How Massage Works - Part Two - The Nervous System

Last month I talked about muscles and how they were the focus of my massage education. Now I’m getting to what I feel is the good stuff! The brain, the nerves, the neurotransmitters! Maybe it’s because I was a psychology major in college, but I find this all super fascinating and a little more interesting than musculoskeletal anatomy. Lucky for me, as it turns out, massage is way more about this stuff than it is about muscles! Surprised? Let’s get into it.

The nervous system is the command center of the body. It receives external and internal stimuli, processes the information, and tells the body what to do with it. The nervous system is constantly monitoring, adjusting and responding. Without it, we couldn’t function. Let’s all give it a round of applause. (Did you move to applaud? Your nervous system told you to.)




You could probably guess that the brain is the...well...brain of this operation and together with the spinal cord makes the Central Nervous System (CNS). The Peripheral Nervous System (PNS) consists of all the nerve tissue outside of the CNS. Nerves branch off the brain and spinal cord to all areas of the body. Messages are carried in both directions. Most of these PNS nerves can carry information from the CNS to the muscles and organs and also carry sensory information back to the CNS.

There are a couple types of sensory nerves that are especially important to massage. Proprioceptors are sensitive to body position, muscle tone, and balance. These are located in the muscles, tendons, joints and inner ear. As we move, the various proprioceptors provide information to the brain about the effort, space and timing of movement. This is known as kinesthetic sense - knowing our physical place in the world. Manipulating the muscle through massage can affect these proprioceptors and encourage the muscles to lengthen or shorten.

Exteroceptors gather stimuli from the external environment such as pressure and touch. These are located in the skin and near the surface of the body. They detect things such as pain, light or deep touch, temperature, and vibration. It is clear that any form of massage will have an effect on these nerves.


The Parasympathetic Nervous System
The Peripheral Nervous System is broken down further into the Somatic and Autonomic Nervous System. The Somatic system is responsible for muscular movement. The Autonomic controls the involuntary smooth and cardiac muscles, organs and glands. This allows our bodies to function without conscious effort.

The Autonomic Nervous System is further divided (I promise you won’t be quizzed) into the sympathetic and parasympathetic nervous system. The sympathetic nervous system regulates the “fight or flight” response to real or perceived threats.  This is the system that releases neurotransmitters including adrenaline at the sign (or even the thought of a sign) of trouble or stress. This prepares the body for action, including making the heart pump faster, contracting muscles, and slowing down digestion. While the sympathetic nervous system is extremely important for our survival, notice that it doesn’t take an actual threat to activate. The stressors of everyday life can trigger a fight or flight response.


The parasympathetic nervous system on the other hand handles the “rest and digest” or relaxation response. When the parasympathetic nervous system is triggered, it has the opposite effect as the sympathetic - the heart slows down, muscles relax, digestion goes back to normal. It’s important to balance out all that sympathetic nervous system business with relaxation and it’s not difficult to do. Even a few moments of deep breathing can evoke the parasympathetic system into action. And guess what else can do the trick? Massage! (Duh)

During a massage, the exteroceptors in your skin are detecting the touch. The 1,000 per square inch of nerve endings are getting all that information about the pressure, movement, and temperature of the therapists’ hands and sending it to the brain which essentially says, “aaaaw yeeeeah” and the parasympathetic game is on.

The Importance Of Touch
If yoga, time in nature, or deep breathing can trigger the relaxation response as much as massage can, what makes massage so awesome?

The sense and act of touch is one you may not often think about but is vitally important for humans. From birth we are dependent on touch for healthy growth, development, comfort and immune function. In adulthood, touch continues to be an important tool for communication and validation. Of course not all touch is positive and often it is the interpretation of touch that determines its value.

“While the physiological mechanisms for the touch response are basically the same in every human being, individual interpretation of touch can be vastly different. Influenced by emotion, gender, age, culture, spirituality, and religious customs, each person’s unique intention and perception of touch make it one of the most powerful forms of communication” - Introduction to Massage Therapy

Touch can sometimes initially trigger the sympathetic nervous system, but when you realize that you are not in any danger, the parasympathetic nervous system takes over and relaxation occurs. Healthy touch also stimulates the release of a hormone called oxytocin which is involved with social bonding, mental stability and reduced anxiety.


Finally, touch activates a region of your brain called the orbital frontal cortex - the same area that lights up when we get a reward. When getting a massage you are quite literally rewarding yourself.

Muscle Movement
You’re most likely familiar with reflexes. Touch something hot and you instinctively pull back - that’s a reflex arc happening in your nervous system. What you may not be quite as familiar with is a stretch reflex. This is when a muscle contracts when it is stretched too far or too fast. The nervous system is protecting the muscle from being torn. There’s also the tendon reflex - the opposite of the stretch reflex. When a muscle and its tendon are put into slow and gentle tension, the nervous system determines that the muscle is not in danger of tearing and allows the stretch to go further. Both of these reflexes are important to know in massage. Slow and steady wins the relaxation race.

As a child learning to perform certain actions and move in the world, we each create a nerve track for those movements. With repetition, we reinforce the pattern in our brain and nervous system creating neurological memories. Whether we learn the movement correctly or incorrectly, the pattern will stick. This learning happens throughout life. If you have ever injured one foot, you know the new pattern of walking you have developed. That pattern becomes ingrained and it is difficult to fix later on even if the foot is healed. The same will happen for postures and repetitive motions. The pattern becomes our new normal. But these tracks CAN be rewritten through persistence. Bodywork, including massage, can create new movement patterns.

Put It All Together
Triggering the parasympathetic nervous system that in turns relaxes the muscles, using therapeutic touch to happy chemicals in the brain, understanding and working with the nervous system’s movement conversation - this is what massage is all about.


“About Oxytocin.” Psych Central,

Braun, Mary Beth, and Stephanie J. Simonson. Introduction to Massage Therapy. 2nd ed., Wolters Kluwer Health/Lippincott Williams & Wilkins, 2008.

Keltner, Dacher. “Hands On Research: The Science of Touch.” Greater Good Magazine, UC Berkeley, 29 Sept. 2010,

Sanvito, Alice. “How Does Massage Work?” Massage St Louis, 29 Dec. 2016,

Taylor, Jason James, and Barbara Janson Cohen. Memmler’s Structure and Function of the Human Body. 9th ed., Wolters Kluwer Health/Lippincott Williams & Wilkins, 2009.

Trudeau, Michelle. “Human Connections Start With A Friendly Touch.” NPR, 20 Sept. 2010,


Molly Kerrigan