Achievable logoAchievable logo
MBLEx
Sign in
Sign up
Purchase
Textbook
Practice exams
Support
How it works
Exam catalog
Mountain with a flag at the peak
Textbook
1. Anatomy and physiology
2. Kinesiology
3. Pathology & special populations
4. Benefits and effects
5. Assessment and planning
6. Sandbox Folder
6.1 Musculoskeletal system benefits
6.2 Mechanical and reflex effects
6.3 Circulatory system benefits
6.4 Nervous system
6.5 Example
6.6 Stephen sandbox
6.7 Spinal nerves and peripheral nerves
6.8 Conditions
6.9 Proprioceptors
Achievable logoAchievable logo
6.3 Circulatory system benefits
Achievable MBLEx
6. Sandbox Folder
Our MBLEx course is currently in development and is a work-in-progress.

Circulatory system benefits

5 min read
Font
Discuss
Share
Feedback

According to MBLEx resources, 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 “massage-related increases in myofascial relaxation reduces vascular resistance within the muscle tissue”.
  • Many of a therapist’s strokes mechanically move lymph and venous blood (deoxygenated blood) toward the heart (“centripital” 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. (TK decide whether to provide more detail).
  • 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, 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 may be described 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 (“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 get fancy and describe this 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.
Sidenote
Oxidation vs. oxygenation

Increased oxygen delivery might be imprecisely stated in MBLEx questions as “increased blood oxygenation”, or “increased blood oxygen saturation”, or even “increased blood oxidation”. That last one is just plain wrong, but I have seen it as the intended answer on an official MBLEx practice question.

There are also benign circulatory system side-effects you should be familiar with. These are not the beneficial effects that clients pay for, but nonetheless 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. (TK run-on sentence)

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.

Mechanisms of Increased Circulation During/After Massage

  • Myofascial relaxation reduces vascular resistance, allowing easier blood/lymph flow
  • Centripetal strokes mechanically move lymph and venous blood toward the heart
    • Promotes venous drainage and lymphatic drainage via one-way vessel valves
  • Increased blood capillary flow rate at the capillary level
  • Reactive hyperemia: tissue refill with fresh blood after temporary compression

Circulatory System Benefits of Increased Flow

  • Increased oxygen and nutrient delivery to muscle, fascia, and skin cells
  • Enhanced healing of muscle/fascia due to more oxygen, nutrients, and white blood cells
  • Increased post-exercise elimination of waste products (metabolites/chemicals)
  • Decrease or elimination of trigger/tender points caused by ischemia
  • Improved perfusion, venous/lymphatic drainage, and tissue rehydration
  • Possible increase in blood platelet count (healing indicator)

Benign Circulatory Side-Effects

  • Short-term increase in skin temperature
  • Short-term skin redness (erythema, hyperemia, flushing)
  • Short-term increase in urine production due to lymph return to blood

Temporary Reduction in Blood Pressure

  • Decreased muscle tension lowers vascular resistance, reducing blood pressure
  • Parasympathetic (relaxation) activity further decreases blood pressure
  • Effects are short-term; massage is not a treatment for hypertension
Previous
Next  | 6.4.1 Organization
All rights reserved ©2016 - 2026 Achievable, Inc.

Circulatory system benefits

According to MBLEx resources, 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 “massage-related increases in myofascial relaxation reduces vascular resistance within the muscle tissue”.
  • Many of a therapist’s strokes mechanically move lymph and venous blood (deoxygenated blood) toward the heart (“centripital” 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. (TK decide whether to provide more detail).
  • 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, 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 may be described 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 (“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 get fancy and describe this 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.
Sidenote
Oxidation vs. oxygenation

Increased oxygen delivery might be imprecisely stated in MBLEx questions as “increased blood oxygenation”, or “increased blood oxygen saturation”, or even “increased blood oxidation”. That last one is just plain wrong, but I have seen it as the intended answer on an official MBLEx practice question.

There are also benign circulatory system side-effects you should be familiar with. These are not the beneficial effects that clients pay for, but nonetheless 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. (TK run-on sentence)

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.

Key points

Mechanisms of Increased Circulation During/After Massage

  • Myofascial relaxation reduces vascular resistance, allowing easier blood/lymph flow
  • Centripetal strokes mechanically move lymph and venous blood toward the heart
    • Promotes venous drainage and lymphatic drainage via one-way vessel valves
  • Increased blood capillary flow rate at the capillary level
  • Reactive hyperemia: tissue refill with fresh blood after temporary compression

Circulatory System Benefits of Increased Flow

  • Increased oxygen and nutrient delivery to muscle, fascia, and skin cells
  • Enhanced healing of muscle/fascia due to more oxygen, nutrients, and white blood cells
  • Increased post-exercise elimination of waste products (metabolites/chemicals)
  • Decrease or elimination of trigger/tender points caused by ischemia
  • Improved perfusion, venous/lymphatic drainage, and tissue rehydration
  • Possible increase in blood platelet count (healing indicator)

Benign Circulatory Side-Effects

  • Short-term increase in skin temperature
  • Short-term skin redness (erythema, hyperemia, flushing)
  • Short-term increase in urine production due to lymph return to blood

Temporary Reduction in Blood Pressure

  • Decreased muscle tension lowers vascular resistance, reducing blood pressure
  • Parasympathetic (relaxation) activity further decreases blood pressure
  • Effects are short-term; massage is not a treatment for hypertension

More from Sandbox Folder

  • Mechanical and reflex effects
  • Musculoskeletal system benefits
  • Example
  • Stephen sandbox
  • Spinal nerves and peripheral nerves