Muscle and circulatory system benefits

revised 2025-08-26 5:59:30 PM EDT

Musculoskeletal benefits

When you first received massage you likely noticed the beneficial effects on your muscles and fascia (TK maybe internal link to “myofascial” distinction) before you noticed the effects on other body systems. There are some specific musculoskeletal effects that you are expected to be able to identify:

• Decreased muscle tension may result from your mechanical lengthening and broadening of the client’s muscles as well as tendons and other fascia.
• Decreased muscle tension may result from your stimulation of Golgi tendon organs (a.k.a., Golgi receptors) and influencing of muscle spindle cells (TK links to A&P).
• Decreased muscle tension may result from “decreasing nervous system excitability” (FSMTB’s wording) and activating the parasympathetic nervous system (TK links to A&P).
• Improved healing of injuries in muscle tissue, tendons, ligaments, and other fascia
• Improving range of motion in joints by disrupting unhelpful patterns of tension in muscles and fascia
• Breaking-up myofascial adhesions (TK internal link) that are limiting muscle function.
• Improvements to fascia pathologies (e.g., plantar fasciitis or patellar tendonitis TK internal links) through the 1) decrease of muscle tension that is contributing to those pathologies and/or 2) decrease of muscle tension that results from associated pain.

MBLEx questions may also expect you to know that decreased tension in muscle and fascia often results from how therapists affect one of the components of fascia: its ground substance, which is called hyaluronic acid. With appropriate pressure and heat, hyaluronic acid’s consistency becomes more like a liquid and less like a solid or gel. Picture marmalade transitioning from solid straight out of the refrigerator to a spreadable almost-liquid on hot toast. This property of hyaluronic acid is called thixotropy (or you could also say hyaluronic acid is thixotropic). Another way of saying this is that the hyaluronic acid becomes less viscous in response to the mechanical forces you apply to muscle and fascia. (TK: link to A&P section IF I decide to give HA details in A&P)

Circulatory system benefits

According to MBLEx resources, beneficial in-session and post-massage increases in circulation are caused by at least four different effects. Make sure that you can first picture each of these processes happening in the body, and only then work on memorizing the fancy terms for them. These four effects are:

• The decrease in muscle tension described above creates room for blood and lymph to flow more easily. This happens because decreases in muscle tension mean that muscles are less tightly squeezing the blood vessels inside. This allows the heart to push blood through those blood vessels with greater ease. Picture water struggling to flow through a hose when someone is standing on the hose, and how much easier water will flow when they step off of the hose. A technical way of saying this would be “a massage-related increase in myofascial relaxation reduces vascular resistance within the muscle tissue”.
• Some of a therapist’s strokes mechanically move lymph and venous blood (deoxygenated blood) toward the heart (“centripetal” movement). Then the one-way valves (TK internal link) in healthy veins and lymph vessels stop the lymph and deoxygenated blood from flowing back into the tissue the therapist just moved them out of. This movement of blood and lymph back toward the heart is called venous drainage and lymphatic drainage respectively.
• Blood capillary flow rate increases due to effects at the blood capillaries (TK internal link) themselves.
• When you use your hand tools to temporarily squeeze blood and lymph out of an area of tissue, a healthy body’s reflexes will respond by bringing even more fresh blood to refill that area. This is called reactive hyperemia.

As a result of the increased flow of blood and lymph there are a number of circulatory system benefits that have been observed, or at least hypothesized. The basic idea is that increased blood flow means that groceries get delivered to myofascial tissue faster and waste products removed from myofascial tissue faster. You’ll want to be able to recognize these detailed descriptions of that benefit:

• Increased oxygen delivery to the cells of muscles, fascia, and skin as a result of more blood reaching those tissues.
• Increased nutrient delivery to the cells of muscles, fascia, and skin. MBLEx items might refer to nutrient delivery in general, or broad categories of nutrients (e.g., micronutrients, macronutrients), or more specific nutrients (e.g., carbohydrates/sugars/glucose, fats/lipids, proteins).
• Increases in healing of muscle and fascia due to increased delivery of oxygen, nutrients, and white blood cells (TK internal link).
• Increases in blood platelet count (TK internal link), which MBLEx items may describe as a sign that massage “increases the body’s healing processes”.
• Increased post-exercise elimination of waste products from muscles. Questions may also refer to post-exercise waste products as “metabolites” or “chemicals”.
• Decrease or elimination of a muscle trigger point / tender point (TK internal link) that is being caused by restricted blood flow. Restricted blood flow may also be referred to as (“ischemia”). (TK maybe multiple links here)
• Sometimes MBLEx items refer to the benefit of “increased blood flow to and from muscles, fascia, and skin” without any additional detail. MBLEx authors might also describe this effect as “improved/increased perfusion”, or “improved/increased venous and lymphatic drainage”. They may also describe it as “rehydration of tissues", because the additional blood flow may bring needed fluid to cells or the space surrounding cells.

There are also benign circulatory system side-effects you should be familiar with. Though these are not the beneficial bodywork effects that clients pay for, oddly-worded MBLEx questions may ask about them as “benefits”:

• Short-term increase in skin temperature due to more warm blood being delivered to the skin
• Short-term increase in skin redness seen in lightly pigmented clients. This may be referred to as erythema, hyperemia, or flushing (not to be confused with strokes called flushing strokes).
• Short-term Increase in the kidneys’ urine production as a result of lymph being moved back into the blood vessels to become part of the body’s blood volume.

In addition to these increases in circulation and the related benefits, some questions may ask you to recognize that massage may temporarily reduce a client’s blood pressure, which can be seen as a benefit for clients who are suffering from high blood pressure. This happens through a combination of at least two effects:

• As discussed above, decreasing muscle tension through any mechanism decreases the resistance to blood flow within the muscle tissue. This may lower the body’s overall blood pressure during the time that muscle tension remains decreased.
• When a client experiences relaxation during and after a massage the resulting parasympathetic activity (TK internal link) can change the body in ways that decreases blood pressure for as long as the relaxation continues.

Notice that both of these mechanisms are short-term, only lasting as long as the decreases in muscle tension and the feeling of being relaxed. Because of that we would never claim that massage is a treatment for high blood pressure. However there are MBLEx questions that ask you to acknowledge that lower blood pressure can be a temporary benefit of a massage session. And now you know how that happens.