Physiological effects

of
Massage
 Benefits of Massage Therapy:-

• Have you ever put your hands on someone’s shoulders and felt if they
were tight or relaxed and sometimes you can immediately feel a
tense bunch of muscles indicating tension or stress. One would
certainly be able to feel if they were either hot or cold. When we are
cold we often rub our hands together, which increase the blood flow
to the area and by that increase the temperature of that part. Thus
therapeutic touch has a beneficial effects on the human body and the
energy of caring is actually transferred was proven many years ago.
Research carried out during World War II has shown that human
touch can have therapeutic effects on children. An understanding of
the basics of human anatomy and human physiology and a
willingness to learn an effective massage sequence means that you
can comfort your patient or individual from stress or tension.
Overall Health Benefit of Massage Therapy:
• Massage therapy and bodywork increases blood circulation thus enabling the body
to pump more oxygen and nutrients into tissues and vital organs. 
• A therapist can render massage that stimulates the lymph system, the body’s natural
defense, against toxic invaders.  
• Helps in releasing endorphins, the body’s natural painkiller. A massage technique can
stimulate the body to produce endorphins, which reduce pain.  
• Massage is being incorporated into treatment for chronic illness, injury and recovery
from surgery to control and relieve pain. 
• Relieves pain for migraine sufferers and decreases the need for medication. 
• Can relax tense and tightened muscles. Massage therapist often render massage to
treat low-back pain and neck pain.
• Reduces overall stress. It helps the body's stress response by lowering levels of stress
hormones such as cortisol. 
• Massage therapy could also treat inflammatory conditions such as arthritis and
tendinitis
• Physical Benefit of Massage Therapy:
• Helps relieve muscle tension and stiffness
• Promotes faster healing of strained muscles and sprained ligaments; reduces pain and swelling; reduces
formation of excessive scar tissue
• Reduces muscle spasms
• Provides greater joint flexibility and range of motion
• Enhances athletic performance; Treats injuries caused during sport or work
• Reduces blood pressure
• Helps relieve tension-related headaches and effects of eye-strain
• Enhances the health and nourishment of skin
• Improves posture
• Strengthens the immune system
• Treats musculoskeletal problems
• Rehabilitation post operative
• Rehabilitation after injury
•  
•  
• Emotional Benefit of Massage Therapy:
• Promotes a relaxed state of mental alertness
• Improves ability to monitor stress signals and respond
appropriately
• Enhances capacity for calm thinking and creativity
• Satisfies needs for caring nurturing touch
• Promotes a feeling of well-being
• Reduces levels of anxiety
• Creates body awareness
• Increases awareness of mind-body connection
 Physiological effects of massage:

• As a therapeutic modality massage is being used for the

relief of pain, swelling, muscle sprain, restricted
movement, tension, anxiety associated with a large
numbers of a disorders affecting muscular, nervous and
cardio respiratory and other systems.
• Massage be it manual or mechanical imparts pressure and
stimulates mechanically the various tissue approached at
the time of force application of a particular technique.
• It is the magnitude, duration and the direction of force
applied during a particular technique that determines the
effects, produced by that technique on the body.
 – 1. Effects on the circulatory system
• a. on the venous and lymphatic flow
• b. on the arterial flow
– 2.Effects on the blood
– 3. Effects on the exchange of nutritive
elements
– 4. Effects on the metabolism
– 5. Effects on the nervous system
• a.On sensory nervous system
• b.On motor nervous system
• c.On autonomic nervous system
– 6. Effects on the mobility of the soft tissue.
– 7. Effects on the respiratory system.
– 8. Effects on the skin.
– 9. Effects on the adipose tissue
– 10. Psychological effects.
 Effects of massage on the circulatory
system:
• On the venous and lymphatic flow
• When massage is applied to the skin it is quite often an
observable change of colour in the area.
• This change has been attributed most usually to the
massage having an effect on the circulatory system.
• Massage aids in the mechanical emptying of the veins
and the lymphatics.
• It facilitates the forward movement of the venous
blood and the lymph and there by reduces the
chances of stagnation of the blood and the lymph in
the tissue space.
• The flow of the venous and the lymphatic channels from the
extremities mainly depends on the activities of the smooth
muscles present in the walls of the vessels.
• The contraction of these small muscles acts as a strong
pumping mechanism which keeps the tissue space clear
from the free fluid.
• The contraction of the skeletal muscle compresses the blood
vessels and exerts a pressure on the fluid present inside
which increase intravascular pressure and by that stimulates
the contraction of smooth muscles present in the wall of the
vessels will further increases the pressure inside the
vessels.
• When this pressure increases beyond the
threshold the valves open up and the fluid moves
onto the next segments.
• As the valves provide only unidirectional flow the
fluid cannot come back to the empty segment.
• When the muscles relax, the segment is refilled
by the fluid from the distal segments. This way
the venous and lymphatic fluids are allowed to
move only in one direction.
• The mechanical action of massage stimulates the smooth
muscles of the vein.
• The different techniques of massage alternately compress
and release the soft tissue facilitates the venous and
lymphatic flow.
• Effleurage, kneading and petrisage squeeze the veins and
the lymphatic vessels and force the venous blood and
lymph towards the heart causing an increased drainage of
the blood and lymph from the part to be treated.
• In case of fluid stagnation due to mechanical factors the
flow of venous and lymphatic fluid is obstructed. Massage
facilitates the drainage and reduces the stagnation of fluid
and also speeds up the removal of waste products.
 On the arterial blood flow:

• Massage improves the blood supply of the area being

massaged.
• A definite vasodilatation along with an increase in the
peripheral blood flow is usually observed after
massage.
• Following events happening during massage to
increase arterial blood flow.
• 1. Release of vasodilators:
• 2. Activation of Axon reflex:
• 3. Decrease of venous congestion:
• 1. Release of vasodilators:
• Massage act as a succession of traumatisation
which provokes and bring about the release of
histamine and other substances by the
stimulation of mast cells (found in the
connective tissues and brain but not in the
blood)
• liberation of histamine increases the arterial
diameter and are particularly responsible for
the axon reflex.
• The patent capillaries open up under the
influence of these chemicals and bring about
an increase in the blood flow to the part to be
massaged.
• 2. Activation of Axon reflex:
• Massage activates the axon reflex leads to
cutaneous vasodilatation
• when the skin is firmly stroked the sensory nerve
endings are stimulated and impulse is carried to
the spinal cord by the peripheral nerves.
• In the way itself a branch of nerves may be
stimulated and instead of going to the spinal cord
impulses return back to the periphery to produce
its effects on the cutaneous vessels which are
supplied by the branch of the same peripheral
nerve.
• The effect is the relaxation of the smooth
muscles of the arterial wall and the
vasodilatation.
• So the reflex arc of the axon reflex is completed
by the two branches of the same sensory fibers.
• Through one branch the impulse is received and
through other it is transmitted back to the
peripheral vessels causing vasodilatation.
• 3. Decrease of venous congestion:
• If any portion of the vessel is dilated than the neighboring
vessels also become constricted (Avon reflex).
• The arterioles become compressed if the venous congestion
is increased.
• The congested venous and lymphatic fluid exerts a
compressive force on the arterioles, narrowing it so the
blood supply to the part is reduced.
• As a result of it the outflow from the veins exceeds the
inflow to the constricted arterioles and congestion is
decreases.
• Massage promotes the forward movements of the lymph
and blood and indirectly helps in restoring the arterial flow.
 Effects on blood:
• Wood and Becker quoted Mitchell to states
that RBC count increased after massage in
healthy and anemic person.
• There is an increase in the RBC and Hb count
following abdominal massage.
• This increase may improve oxygen carrying
capacity of blood.
• Smith et al (1994) have demonstrated on
increase in the neutrophil count following 30
minutes of massage performed 2 hours after
intense exercise.
• According to Kresge (1989) massage raises
the RBC count by mobilizing stagnant blood
cells in the splanchnic circulation rather than
by increased production.
 Effects on the exchange of metabolites:
• Massage promotes rapid disposal of waste products and the
replenishment of the nutritive elements.
• Massage increase the movement of liquid and gases in the
body by increased arterial flow which brings more oxygen
and nutritive elements and causes more rapid oxygenation.
• Massage speeds up the lymphatic and venous flow promotes
rapid disposal of the waste products of metabolism.
• These changes make the exchange of waste product between
the blood and the tissue at cellular level more efficiently.
• This may overall improve the trophic condition of the part
being massaged.
 Effects on metabolism:
• Traditionally massage has been applied for the
purpose of promoting the general status of
wellbeing.
• Increase of arterial blood flow and venous and
lymphatic drainage massage may accelerate the
various metabolic process of the body.
• Massage affects an increase output of urine,
increase rate of excretion of nitrogen, inorganic
phosphorus and sodium chloride.
 Effects on the nervous system:
• The nervous system consists of sensory, motor
& autonomic component.
• 1. Sensory system
• Massage has a sedative effect on the CNS if
applied monotonously with slow rhythm.
• Massage used appropriately in accessible
peripheral areas of damage has been observed
as having a positive effect in reducing pain.
• Massage may contribute in some way to pain
control at all the indicated level and therefore
may influence pain perception and its
threshold.
• Pain receptors are not readily adaptive so if
harmful chemicals are present as a result of
injury pain signals are likely to be triggered
and carried to the CNS.
• It is speculated that under these circumstances the
massage may have altered the local circulation in such a
way as to reduce or remove noxious substances.
• There by reducing or removing stimuli reflected in a
corresponding reduction of response by the pain receptors.
• Massage helps to stimulate the peripheral sensory
receptor, mainly touch and pressure receptors, present in
the skin and soft tissue.
• These sensations are carried out by the large diameter A
beta fibers which play an important role in inhibition of the
perception of pain, carried by A delta and C fibres.
• That will complete with incoming pain signals to the spinal cord.
• This input of adequate level may block pain signals by a process of
presynaptic inhibition at the level of substantia gelatinosa of spinal cord and
may reduce or prevent transmission to conscious level.

• (Pain is a complex phenomenon of many components and at the very

encompasses physical and emotional elements.
• Pain is acute, sharp, fast pain which carried to the CNS along A delta nerve
fibers and chronic, aching slow pain served by C fibers.
• Pain is perceived individually and perception thresholds seem to be variable
between individuals and even within a given individual at different times.
• Control or suppression of pain is deemed to occur at different levels within
the nervous system influencing pain are firstly peripheral areas where in the
presence of tissue damage chemical substances like brardykinin, serotonin
and substance P are released and stimulate the free pain receptors
commonly producing the slow pain of injury.
• The spinal cord is the next point at which pain may be blocked
before signals descend to the cerebrum for conscious appreciation
of the sensation since the presentation of the pain gate theory
there has been a basis for believing that sensory traffic into the
dorsal grey areas of spinal cord segments is shifted and sorted.
• This is by the complex neuronal circuitry especially including that
within the substantia gelatinosa.
• Signals from different sources are carried along fibers of different
diameters and compete across the synapses of the circuitry for
which signals will have the right to further transmission.
• Input of signals along large diameter fiber pathways compete with
pain signals along smaller diameter fiber pathways and can close
the pain gate.
• This occurs via various influences on synapses.
• Preventing pain signals from further transmission to conscious
level.
• Higher level of the CNS are considered to be involved in
pain control most probably involving descending
pathways and release of endogenous opiate substances.
• Some of the descending fibers from area such as
brainstem, reticular formation are triggered by certain
pain signals reaching that level of the CNS some of the
subsequent endogenous opiate release will be at the
reticular formation and at higher levels but also at spinal
cord level and it is suggested this will result in the
suppression of pain signals entering at these sites.)
 2. motor system

• Facilitatory effects of massage on

motor system:
• Massage can reflexely increase the muscle
tone by stimulation of the skin receptor of the
muscle spindle.
 Following are the facilitation techniques helps in
massage therapy.
• Touch: applied over the surface where treatment has occurred
produce skin stimulation which helps to facilitate the activities in the
motoneuron pool.
• Pressure: pressure over the muscle belly has the effect of activating
the muscle spindle by distorting the shape of muscle fibres and
creating stretch stimulus.
• Cutaneous stimulation: by quick light brushing, stroking. Clapping
and pressure over the relevant dermatome is used as a preparatory
facilitation to increase the excitability of motoneron which supply the
inhibited muscle.
• For the skin supplied by anterior primary rami, the excitatory effect
is local and is mainly confined to superficial muscles.
• For the skin supplied by posterior primary rami, the excitatory
effect is on deep muscles.
• ( the tone of muscle is maintained by the activity of muscle
spindle.
• Muscle spindle contains the intrafusal fibres supplied by gamma
motorneuron and lies parallel to the extrafusal fibres of the
muscles that are supplied by alpha motoneuon.
• The capsule of muscle spindle is attached with the extrafusal
fibres.
• Any stretch to the muscle spindle, either by activation of
gamma motoneuron or by passive mechanical procedures,
activates the reflex arc.
• The impulse travels via the afferent nerve fibres and propagates
toward the spinal cord.
• Some impulses are mono synaptically transmitted to the alpha
motoneuron of the same muscle. The activation of it produces
contraction of extrafusal fibers of the muscle.)
• Inhibitory effects of massage on motor
system:
• Activation of tension dependent Golgi tendon
organ has an inhibitory effect on the stretch
reflex mechanism reduces the tone of muscle
which helps in the treatment of spasm,
associated increase of tone in psychological
stress, anxiety in neurologically healthy
person.
• On autonomic nervous system
• Massage has reflex effect and it can influence
the functioning of visceral organ by
modulating the autonomic nervous system
through peripheral sensory stimulation.
 Effects on the soft tissues:

• Massage has significant effect on properties of the

soft tissues like elasticity, plasticity and mobility.
• The tissues affected are muscles, sheath, ligaments,
tendons, aponeurosis, joint capsules and superficial
and deep fascia.
• Different types of massage stretch the constituent
collagen fibers of these tissues in different directions.
• The adhesions present between fibers are broken
and maximum mobility between fibers and adjacent
structure is ensured.
• The main function of muscle is to contract.
• when a muscle contracts not only its length reduces but
the width of muscle also increases.
• the full mobility of muscle in broadening out must be
maintained in order to achieve adequate shortening of
muscle.
• Different massage techniques especially transverse friction
mechanically separate the glued muscle fibers and restore
the mobility.
• The fibrin formed within the chronic endurated structures
following chronic or sub acute inflammation can effectively
be stretched and mobilized during pressure manipulations.
• This way massage maintains and restores the
mobility of soft tissues as well as prevents adhesion
formation, joint stiffness, and contracture.
• Massage does not increase the strength of the
muscle which can only be achieved by active
contraction.
• It can prepare the muscle for contraction by
increasing the circulation and facilitating the
removal of metabolic waste products.
 Effects on the respiratory system:
• Percussion and vibration techniques of massage assist
the removal of secretion from the larger airways.
• After chest physiotherapy both in adult and in paedia
group increased secretion clearance combine with
percussion and vibration which helps to loosen the
secretion.
• After the removal of secretion gas exchange becomes
more efficient.
• Efficacy of these techniques is dependent on the skill of
the therapist and complications have been reported
mostly due to poor technique administration like
hypoxia, bronchospasm.
 Effects on the skin.
• In general massage increases the temperature of skin, activates the sweat
glands, improves the nutritive status of the skin and increases the skin
conductance.
• Massage facilitates the movement of the skin over the subcutaneous structures
as a result skin becomes softer, supple and finer.
• After prolonged massage the skin becomes tough, more flexible, elastic and its
sensitivity is reduced so that it can be handled fairly roughly without causing
much discomfort.
• It has a soothing effect on the highly sensitive and vascular papillae over which
deeper layers of the cuticles fits.
• The dead cells are removed, the sweat glands, hair follicles and the sebaceous
glands become free from obstruction and can function more effectively.
• Activation of sweat glands increases perspiration so that the heat dissipation is
increased.
• Increased sebaceous secretion from exocrine glands of skin improves
lubrication and appearance of the skin.
 Effects on adipose tissues:

• Massage was found responsible for activation of

lipolysis.
• The release of catecholamine by the tissue nerve
endings were particularly stressed as the cause.
• This was confirmed when activation of lipolysis
was depressed by beta blockers.
• Studies say that massage is ineffective in weight
reduction
 Psychological effects of massage:

• Massage can lower the psycho emotional and somatic

arousal such as anxiety and tension.
• During massage treatment close contact is established
between therapist and patient who help to overcome
the feeling of strangeness and anxiety.
• The surrounding, equipments, treatment area and the
assured way in which therapist handles the patient all
exerts a strong placebo effect.
• It helps to reduce tension and anxiety and induces
relaxation.
• This effect is used for the purpose of general relaxation.
 Physiological effects at a glance:

– Increase venous blood and lymphatic flow.

– Increase arterial blood flow to the muscle and skin.
– Decrease stagnation of fluid in tissue space.
– Removal of waste products of metabolism.
– Increase WBC,RBC and Platelets count in circulating
blood.
– Increase nutritive exchange between blood and cells.
– Accelerate various metabolic processes.
– Increase trophic status of the part to be massaged.
– Induce sedation.
– Reduce pain.
– Facilitate contraction in hypotonic muscle.
– Decrease Excitability of motoneuronal pool in
neurologically healthy person.
– Modulate autonomic response.
– Increase electrodema responcse.
– Break the soft tissue adhesions.
– Mobilize soft tissues.
– Promote lipolysis.
– Increase removal of secretion from lungs.
– Increase Gaseous exchange across pulmonary
capillaries.
– Increase removal of dead cells from skin.
– Increase activity of sweat and sebaceous glands.
– Modulate psychosomatic arousal.