Sally Kay-Reflexology Lymphatic Drainage RLD

Posted by Rosie Plunkett – Friday, July 6th, 2018

Sue Ricks chose Sally to open the UK Reflexology Conference with her ground breaking findings and research…. Sally has very kindly given us permission to publish some of her work. You will see Judith Whatley’s name appear often here, together Sally and Judith make the most amazing team to get a paper published….other speakers have told me they also want to team up with Judith for that very reason.

Sally Kay is a multi-award winning reflexology practitioner, tutor and published researcher. Sally has developed Reflexology Lymph Drainage (RLD), from first principles and through extensive clinical practice. This innovative approach to reflexology has attracted, national and international awards, and widespread recognition.
Sally has been a guest speaker at conferences in the UK, Europe and America. She teaches RLD to reflexology practitioners around the world and has published articles in professional journals which include, Complementary Therapies in Clinical Practice, International Therapist and Reflexions.
Clinical experience and further evidence from a growing body of case studies suggests RLD may be useful for clients with non-cancer related, auto-immune disorders, e.g., Rheumatoid arthritis, Fibromyalgia, allergies, migraine and many other inflammatory conditions.
On the strength of the findings of RLD research projects and case studies, plans are already in place for further research at Cardiff Metropolitan University.

In the last two years Sally has been fortunate to visit some of the ancient roots in reflexology. Travelling to Asia and specifically China she was interested to compare her gentle RLD protocol with the deeper techniques traditionally used.
The Reflexology Lymph Drainage DVD is available and her book is coming soon
“Bridging the gap between reflexology practice, and proving its worth, is notoriously difficult. I hope that the initial project may form the cornerstone of future studies, which will contribute to the understanding, and integration of reflexology”.

Reflexology Lymph Drainage RLD
  RLD development
  RLD research abstract

  Summary of clinical research results 
RLD was developed through clinical practice while working in cancer care. Patients who received this treatment experienced less discomfort and swelling and an increase in strength and arm mobility. As a pattern began to emerge in these patients, so did the prospect of measuring the effect of reflexology. This coincided with preparation for my final year dissertation for a BSc(Hons) in Complementary Therapies, and the opportunity to conduct the initial research into RLD. 
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, as well as my arm”
“The pain’s gone” 
RLD aims to stimulate the function of the lymphatic system and drain excess lymph away from the damaged area. 
Lymph-oedema, is defined as “persistent tissue swelling due to blockage or absence of the lymph drainage channels with accumulation of interstitial fluid.”
Primary lymph-oedema has a genetic predisposition, and secondary lymph-oedema is caused by surgery, accident, injury or trauma 
Cancer causes of secondary lymph-oedema include, surgery, radiotherapy, spread of disease and site of tumour 
Long term physical side effects of lymph-oedema include, pain, distorted limb shape, impaired function, decreased elasticity and mobility of skin, fibrosis, dry skin, acute inflammatory episodes 
Psychological & psychosocial problems – anxiety, loss of confidence, altered body image, uncomfortable wearing certain clothing and altered ability to complete everyday living activities.

Abstract (European Journal of Integrative Medicine Volume 4, Issue 3, Pages e359-e360, Sept. 2012)
Reflexology for the management of secondary lymph-oedema in patients affected by treatment for breast cancer: an exploratory study.
Authors: Sally Kay, Judith Whatley, Philip Harris
Breast cancer is the most common cancer in the UK. Following medical intervention approximately 20% of breast cancer patients suffer lymph-oedema. After breast cancer, a person may experience psychological or emotional difficulties due to altered body image, and a swollen limb can exacerbate this (Mackereth & Carter 2006). Research suggests that survivors with lymph-oedema are more disabled, and they experience a poorer quality of life and more psychological distress than survivors without lymph-oedema, (Bernas, Pyszel 2006, Ridner 2005). There is a need for more effective interventions and further research into a range of physical therapies for the management of lymph-oedema. Reflexology is a physical therapy focusing on the feet. Practitioners use specific pressure with thumb, finger and hand techniques to stimulate these reflexes on the premise that this effects a physical change in the body. Anecdotally, cancer patients suffering from lymph-oedema report positive effects on the swollen arm after reflexology treatment.
Aims and objectives:
To explore the use of the RLD (reflexology lymphatic drainage) technique as a precision treatment for the reduction of lymph-oedema, swelling of the arm following treatment for breast cancer.


As part of an undergraduate project, six participants with unilateral secondary lymph-oedema were recruited from a South Wales cancer-care organisation. The participants received four consecutive weekly reflexology lymph drainage (RLD) treatments. Limb Volume Circumferential Measurement (LVCM) was the primary outcome measure used. This method is widely used for calculating arm volume (NHS 2008). Measure Yourself Concerns and Wellbeing (MYCaW), was used to gather subjective data (Patterson 2006). LVCM and MYCaW measures were taken at baseline, the intervention stage, and at follow-up (one week post-intervention).
Positive trends were observed on both outcome measures for all six participants. As a group, the results indicated a statistically significant reduction in arm volume, from baseline to follow-up (t=6.93, df=5, p=0.001) on LVCM. MYCaW mean profile scores from baseline to follow-up, also showed a significant improvement (Z=-2.207, p=0.027). The results were also supported by the qualitative data reported by participants.
Conclusion: Findings of this exploratory study suggest that RLD may be helpful in the management of secondary lymph-oedema. A more robust research design is needed to test for a causal link between the application of reflexology and possible outcome benefits.
Summary of difference between the swollen and non-swollen arm (n=

In 2013 on the strength of these initial findings, Welsh Cancer Charity, Tenovus awarded funding, £12,263.00, for further RLD research (n=26), to be conducted in partnership with Cardiff Metropolitan University. The intervention phase was completed between January and June 2014.
Published: January 2016, Clinical Practice in Complementary Therapies
Use of reflexology in managing secondary lymph-oedema for patients affected by treatments for breast cancer: a pilot study
Authors: Judith Whatley, Rachael Street, Sally Kay Philip Harris Abstract
The aim of this feasibility study was to examine the use of reflexology lymphatic drainage (RLD) in the treatment of breast-cancer related lymph-oedema (BCRL) with a view to further research.
An uncontrolled trial was conducted with 26 women who had developed lymph-oedema in one arm following treatment for breast cancer. Changes in upper-limb volumes and in participant concerns and wellbeing were measured. Qualitative data were also collected.
A significant reduction in the volume of the affected arm was identified at follow-up compared to baseline. This reduction in volume appeared to be maintained for more than six months. Participant concerns were significantly reduced and their wellbeing significantly increased. No serious adverse effects were reported.
RLD may be a useful intervention for BCRL although the results could not be attributed to the reflexology intervention because of research design limitations. The main conclusion was, however, that there was sufficient evidence for further research using a randomised controlled trial.
Quantitative data – objective arm measurements (LVCM)
All 26 participants had reductions in swelling of the affected arm. The average difference between swollen and normal arms before RLD was 348.8ml, and the average amount lost was 36.2% of this (126.3ml). All of the statistical tests run on the before and after volumes showed that all effects were statistically significant (p<.001)
Quantitative data – subjective MYCaW scores
Subjective scores of participant concerns and wellbeing using MYCaW indicated changes on all three scales to be of clinical significance to the participants. The levels of the primary and secondary concerns were both significantly lower at follow-up when compared to baseline (p<001). And participant wellbeing increased significantly from baseline to follow-up (p<01). Nobody dropped out during the study the attrition rate was zero.
An example of quotes from the qualitative data – exit interview “….I found the whole thing was one of the top 10 highlights of my life”
“….I was really quite sceptical thinking, ‘this isn’t going to work, but I’ll do it anyway, and I was amazed, really totally amazed to see the difference in my hand after the first session was just, …..I couldn’t get over it”
”Its lighter, I haven’t got the heaviness, I haven’t got the aching in my arm, the swelling has gone down, I can stretch my arm, it just feels a lot better”
“I look at myself in the mirror now and I can see there’s an actual shape to my arm whereas before it went straight down”
”I want to continue because I think its wonderful……I think its the best thing that’s happened”
“It’s absolutely amazing because people do suffer with lymph-oedema for years and it’s so painful, if something as pleasant as this can do something it’s wonderful. It’s a wonderful, wonderful thing”
What else is RLD useful for?

Since 2012, I have been teaching RLD to reflexologists throughout the UK and Ireland, while continuing to use it in everyday clinical practice.
The research results suggest it is highly probable that RLD causes an effect on the lymphatic system. Surely it follows that RLD may also cause an effect on the immune system. And with an increase in auto-immune disorders, I believe this sequence helps the body respond to inflammatory and auto-immune conditions, for example, rheumatoid arthritis, eczema, hay-fever and other allergies, (and much more).
Part of the RLD training, involves submission of a case study, not necessarily secondary lymph-oedema related. From this, and my own clinical experience, I have a growing body of anecdotal case study evidence of RLD being used to support clients with an extensive range of inflammatory, auto-immune disorders as well as secondary lymph-oedema.

For news and updates about RLD research, training and case studies here is a link to the RLD Facebook group

Sally has an excellent DVD for sale ….available from

Sally will be running a full two day course at the Christie is the last weekend of January, 26th & 27th 2019 and is being co-ordinated by Sarah Wilkins.
Numbers will be limited to 20 students.

Here is a link to the latest published research, access to the full paper is free for the next couple of weeks

Sally Kay…Reflexology Lymphatic Drainage
Reflexology Practitioner, Tutor & Researcher
01633 895911 / 07977212332


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