Why Does Massage Feel So Good?

People crave massages for a number of reasons, from feelings of relaxation and pain relief for tight and sore tissue, through to injury recovery and the temporary easing of chronic pain.

The question is, why does massage feel so good? Soft Tissue Therapist Bodine Ledden, from Advanced Clinical Education, takes a deep dive into the science behind the magic of massage.

Sensation

Let’s start by looking at sensation. All sensory information from the surface of the body, known as the periphery, makes its way to the central nervous system (CNS) via ‘afferent’ neural pathways. It reaches an area of the brain called the somatosensory cortex, which has all regions of the body mapped to it. Areas that have more neural sensory representation in the body – such as the face, hands and feet – have larger areas mapped in the brain.

It is not until a nerve impulse makes it all the way to the somatosensory cortex that it is interpreted as a feeling of touch, such as sharp, hot, cold or vibration.

The messages from the periphery are very important for alerting us to our surroundings and protecting us from danger. The nerves that detect dangerous or potentially harmful stimuli are called ‘nociceptors’. These messages need to reach a certain threshold to be sent to the brain. The brain decides what is painful or not through a complex interplay of different brain regions. This is further influenced by previous experience, stress, mood, emotion, thoughts and beliefs. This combination of factors helps to explain why everyone feels pain to differing degrees.

The receptors

There are multiple receptors in the body that have specific jobs to detect different types of stimulus. Let’s look at the different nerve fibres.

The low threshold fibres are very fast and detect touch, vibration and proprioception. This serves to make us constantly aware of our surroundings.

The A-alpha fibres are the largest and fastest. They provide our central nervous system with constant feedback about body position, posture, muscle length/tension relationship, these are proprioceptors. Examples of proprioceptors include the Muscle Spindle and Golgi Tendon Organ which play a role in balance, stretching and muscle energy techniques.

The A-beta fibres detect pressure and touch. These fibres are referred to as ‘low threshold’ fibres, as they are much easier to activate and are very important for providing information to the CNS about our surroundings. These fibres are surrounded by a protective myelin sheath allowing them to send messages to the CNS very quickly. The A-beta fibres are primarily activated through manual therapy.

We then have slightly smaller A-delta fibres that are responsible for alerting us to danger by detecting noxious or potentially harmful stimuli. These fibres are lightly myelinated (protected) and have a high threshold, meaning that it takes a higher intensity stimulus to be able to activate them.

And then we have the C-fibres, which are high threshold fibres. These are the smallest fibres and do not have a protective myelin sheath surrounding, so their messages travel very slowly. C-fibres are the main nociceptors (nerves that detect danger). They give us the feeling of heaviness and aches, and diffuse non-specific pain.

How the nerve fibres all work together

You kick your pinkie toe on the edge of a coffee table in the dark. Ouch! …but not yet. The first thing is that you realise you have kicked your toe. This very fast message from the A-delta nerve has made it all the way to the somatosensory cortex that has the little toe mapped to a specific piece of real estate in your brain. This immediately brings our awareness to the pinky toe. We often wait a second and then experience the ‘second pain’, the ache that makes your toe feel like it’s four times the size that it should be. This horrible throbbing pain comes from the C-fibres. Your next reaction is to grab onto your toe and hold it and rub it because this makes it feel better. This touch sensation stimulates the A-beta fibres.

How is this relevant to manual therapy?

OK, consider those sore upper trapezius muscles in your massage client. They present with an aching, tired, non-specific pain. There is an upregulation of various sensitising chemicals and neurotransmitters in the area that make the tissue more sensitive and much easier to activate the high threshold C-fibres. This means the threshold required for activation has reduced, and is sending constant signals back to the brain to alert the CNS of danger in the tissue, which makes the individual much more aware of that painful area. They will grab on to the area and try to stretch it and massage it themselves to get some relief, but unfortunately it only provides them with very short term improvements.

What happens next? They book an appointment with you and you apply your choice of manual therapy techniques to the area in order to reduce their pain. 

But why does massage provide relief from pain?

There may be many mechanisms to consider.

Interrupting pain with pleasure

One could be due to the ascending inhibitory system or the ‘Pain gate’. This means by activating the low threshold A-beta fibres through touch/massage, the noxious C-fibres are inhibited from making it to the somatosensory cortex, and therefore the painful message does not make it to its destination. So, essentially, we feel the nice touch rather than the aching pain.

Increased blood flow

Massaging the area will also increase local blood flow, which can have a flushing effect on the tissue, neutralising pH. The local capillary dilation can improve oxygen and nutrients to the tissue and restore homeostatic balance.

Feelgood opioid hit

The feeling of a massage also produces feelgood hormones, called endogenous opioids, that inhibit painful messages from travelling to the brain. These ‘painkiller’ opioids are the same type of drugs as morphine, but they are made within our own bodies. Massage can also result in the release of serotonin, the same chemical that provides us with that good feeling after exercise and can significantly affect pain modulation. Pretty amazing, right?

When we consider why massage can make us feel so good and alleviate pain, it becomes clear that the role of the far-reaching nervous system is key. Your client may not realise it, and they may not care, but there’s science behind the magic in those healing hands.

ARE YOU A MASSAGE THERAPIST LOOKING FOR PROFESSIONAL DEVELOPMENT? 

Advanced Clinical Education is Australia’s leading provider of professional development for massage therapists.

Delivering a wide range of face to face and online education in the form of workshops, conferences, retreats, online courses, webinars, in-service training, podcast and video content and more.

Check out their courses here. 

LOOKING TO GET QUALIFIED AS A MASSAGE THERAPIST? 

The Australian Institute of Fitness offers practical and comprehensive massage therapy courses.

Choose from:

• Remedial Massage Therapist – HLT52015 Diploma Of Remedial Massage
• Massage Therapist – HLT42015 Certificate IV In Massage Therapy