Are You Up For A Challenge? I Was.

I doubt there is a reflexologist who hasn’t encountered the client who reveals upon arrival that she or he is extremely ticklish on the feet. I admit that it sometimes confounds me that someone who is uncomfortable having his or her feet touched would book a reflexology session to relax – but that’s a thought to pursue some other time, perhaps.

That was not the case though with the man who walked into my office recently – the most extreme and novel case of ticklishness I had ever encountered.

I have always been able to work past the ticklish issue with clients using slow and firm movements. Historically, by the time I reach the second foot, the person is usually in la-la land.

The Challenge

This 30 plus year-old man was so ticklish he could not touch his own feet, especially the toes. They were off-limit. (He couldn’t even handle a sheet touching his toes.) He obviously was not coming to relax; he braved the appointment because of painful plantar fasciosis in both feet. He was desperate. Doctors were talking surgery and he did not want that.

I decided to do a little research to better understand what sets the situation off, hoping that it would help me figure out how to deliver my protocol for plantar fasciosis without too much discomfort. Here’s what I learned:

What’s Going On?

There are two classifications of tickling (Who woulda thunk!):

1. Gargalesis – Coined by psychologists Arthur Allin and G. Stanley Hall, this is what most people think of; the kind that causes squirming, laughing and sometimes takes your breath away. It happens when you are lightly touched by another person on certain parts of the body, such as the armpits, ribs, neck, inner thigh and/or the feet.

One theory on how/why gargalesis developed is that it is an evolutionary mechanism against unwanted touch of vulnerable parts of the body. We squirm to get away from non-violent touch such as being tickled by a feather or someone’s fingers as a method of self-defense; to teach ourselves how to protect ourselves from touch that could injure or harm.

Why we laugh though is a mystery. And why does someone experiencing gargalesis laugh when touched by another but not when they touch themself?

Dr. Anthony Komaroff, a renowned medical doctor and researcher, has doubts about the theory that claims that the lack of surprise is what negates the sensation if we touch ourselves. He cites evidence that even without the element of surprise or with the full knowledge that you will be tickled by someone, some people still laugh as a response.

Another theory posits that it is a form of bonding, which is why we only laugh if the tickler is someone we are familiar and comfortable with, not a stranger.

Like I said, it’s a mystery.

2. Knismesis is very light stimulation of the skin that produces a tingling sensation that produces an itch, or makes you want to rub an area and/or move away from it. It rarely produces laughter and can be brought on by someone else, by a crawling insect or the self.

I believe the latter is the form of ticklishness that my client lives with.

My Strategy

I’m thrilled to report that other than a brief couple of seconds the strategy I conjured up worked! My client was pleasantly surprised that he was “okay with it”, and was just as surprised perhaps to learn where the root cause of the plantar fasciosis likely lay.

Here’s how the game plan played out:

* First off, very clear and ongoing communication. I relayed what I proposed we do, got his buy-in, and then continued to communicate throughout the entire session as to the next step I was going to move on to. There were no surprises.

* I start all my foot reflexology sessions with a foot soak and an exfoliation with a ‘scrubbie glove’. In this case, I asked him to put his feet in the water and gave him the option to scrub his own feet or just remove them from the water and dry them off himself. He chose not to scrub.

* I then instructed him to put his socks back on and lay supine on the table. I explained that I would grab hold of his foot firmly and showed him on my own hand how I would, again firmly and slowly, knuckle walk the bottom of his foot and thumb-walk along both sides for about 15 minutes per foot. I informed him that the conventional reflexology techniques would begin to relax his nervous system and communicate with the other parts of his body involved with plantar fasciosis. I assured him that I would do nothing ‘light or fluffy’ nor would I touch his toes. He even accepted my offer to place an eye pillow over his eyes! I think the slow, repetitive movements helped him to be able to receive this part easily. No surprises. The next segment was the trickier part of the session.

*  Now we were going to move into some different techniques to address plantar fasciosis. He removed the socks and turned over onto his stomach while I applied nitrile gloves. I was hoping that the gloves would provide a bit of a barrier between his skin and my hands, just as the socks had done on his feet.

I applied the techniques to the lower leg with no problem – not his feet, right? And then I had to apply some lubricant to the bottom of his feet before proceeding. That was very uncomfortable for him, and fortunately lasted but a couple of seconds. We were both pleasantly surprised that he was able to lie still to receive the various remaining gliding strokes on the bottom of his feet.

He reported that his feet felt better when he got up to walk, which pleased me to no end. I felt satisfied with the session and had enjoyed the extreme focus it took not to inadvertently move in any way that might aggravate the situation.

Whether gargalesis and knismesis are the result of reflex actions or a learned behavior, no one seems to really know. I guess it’s just not one of those conditions high on the list of needed research. I’m just glad that I was able to help this man and hope he is comfortable enough to return to knock this plantar fasciosis to the curb!