Foot massage in Palo Alto: what $78 actually buys

Both feet twice over, plus the ankles and the lower calf. Fifteen minutes a foot is enough to go slowly across the sole and work the heel and arch properly. There is time to take each toe individually, then come back over the whole surface at a different pressure.

Firmer than you would want on your back. The sole tolerates a lot of pressure, and the arch and heel usually take the most of anyone's foot. Tenderness under the heel or along the inside edge is worth naming out loud in the first couple of minutes rather than breathing through for half an hour.

Thirty minutes on the body, oiled, at the pressure you ask for — usually back, neck and shoulders, because that is what half an hour covers well. If you would rather the time went to the legs or the hips, say so before the therapist starts.

The pressure work feels good and may help you relax, and that is a defensible claim. The bigger one is not: reflexology's founding idea is that points on the sole map to particular internal organs, and that pressing a point treats the organ it maps to. That mapping has not held up when it has been tested, and no therapist here will tell you it has.

The NCCIH overview of massage therapy groups reflexology with the styles that work on specific points rather than the whole body. Short-term relief of pain and tension is what massage in general has the best support for. That is a smaller claim than the reflexology charts make, and it is the one we stand behind.

So book it for what it reliably is: half an hour of close, firm attention paid to the part of you that carries your weight all day, followed by half an hour on the back and shoulders.

Three groups, mostly: people who stand for a living, people who run or walk a lot of miles, and people who would rather not undress for a full hour of body massage.

Nurses, teachers, kitchen staff, hairdressers, retail and lab work all end the day in the feet before anywhere else. Thirty minutes on the soles and calves is a more direct answer to that than an hour spread over the whole body.

The calves and the plantar surface take the load, and both respond to firm work between runs rather than the day after a race. Book it on a rest day, and keep the pressure short of anything that makes you flinch.

The first half of this session is feet and lower legs only, which is a gentler way in than an hour face down. If the second half still sounds like more than you want, a 45 minute Body Massage at $80 is the other short option on the menu.

Massage may make tired, aching feet feel better for a day or two, and it will not resolve a structural problem. Heel pain that is sharpest on the first few steps out of bed is the classic pattern for plantar fasciitis, which Mayo Clinic describes as irritation of the band of tissue running from the heel to the toes, most common in runners and in people who spend hours on their feet.

Skip the massage and see a clinician if the pain is worsening week over week, if there is swelling, numbness or pins and needles, or if you cannot put weight on the foot. MedlinePlus lists the common foot problems and what each one usually needs, and an hour on the table in the middle of an undiagnosed injury costs you $78 and delays the appointment you actually needed.

Diabetes and peripheral neuropathy are the other reason to check first. Reduced sensation means you cannot reliably feel pressure that has gone too far, so tell the therapist before the session rather than during it.

$78 buys thirty minutes on the body; $90 buys sixty. If your feet are the reason you are booking, the combo is the better hour. If your back and shoulders are the reason, book the Body Massage and let the feet wait.

The 45 minute Body Massage is $2 above the combo for fifteen minutes less on the table, which makes it a booking for people short on time rather than short on money. The combo is the cheaper hour and the only one of the three with reflexology in it.

Ask for them. A 90 minute Body Massage at $135 has room for twenty minutes of foot work without losing the back, and a 120 minute at $180 has room for considerably more. Neither is billed as reflexology, but the time goes where you ask it to.