What Happens in the Body During Massage?
A question that I frequently get asked by clients is some form of, “so how does this all work?”. If you have ever had a massage (even if it’s on your couch from a loved one), you know that massage works. In fact, sometimes our bodies are just begging for a massage. Why is that? And what about “Massage Brain”? That semi-dopey feeling you get after a super relaxing amazing massage. What’s that about?
I wanted to use this post today to address these kinds of questions, after all...they are perfectly reasonable questions to ask! It's one thing to know that something works, it’s another thing altogether to understand why it works. Especially when it comes to the body. In this post I will to focus primarily on the physiological response of the body to massage, aka. why your tight muscles feel not so tight after a massage. There are energetic components that impact and effect the body in massage, and I’ll touch on those briefly, but today is all about the sciencey stuff!
When thinking about massage we have to take into consideration what parts of the body are being impacted. While it is not that big of a stretch to argue that every part of the body is impacted by massage, for today’s sake we will look at the following systems:
The Skin
The Circulatory System
The Musculoskeletal System (muscles and bones)
Other systems that are impacted by massage/bodywork include the respiratory system, the digestive system, and the endocrine system (hormones). Today though we’ll focus primarily on the first three systems.
How Massage Affects The Skin
Did you know the skin is the body’s largest organ? The skin is a wonderful place to start when considering the physiological (referring to the function of living organisms) impact of massage on the body. This is because massage starts with the skin. It is through the touch of the Massage Therapist (or super amazing significant other or friend) that we are able to enjoy the benefit of massage. That all seems relatively obvious, so what kinds of effects to touch have on the body?
Our skin is chock full of nerve endings whose job is to relay information back and forth from wherever they are to the brain. Not only big stuff (ow, that Lego I just stepped on), but also the softest of touch (a feather over your cheek). The job of these nerve endings is to help the brain and the rest of the body know what is good sensory input and what is bad/dangerous sensory input (feather: ooo, yes. Lego under foot: boo, no). When nerve endings are stimulated, the messages that they send to the brain initiate chemical responses that can stimulate the release of endorphins. The primary function of endorphins is to decrease and regulate the body’s response to pain. So during a great massage it’s not uncommon to experience a release of endorphins which can then lead to that feeling of content relaxation (aka Massage Brain). Endorphin release can also combat the release of cortisol and adrenaline which are hormones associated with our fight or flight response.
Now, does that mean that cortisol and adrenaline cannot be released during a massage? Nope! For some of us, there are certain associations with touch (whether from past trauma, personal preference, or general sensitivity) that can actually make touch from others stressful, not relaxing. Which is absolutely fascinating, because it means that neural networks/pathways associated with specific areas on the skin can activate different parts of the brain and yield dramatically different results in different people. For some people getting a foot massage is incredibly relaxing, and they find themselves bathing in a sea of bliss-making endorphins. For others just touching the feet at all is an immediate cortisol ridden stress soup overload. So cool (for the science, not the stress soup).
How Massage Affects The Circulatory System
Okay, so now that we’ve talked about the skin, let's talk about the circulatory system, the skin’s BFF. When we think of the circulatory system, the most important thing to acknowledge is that movement is key (like with most things). A healthy circulatory system allows blood and lymph to move freely throughout the body, carrying important nutrients where they need to go, and removing waste products from where they shouldn’t be. When receiving a massage, the mechanical stimulation and warming of the tissues of the body causes blood vessels to dilate (this is also known at vasodilation). The dilation of blood vessels and the increase of pliability in previously bound up tissues facilitates productive movement and exchange of blood and lymph flow throughout the body. This not only facilitates healthier skin and muscle tissue, but also decreases the workload on the heart by making it easier for the heart to do its job.
The same goes for the lymphatic system, which is part of the Waste Management team in the body. Here’s an interesting fact: the lymphatic system doesn’t actually have a pump (like blood does with the heart), but relies solely on movement to do its job. The natural movement of the body is what forces lymph fluid throughout the body. So if you are tight as a board, the lymphatic system struggles to do its job. Which is definitely no good...imagine how incredibly awful your garage would smell if Waste Management just stopped coming by to pick up the garbage. Now imagine that stinky garage is in your body. No thanks.
How Massage Affects Musculoskeletal System
Okay, here’s where the big bucks are. I can talk all day about the skin, the circulatory system, the nervous system, fascia, and geek out about anatomy and physiology, but the reality is that no one (absolutely no one) comes to me for a massage “because it feels like their circulatory system is congested”. I mean, it very well could be, but that’s not why they're coming to me. People come to me because of their muscles! Tight neck, sore back, bum shoulder, wonky hip, hamstrings made of concrete, you get it. So how does massage affect muscles? What makes a muscle tight, and why does it relax with massage?
Let’s start with why muscles get tight in the first place. Muscles are very similar to the skin, in that every muscle in your body has parts whose sole job is to help the brain understand what’s going on with the muscles. These are known as proprioceptive components. Proprioceptive refers to a kinesthetic awareness of posture and position. These components sense information such as whether a muscle is contracted, relaxed, actively lengthening, or actively contracting. Sometimes muscles, for a number of reasons (habitual posture, stress, strain, trauma, weakness in other crucial parts of the body, etc.), can get stuck in the “on” position, where the components in the muscle that are in charge of contracting that muscle get a little too enthusiastic, and forget to turn off, or simply contract the muscle too hard too fast.
So, if a muscle gets stuck in the on position, what can happen? Well, if you’ve ever felt like your shoulders are full of rocks, you can thank those try hard proprioceptors who don’t know how to chill. That being said: why your muscles got stuck in the on position in the first place is a huge factor in creating an effective treatment plan for a therapist. Whether it be a weakness, a postural habit, your pillow, the fact that you grind your teeth, some sort of unresolved physical trauma, scar tissue, etc. All of these components can cause “rocky shoulders”, but they require different long term treatment plans to get positive results.
So what happens during massage? When in a massage, the manual manipulation of muscle tissue helps to facilitate warming of the tissue, an increase in circulation, a release of endorphins, and the activation of the sympathetic nervous system. All of these factors help those components in the muscle take a chill pill and relax. In a nutshell, massage facilitates a relaxation response from the components in a muscle that cause excessive contraction.
Let’s Talk About Fascia
Okay, so I would be completely remiss if I wrote this whole post about what happens in the body during massage and I didn’t talk about fascia once. In the past few years, fascia seems to really be coming into its own as a star of the health and fitness world. Maybe you’ve seen some of this craze, maybe not. To be honest, this fame is totally deserved. Fascia is amazing. I’ll keep it short and sweet here because this article is not a love letter to fascia. That’ll be for another day.
For now I will say this: In your body, fascia is everywhere. Literally everywhere. It may be easier to think of fascia as a comprehensive network of connective tissue, rather than a separate “thing” like a muscle. This connective tissue isn’t just involved with muscles, but also tendons, ligaments, joints, bones, organs, bursae...everything. This collagen based material is truly what knits us together to create a cohesive, fully functioning being. In some schools of thought (see the work of Thomas Myers), the body is looked at more as one cohesive system with many “small pockets” (muscles), rather than a body made up of a bunch of independent parts (muscle here, tendon here, organ over there, etc).
Fascial research is still budding and providing us with new insights and information all the time. Based on my current understanding, there are basically two camps. The camp that believes massage therapy can in fact have an impact on the fascia, and the camp that believes the impact is more closely tied to the way manual manipulation influences the nervous system and the circulatory system.
In Conclusion
The human body is an incredible organism with many, many different structures, components, and interactions. Simply performing the simplest of tasks requires a coordinated symphony of movements, neurological impulses, and chemical interactions. The scientific community is making discoveries all the time about the human body. The things we know about massage and the impact that it has on the body will continue to evolve and change as time goes on. Regardless of what we know scientifically though, touch has been used as a healing practice for as long as humans have been around. No matter why it works, if healing occurs, and after you leave the massage table you feel better than you did when you came in, it seems worth trusting that response. Taking good care of ourselves is an act of love and devotion for the body. We only have one, so we might as well take the time to treat it well.
Resources
Lowe, Whitney. “Understanding the Proprioceptors”. Massage Today. 6 March 2019, https://www.massagetoday.com/articles/1551797026326/Understanding-the-Proprioceptor
Myers, Thomas. “What is Fascia”. Anatomy Trains. https://www.anatomytrains.com/fascia.
Osborn, Karrie. “A Fascia Epiphany”. ABMP, 18 June 2021, https://www.abmp.com/updates/blog-posts/fascia-epiphany.
Rawlings, Jenni. “Fascia Myths and Fascia Facts”. Yoga International,7 Nov 2019, https://yogainternational.com/article/view/fascia-myths-and-fascia-facts.
