This gentle massage offers comfort and reassurance and can provide an opportunity for relaxation. The guidance shows you how to massage the feet to be soothing, enhance bonding and increase body awareness. It is not intended to be massage therapy. Both you and the individual being massaged may experience a sensation of wellbeing, bonding and a reduction in stress as a result of the release of feelgood hormones that are triggered by positive touch. This may in turn relieve some stress related health issues, ease pain, improve sleep pattern and appetite and the functioning of the digestive system.

Do not massage if you or the individual are showing signs or symptoms of being unwell (e.g. sore throat, cough, runny nose or a high temperature). It may be unsafe to massage if the individual has an infectious skin condition, a contagious disease, or a serious medical condition, unless medical approval is given. It is important to be mindful of conditions such as osteoporosis and if in any doubt, seek further medical advice before proceeding.

What you need

• A massage oil or carrier oil (a pure, unrefined vegetable oil such as grape-seed oil) or cream. Use an oil or cream that you know to be safe or carry out a patch test, which involves rubbing a small amount of the oil on a clear patch of skin to check for allergic reactions. If redness or a rash appears, wash the area and dry thoroughly. Document this and try an alternative oil, carrying out the patch test on a different area of skin.
• Towels and cushions or bolsters

Guidance and instructions

• Any open wounds on your hands must be covered with a bandage or protected by wearing disposable gloves. If your nails are long it is important to be mindful of their length to avoid any nipping or scratching.
• Comfort is vital for a successful foot massage. Ensure that the person’s legs and feet are well supported, for example resting them on cushions or bolsters and cover with towels. This protects the cushions and bolsters from oil drips and spillage and the towels can be used to wrap up the feet at the start and the end of the massage to ensure that they stay warm. This action can also help to signal the beginning and ending of the experience.
• Position yourself in a way that prevents you from over-stretching or straining.
• Adjust environmental factors to facilitate relaxation e.g. comfortable temperature, soothing lighting, avoiding lights shining directly into the individual’s eyes.
• It is important to note that during relaxation the breathing and heart rate of the individual may change as the body rests and stills. An increase in skin temperature and redness from skin to skin contact is normal, but if this is severe, reduce friction or stop massaging that area of skin.
• If you notice any signs indicating that a particular massage stroke is unwelcome, move on to the next stroke, or to the other foot. End the foot massage if it is clearly not wanted (see step 22). Document and try another day as next time the responses may be different.
• Repetition is important. With the first massage stroke, the individual ‘receives’, with the second repeated stroke the individual might ‘remember’ and after the third repeated stroke the individual may feel more comfortable and ‘relax’ as the sensation becomes familiar and predictable.
• Try not to rush – stay focused on the individual and allow space for both of you to “just be”.

STARTING THE FOOT MASSAGE:

1. Wash your hands thoroughly giving a running commentary as you go, as appropriate. “I am washing my hands now”, “I think we are ready to start”. By doing this it creates a routine to follow each time and develops an element of familiarity.
2. Give a brief explanation of what is going to happen (using appropriate verbal and non-verbal communication), looking for signs and indications that touching the feet will be acceptable as you move your hands to rest on the feet. Wait a moment to get a response of approval and acceptance before proceeding.
3. Take 3 comfortable breaths – breathing in through the nose, out through the mouth, building a sense of calm and ease as you feel the natural movement of your own breath flowing easily and rhythmically through your body. Ideally do this whilst resting your hands on the towels on each foot as this indicates the beginning and end of the routine. Your own emotional state can affect the quality of the massage so this is an important part of the massage routine.
4. Let the individual choose which foot to start with if they can and want to, perhaps by touching right then left and looking for responses as to preferences.
5. Fold back the towel of the first foot to be massaged and rest your hands on the foot to warm it before starting.
6. Explain that you need to check the foot to establish if there are any sore areas that need to be avoided during the massage. Check the foot and ankle for bruising, recent scars, open wounds, blisters, sores, rashes, pressure sores, ulcers or areas of inflammation (which may appear as areas of discolouration or resemble a bruise often located on the heal or ankle, near the bone). If the heel or ankle appears to have black bruising this could indicate a deep pressure injury and should not be massaged. If there is a possible deep pressure injury a health care professional should be informed. As well as avoiding the specific area, disposable gloves should be worn if there are verrucas or toe infections.
7. Take the lid off the oil and bring the lid under the individual’s nose briefly so that the individual can smell the oil that will be rubbed into their skin if they want to.
8. Rub the oil in your hands to create a squelchy noise (to indicate that the oil is coming) and also to warm up the oil in the hands. The lid of grape-seed oil should be put straight back on the bottle to avoid spillage and reduction in oil quality.
9. From the moment you place your hands on the feet start to look for any positive responses or indication of discomfort and adjust appropriately. There are over 7,000 nerve endings supplying sensory feedback related to the feet.  Consequently some touching may be ticklish and can be off putting. A light feathery stroke can be overwhelming for some but soothing for others. If some strokes cause over excitement for a touch sensitive individual, then just hold your hands still on the body part to facilitate the relaxation process. Pausing allows space for responses and feedback and may prevent over-stimulation.
10. Hold the foot in-between your hands to make a foot sandwich to start.
11. With the thumbs together on the top of the foot stroke out gently to the sides in a gliding motion, repeat several times.
12. Make circular movements with the fingertips covering the whole of the top of the foot.
13. Holding your thumb and index finger either side of the toe delicately stroke up each side of each toe and stroke across the tip of each toe. If the individual has overlapping toes do not try to move toes into position but carry on with the toes in their natural position.
14. You can count each toe as you go if you feel this is appropriate, i.e. if using your voice aids the sense of connection (count in higher numbers or other languages if suitable).
15. Repeat circular movements with your fingertips covering the whole of the top of the foot before moving your hands to the sole of the foot.
16. Travel around the sole of the foot by making small circular movements with your thumb or both thumbs covering the whole of the sole of the foot. This is a gentle gliding movement.
17. Repeat the starting stroke again (see step 11) – with the thumbs together on the top of the foot stroke out gently to the sides in a gliding motion, repeat several times.
18. Finish by holding the foot at the end making a foot sandwich.
19. Cover with the towel, resting hands on the towel, hold still to indicate that this foot is now finished.
20. Use a towel to wipe away any excess grape-seed oil.
21. Repeat the routine on the other foot from step 10.
22. Rest your hands on top of the towel on each foot holding still to indicate that the whole routine has come to an end and bring a sense of comfort, stillness and reassurance.
23. Wash your hands – giving a running commentary as appropriate.
24. To end the massage you may like to thank the individual for sharing their time with you and allowing their feet to be massaged.

What to observe, assess and record

• Look for known responses, document any observations and capture any evidence so that follow-up sessions can be more responsive.
• Signs of communication and engagement before, during and after, e.g. eyebrow movements, head and mouth movements, eye contact, contented sounds, frowns, nervous laughter, sighs or any obvious signs of likes or dislikes.
• Changes in mood – more or less excited, subdued, happy, sad, calm, agitated, anxious, less/more irritable.
• Signs of tension or discomfort – squirming, pulling the body part away, tightness and contraction of the muscles, curling the toes.
• Signs of comfort – the foot/ankle and/or leg relaxing and letting go, uncurling the toes, more controlled movements of foot and leg.
• Changes to breathing – deeper, abdominal breathing as the body rests and stills.
• More energised or more lethargic.
• Able to concentrate and focus more.
• Improved circulation – did feet warm up during the massage?
• More responsive to touch – liked or disliked particular strokes?
• Different responses to left or right foot?

© Sage Savage

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Created January 2021