Mechanical and reflex effects

revised 2025-08-26 5:52:37 PM EDT

MBLEx questions may require you to classify beneficial effects as either “mechanical” or “reflex” effects. Mechanical effects are the direct, immediate physical effects of what the therapist does with their hands or other massage tools. Examples include:

• Increasing local blood and lymph circulation by physically pushing fluids through vessels.
• Breaking up adhesions or scar tissue through direct manipulation.
• Reducing muscle tightness by stretching muscle fibers.

In contrast, reflex effects are indirect responses to bodywork, mediated by the nervous and endocrine systems’ responses to massage:

• Lowering heart rate and promoting relaxation through activation of the parasympathetic nervous system.
• Reducing pain perception via the gate control theory or release of endorphins.
• Affecting internal organ function through reflex arcs (e.g., abdominal massage influencing digestion).

Mechanical forces we apply to the body

There are scholars in massage who approach massage like mechanical engineers, attempting to describe a therapist’s contact according to the forces the therapist applies to the client’s tissue. These mechanical descriptions of massage sometimes appear on the MBLEx. MBLEx items may also refer to these forces as “stress” or “load” (e.g., “bending force”, “shearing stress”, “tensile load”).

Compressive or compression force

This is exactly what it sounds like: you are squishing soft tissue to be temporarily flatter. There are a number of ways we use compressive forces in massage:

• When you gently pinch and hold an upper trapezius tender point between your thumb and forefinger you are applying compressive force to that tissue.
• When you apply your body weight to compress soft tissue toward bone you are applying compressive force. Picture that your client is lying supine on the table. You place your palms flat on the client’s thigh and then shift your weight into your hands to press down on their thigh. As a result you compress skin, fascia, and quadriceps between your hands and the client’s femur.
• Each contact of a percussive tapotement stroke is momentarily compressing soft tissue toward bone. Imagine a slow-motion video of applying hacking (TK internal link) to the thigh.
• You can pull the ends of a muscle (attachments) closer to each other, as when using muscle approximation to treat muscle spasms in a long muscle group like the quadriceps (Benjamin & Tappan, 2016, p. 134). This is compressing a muscle group along its length, rather than compressing it down toward the bone.

Tension or tensile or elongation force

Tension force, also known as tensile or elongation force, is pulling or stretching force intended to lengthen muscles, fascia, and tendons. It occurs in during techniques like longitudinal gliding, traction, and myofascial stretching. It is intended to increase tissue flexibility and range of motion by directly elongating shortened or contracted tissue.

Shearing force

Shearing forces involves sliding one layer of tissue over another in parallel but opposite directions. This type of force is used in techniques such as skin rolling, deep transverse friction massage, and myofascial release. Shearing is useful in that it disrupts adhesions between tissue layers and promotes the movement of fascia relative to other tissues layers, which may increase range of motion and the ease of holding the body upright in gravity.

Twisting force

Twisting forces are rotational or torsional force applied in opposite directions around an axis, effectively rotating tissues. In massage, this is often seen in wringing or spiral movements, where tissue is grasped at both ends of a limb segment and twisted in opposing directions. Twisting helps release fascial restrictions and encourages circulation through a multidirectional stretch.

Bending force

Bending forces are curving or angling pressure that causes tissue to bow or flex. For example, lifting the quadriceps anteriorly from the femur creates an arc or bow in the muscle group. Bending forces may also have an effect during joint mobilizations or when limbs are maneuvered over a fulcrum, such as a therapist’s hand or a bolster. Bending forces can assist in improving mobility by applying gentle pressure that encourages movement and flexibility in both soft tissues and joints.

Categorizing massage contacts according to force

These definitions of forces are used to categorize massage contacts into groups. The following category definitions appear in the ELAP blueprint (TK internal link) and may be asked about on the MBLEx: