History of RLD 

RLD was developed through clinical practice while working in cancer care outpatient clinics, using reflexology for patients suffering from all kinds of cancers at all stages of the disease. Many of the patients had been treated for breast cancer and consequently suffered secondary lymphoedema. Complaints relating to lymphoedema often included, a swollen arm, painful shoulder, uncomfortable underarm swelling, weakness and problems with everyday living activities. In summertime patients found the support sleeve uncomfortable in the heat as well as unsightly and it was often described as "a label", and "a constant reminder". 

Clinic appointments were time limited. The treatment focused on the primary concern of the patient and was adapted accordingly. During the time there, it became apparent that patients who had swollen arms and pockets of fluid under their armpits were deriving great benefit from reflexology treatment. As the treatment progressed patients could feel tingling in the swollen arm while the corresponding foot reflexes were stimulated. Their clothing and jewellery seemed much looser after treatment and their swollen arm felt more comfortable.

Patients who had received this treatment experienced less discomfort and swelling and an increase in strength and arm mobility. RLD protocol was developed and formalised, it is performed on the feet and is tailored to the affected arm. It differs according to which side has been treated for breast cancer. 

As this pattern began to emerge in patients who received RLD, so did the prospect of measuring the effect of reflexology with objective measurements. With the support of Hospice of the Valleys, training in limb volume circumferential measurement (LVCM) was arranged. This enables the volume of fluid held in each arm to be calculated, and compared before and after treatment, and then compared with the non swollen arm.

A research proposal was submitted and NHS ethical approval was granted. Six participants were given RLD treatments, once a week for four consecutive weeks and measurements were taken before and after each treatment. In addition to capturing the objective data, participants were asked to describe their concerns and comment about how they felt. This was recorded using a standard outcome measure, MYCaW (Measure Yourself Concerns and Wellbeing) and as part of the consultation and feedback. All of the participants reported feeling movement of fluid during their reflexology treatment. 

Comments at the end of the study included the following:-                
‘I feel like I’ve got my arm back’
‘I feel good about myself and it has helped my confidence. The sleeves on my clothes feel looser.’
‘I can make a fist’
'I feel normal again'