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published 11/09/04, updated 5/26/10

Massage Therapy for Tired Feet (and Plantar Fasciitis!)

Perfect Spot No. 10, in the arch muscles of the foot

by Paul Ingraham, Vancouver, Canada MORE

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Credentials and qualifications

I am a writer and retired Registered Massage Therapist (unusually well-trained for a massage therapist, a 3000-hour program). I’m almost done with a Bachelor of Health Sciences degree. I am a peer reviewer for The Natural Standard, and a copyeditor for Science-Based Medicine. My most important qualification is more than a decade of workaholic post-graduate study, clinical experience, and constant conversations with readers from around the world, including many experts who have provided countless suggestions and criticisms.

For more information, see: Who Am I to Say? More information about my qualifications, credentials and professional experiences for my readers and customers.

Trigger points (TrPs), or muscle knots, are the world’s most common cause of aches and pains, and yet they are rarely diagnosed correctly. Having too many stubborn trigger points is called “myofascial pain syndrome” (MPS). The Perfect Spots series of articles highlights trigger points that are unusually common and yet relatively easy to treat yourself — the most satisfying and therapeutically significant places to apply pressure on the human body. For a complete, advanced tutorial that walks you through every possible self-treatment option for muscle pain, see Save Yourself from Trigger Points & Myofascial Pain Syndrome!

If you have — or think you may have — plantar fasciitis, you may prefer to start with this article instead: Save Yourself from Plantar Fasciitis!

The tenth of the Perfect Spots is one of the most popular of the lot, and right under your feet — literally. It lies in the center of the arch muscles of the foot. This is one of the Perfect Spots that everyone knows about. No massage is complete without a foot massage!

Why is the arch of the foot a perfect spot for a massage?

It isn't difficult to understand why the arch muscles of the foot would harbour a Perfect Spot for massage. They are, after all, the hardest working muscles in the human body. Our feet absorb an incredible amount of punishment, yet usually feel no worse than just stiff and tired. Injury here is common, but not nearly as common as you might expect.

The arch of the foot is a fascinating structure. The arch is like a bow without an arrow, and its curved shape is created by a “string” of muscles and elastic connective tissues. Every time you take a step, your weight pushes down on the arch, and your arch muscles hold it up and pull it back into shape as the pressure is relieved. Your entire weight is easily supported by muscles about the size of your index finger. No wonder they get exhausted! Of course, it does help that they aren’t completely on their own. Some leg muscles also reach down and underneath the arch, like stirrups, to help support it. Still, the pressure on the muscles of the arch is enormous and constant.

When these support mechanisms fail and the arch can no longer hold its curve, the result is a flat foot. As well, the connective tissue in the arch may start to tear, causing a painful condition called plantar fasciitis (see Save Yourself from Plantar Fasciitis!). However, most people just develop really significant muscle knots in the arch.

There is another reason why this spot is significant. The skin of the feet has a disproportionate number of nerve endings, like the face and the hands, yet the feet are generally abused or at least neglected. Therefore the sensations of foot massage seem particularly rich and diverse in contrast to the usual stomp, stomp, stomp of their daily stimulus.

How do you find muscle knots in the arch of the foot?

Not only is this probably the most perfect of all Perfect Spots, but it is also perfectly easy to find: it is exactly in the center of the bottom of the foot, halfway between the heel and the ball, and halfway between the inside and outside edges (perhaps slightly closer to the inside).

The arch muscles generally feel best when pressed on an angle, for example towards the outside of the foot. But this is a minor point: any angle will do!

Find a therapist who specializes in trigger point therapy! Trigger points (muscle knots) are a cause or complication of most other kinds of pain problems, but it can be hard to find expert assistance. For 25 years NAMTPT (the National Association of Myofascial Trigger Point Therapists) has represented myofascial pain specialists and connected them with their patients. We publish the largest therapist directory available and a unique symptom checker to help you identify sources of pain. Pain practitioners can learn from experts in the field of myofascial pain at our annual conference.

What does massaging the arch of the foot feel like?

You will know it when you feel it! Having massaged thousands of people and thousands of feet, I can tell you without hesitation that the center of the arch muscles is a popular, “feel good” spot. It usually produces a clear, sweet ache with mild to moderate thumb pressure only.

Note that despite its popularity, Perfect Spot No. 10 usually does not cause any referred sensation — that’s the satisfying, spreading ache that is often associated with other significant trigger points. Don't take the lack of referred sensation to mean that what you're doing isn't working!

All massage feels better when someone else does it, but this is especially true of foot massage. Although it is easy to massage your own foot (and highly recommended if you have no other choice), receiving a foot massage is one of life’s truly delicious experiences, the apple pie à la mode of touch.

What about reflexology?

Some believe that there is yet another reason why foot massage feels so good: there may be neurological and/or energetic connections between each part of the sole of the foot and every other region and system of the body. This is called reflexology. Reflexologists claim that foot massage can have a therapeutic effect on any part of the human body.

This claim is extraordinary, and “extraordinary claims require extraordinary evidence” (Carl Sagan, Broca’s Brain, 1972). I have certainly never seen nor heard of such evidence, although (to quote another old chestnut of skepticism) “absence of evidence is not evidence of absence.” The phenomenon may exist, whether there is clear evidence for it or not. However, it is most likely that the profound sensations of foot massage simply gave someone the idea that foot massage was unusually important.

I have no trouble with the general idea of therapeutically significant connections between body parts, or even with the particular idea that massaging the foot could affect organs and systems. That is plausible.

I doubt, however, that the average colourful reflexology “map” is 100% accurate — at least, not compared to the average textbook anatomy diagram. If the connections exist at all, they are probably subtle, and there is probably significant natural variation between individuals. Only a study of a large number of carefully compared observations by several extremely skilled and knowledgeable practitioners could hope to confirm that stimulating a certain tiny spot on the foot has a therapeutic effect on a certain organ — and even then it wouldn’t necessarily be true of every person.

My own personal experience with reflexology is that it feels as good as any other foot massage, but no better, and has no apparent additional therapeutic effect. Still, a foot massage is always a pleasant experience in and of itself.

Appendix A: Is trigger point therapy too good to be true?

Trigger point therapy isn’t too good to be true: it’s just ordinary good. It can relieve some pain cheaply and safely in many cases. The existence of trigger points is not controversial. You can measure their electrical activity, take samples of their highly acidic tissue chemistry, and now a new MRI-like technology can now show them as well.

The Perfect Spots are based on a decade of my own clinical experience, and on the research and writing of Drs. Janet Travell and David Simons, pioneers of myofascial pain syndrome research. They produced “the Big Red Books” (a massive pair of texts).

Trigger points are clinically significant, but unfortunately obscure. As Dr. Simons wrote, “Muscle is an orphan organ. No medical speciality claims it.”

Want to know more? This is the tip of the iceberg. There’s a whole book …

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Not too good to be true.

Just ordinary good. Trigger point therapy isn’t a miracle cure, but it is a valuable life skill. Practically anyone can benefit at least a little, and many will experience significant relief from stubborn aches and pains. The first several sections are free.

Appendix C: Quick Reference Guide to the Perfect Spots

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