A practitioner looks for sensitive areas and blockages in the foot. The sensitive areas are usually evident since the client will physically respond in some way. Apart from any pain response from the client, the practitioner is able to detect blockages. The tissue may be atonal, or somewhat squishy, or it might be hypertrophic or tough. Both of these situations suggest zonal imbalances. The reflexologist might encounter crystalline deposits, which feel like little grains of salt under the skin, or other related blockages which, when felt, should be crushed. As stated earlier, the removal of a blockage in the foot improves the blood and nerve supplies as well as the energy flow to the corresponding body area.

The correct amount of pressure to be employed is that which would elicit discomfort or pain in a sensitive area, but which is still relaxing and pleasurable. In other words, that which hurts good. Enough pressure should be used to elicit sensitivity to ensure that blocked reflex areas have been located and sufficiently accessed, but not so much pressure as to make the client tense or cause him or her to dislike the treatment. Often, however, the more pressure that is used, the better it feels to the client because more endorphins are released into the bloodstream. (Endorphins are the body's pain killers or blockers. It is naturally produced morphine.) Also of course, the amount of pressure that is comfortable will vary from client to client.

The actual technique or stroke used by the reflexologist is to use one hand to hold the foot back and straight, and use the other to do an inchworm-like motion on the foot. For the most part, the practitioner applies the inside or medial edge of the thumb at a 45 degree angle to the foot. The movement of the thumb is just like that of an inchworm. The thumb moves or slithers along, taking tiny bites or steps, burrowing along the entire foot. The thumb applies a fluid and continuous movement and pressure, and never leaves the surface of the foot.