of a combination of online and in-person learning. Because reflexology requires hands-on practice to really understand how to do it, you’re unlikely to find any fully online reflexology programs.

Furthermore, you need to complete a certain number of in-person training hours if you ever want to sit for national certification or become a member of the only national membership organization for this profession, the Reflexology Association of America (RAA). 

There are some online massage programs that will teach you the basics and grant you a certificate of completion, but this is not the same as a national-level certification. It’s in your best interest to find a program that includes in-person instruction and practice.


Reflexology certification and licensure

No matter where you live, completing a reflexology program and getting certified is the best practice if you want to boost your credentials. Even though most states don’t have licensure requirements for reflexologists, many reflexology associations recommend that you get certified by the ARCB and become a member of their organization to enhance your legitimacy as a competent reflexologist.

Requirements can vary by state

As mentioned, many states do not have licensure or certification requirements for reflexologists to practice besides having a business license issued by your city or county.

That being said, counties and municipalities may have their own requirements for reflexologists. Other states require you to have a massage therapy license in order to practice reflexology. The Reflexology Association of America (RAA) provides a summary of state laws that can help guide your search.

States that require a license

The exceptions are North Dakota, Tennessee, New Hampshire, Washington, and Nevada—these states require reflexologists to obtain a reflexology license or register with their state health department.

To do so, applicants must complete a verified reflexology education program and/or obtain certification from the American Reflexology Certification Board (ARCB). The ARCB is the only national certifying board for reflexology in the United States.

Maintaining your certification

The ARCB offers two certifications and corresponding exams for foot and hand reflexology. To maintain your certification, you must pay an annual renewal fee and complete 12 continuing education credits every two years.


Reflexologist salary

You can expect reflexology pay to correspond closely to massage therapist salaries in the area where you plan to practice. It’s common for many reflexologists to be massage therapists that have incorporated reflexology into their practice.

Massage Therapists

National data

Median Salary: $46,910

Projected job growth: 20%

10th Percentile: $24,450

25th Percentile: $34,770

75th Percentile: $60,510

90th Percentile: $77,600

Projected job growth: 20%

State data

State Median Salary Bottom 10% Top 10%
Alaska $121,120 $30,330 $154,310
Alabama $28,810 $17,050 $48,730
Arkansas $37,970 $23,440 $60,400
Arizona $43,150 $29,160 $61,890
California $47,590 $29,270 $92,590
Colorado $47,900 $29,670 $62,600
Connecticut $53,060 $26,100 $113,830
District of Columbia $47,230 $31,340 $61,250
Delaware $43,600 $24,040 $78,690
Florida $38,600 $23,360 $73,190
Georgia $38,050 $18,050 $62,650
Hawaii $49,080 $23,260 $96,520
Iowa $46,440 $24,580 $60,490
Idaho $47,980 $24,470 $128,110
Illinois $49,130 $23,670 $79,010
Indiana $47,960 $22,680 $80,880
Kansas $39,370 $16,860 $66,060
Kentucky $48,700 $28,810 $78,560
Louisiana $29,550 $17,440 $78,990
Massachusetts $58,190 $37,070 $97,240
Maryland $46,940 $24,440 $122,960
Maine $39,200 $30,150 $77,450
Michigan $59,040 $26,040 $97,410
Minnesota $46,910 $29,130 $73,290
Missouri $36,610 $21,420 $60,450
Mississippi $43,460 $28,310 $51,520
Montana $59,380 $22,680 $82,970
North Carolina $47,120 $22,740 $68,920
North Dakota $60,550 $30,380 $87,620
Nebraska $46,640 $23,110 $79,010
New Hampshire $47,980 $23,250 $77,440
New Jersey $44,870 $29,110 $61,670
New Mexico $38,330 $28,190 $79,010
Nevada $30,700 $17,720 $59,380
New York $47,460 $31,930 $75,940
Ohio $46,490 $29,380 $76,190
Oklahoma $47,550 $26,160 $59,380
Oregon $70,300 $30,350 $94,020
Pennsylvania $46,410 $25,890 $71,500
Rhode Island $30,350 $24,540 $30,350
South Carolina $35,880 $17,440 $55,800
South Dakota $30,780 $23,340 $49,300
Tennessee $45,400 $18,850 $60,400
Texas $42,860 $22,330 $62,680
Utah $45,910 $18,020 $65,640
Virginia $46,460 $21,190 $76,250
Vermont $47,850 $29,650 $61,340
Washington $65,610 $31,150 $88,610
Wisconsin $39,300 $17,470 $61,450
West Virginia $46,640 $23,340 $75,450
Wyoming $47,820 $29,010 $61,690

Source: U.S. Bureau of Labor Statistics (BLS) 2021 median salary; projected job growth through 2031. Actual salaries vary depending on location, level of education, years of experience, work environment, and other factors. Salaries may differ even more for those who are self-employed or work part time.

Factors that can influence pay

The field offers a lot of scheduling flexibility and the number of hours you work per week will impact your income. Salaries will also vary based on your geographic location, employer type, and experience level. 

Self-employed practitioners keep the entire amount they earn per session but must pay their own taxes and expenses. However, those employed at a spa, fitness center, or other establishments typically earn a percentage of the session cost, plus tips.

An expert’s advice for boosting earning potential

Frank said there are a few ways you may be able to boost your earning potential as a reflexologist.

“First of all, you want to be skilled enough. You want to make sure that your skills are such that people are getting results and/or just enjoying it and coming back.” Her second piece of advice is to simply get out and educate people about reflexology.

For example, Frank gave (and still gives) presentations at a local health food store. She’s presented at conferences and has given both paid and free sessions at a variety of health and wellness events. “Whenever and wherever you can, spread your message and put your cards out there.”

Frank’s third suggestion is to consider specializing. By specializing, you are offering a unique service to clients that will be sought out by the people that need it, and you can leverage that demand to increase your overall earning potential.

Starting your reflexology career with the right education and credentials can help you build a foundation for long-term success in this expanding natural health field.

kendall upton

Written and reported by:

Kendall Upton
Staff Writer

Updated: November 1st, 2022.

Linda Frank, NBCR, NCREd

With professional insights from:

Linda Frank, NBCR, NCREd

Founder & Director of Reflexology Academy NW; Founder of Head to Heel Reflexology for Better Health, LLC