How Sports Massage Affects the Body: What Research Shows

Sports massage creates both physical and sensory input. Pressure, movement, stretching and touch interact with the skin, muscles, nervous system and a person’s perception of soreness or restriction.

Research suggests that these effects can make sore or overworked areas feel more comfortable, produce modest short-term improvements in flexibility and improve how recovered someone feels after exercise. Scientists have also identified changes in autonomic activity and cellular signalling following massage.

Not every effect occurs in every person or after every technique. Pressure, treatment duration, timing, training load and previous experience can all influence the response. This is why an individualized appointment is more useful than applying the same routine to every active person.

Sports massage is a goal-directed approach to massage therapy organized around physical activity, training demands and recovery needs.

It is not one standardized technique, and it does not always require deep pressure. Depending on the person and the purpose of the appointment, treatment may include Swedish massage techniques, focused pressure, myofascial techniques, compression, trigger-point work, joint mobilization or assisted stretching.

An RMT may also adjust the treatment according to when the client needs to train or compete again. A focused appointment during a recovery week may look very different from treatment provided shortly before an important athletic event.

*For practical information about appointments at our Midtown Toronto clinic,  visit our sports massage therapy service page.

Massage mechanically moves and compresses the skin and underlying soft tissues. At the same time, receptors that respond to pressure, movement and stretch send sensory information through the nervous system.

The brain uses this information when interpreting pain, tension, body position and whether a movement feels comfortable or threatening. This helps explain why an area can feel different after massage even when no structural change can be seen.

Treatment can also change a person’s tolerance for movement or pressure. A calf, shoulder or hip that initially feels guarded may become more comfortable as the nervous system receives repeated, manageable sensory input.

These effects do not require the therapist to force the tissues or use the deepest pressure possible. A productive amount of pressure is one that provides useful input while allowing the person to remain comfortable enough to breathe, communicate and avoid excessive guarding.

Many people experience massage as calming. Breathing may slow, muscle guarding may decrease and the person may feel less alert to discomfort in the treated area.

A 2010 review by Field, Diego and Hernandez-Reif examined research comparing moderate- and light-pressure massage. The authors proposed that moderate pressure may provide stronger sensory input and influence vagal and other autonomic responses.

Pressure is only one part of the experience. Treatment rhythm, environment, expectations, sensitivity and whether the technique feels safe and familiar can all influence the nervous system’s response.

Massage is therefore not automatically sedating. A focused or stimulating technique may temporarily increase alertness, while slower familiar work may feel more relaxing.

This variation is one reason therapists ask for feedback. The goal is not to create one predetermined nervous-system response. It is to choose techniques that are appropriate for the person and the purpose of the appointment.

Delayed-onset muscle soreness usually develops after unfamiliar or demanding exercise. It may be most noticeable between 24 and 72 hours after training.

Sports massage is commonly used during this period because it can make stiff or overworked areas feel more comfortable.

A 2020 systematic review and meta-analysis found that massage produced a small improvement in delayed-onset muscle soreness. This does not mean massage instantly repairs everything that occurred during exercise. It means that treatment can positively influence how soreness is experienced while normal recovery continues.

That can be a worthwhile outcome. Less soreness may make ordinary movement, sleep or preparation for the next appropriate training session feel easier.

Massage should still be adapted to tissue sensitivity. An area that is already very sore may respond better to moderate, broader treatment than to aggressive pressure.

Researchers distinguish between perceived recovery and measures such as force production, blood lactate or repeated athletic performance.

In a study involving eight amateur boxers, massage improved participants’ perceptions of recovery compared with passive rest. It did not produce the same improvement in measured boxing performance or blood-lactate removal.

That difference does not make perceived recovery unimportant.

Recovery is partly a physical process and partly an experience. How sore, prepared or comfortable someone feels can affect confidence, willingness to move and the overall experience of returning to activity.

Massage can therefore be useful without needing to produce an immediate increase in strength or speed. Helping someone feel more comfortable and prepared is a legitimate treatment outcome when it is described accurately.

The 2020 systematic review also found a modest improvement in flexibility following massage.

Several processes may contribute to this response. Massage can reduce sensitivity, change the sensation of muscular tension and make a position or stretch feel more tolerable. Assisted movement may also give the nervous system repeated exposure to a range that initially felt restricted.

These changes are often short-term, but temporary changes can still be useful.

A more comfortable range of motion may create an opportunity to practise a movement, complete an appropriate mobility exercise or return to an activity with less hesitation. Active movement and strengthening can then be used to reinforce that range.

This is why massage and exercise do not need to compete. Hands-on treatment may improve immediate comfort, while active rehabilitation or training develops longer-term capacity.

Some massage research has examined more than soreness and flexibility.

In a 2012 study, researchers collected muscle biopsies from 11 young men following exhaustive cycling exercise. One quadriceps received ten minutes of massage while the other served as an untreated comparison.

The researchers identified changes in cellular pathways associated with mechanical stimulation, inflammatory signalling and mitochondrial biogenesis signalling in the massaged tissue.

This study is important because it demonstrates that massage is not physiologically inert. Mechanical treatment can produce measurable responses within muscle cells.

It was, however, a small mechanistic study conducted under specific conditions. Its findings help researchers investigate how massage interacts with exercised muscle, but they do not define every clinical outcome or every person’s response.

The appropriate conclusion is that massage can influence cellular signalling after exercise—not that one treatment completely resolves inflammation or repairs an injury.

Massage frequently produces a sensation of warmth, and rubbing the skin can cause visible redness. These effects demonstrate a local response, particularly in the skin and superficial tissues.

Blood flow within exercised muscle is more complicated.

A 2010 study of the forearm found that massage mechanically reduced post-exercise muscle blood flow and slowed lactate and hydrogen-ion removal under the specific experimental conditions. The boxing study also found no improvement in blood-lactate removal following massage.

These findings challenge the traditional claim that massage works by flushing lactic acid from tired muscles.

Lactate is not a toxin that remains trapped in the muscles for several days, and delayed-onset soreness is not caused by stored lactic acid. Light active movement may be more effective when the immediate goal is maintaining blood flow after exercise.

Massage does not need the lactic-acid explanation to be useful. Its effects on sensory input, soreness, movement comfort and perceived recovery provide a more credible explanation of its role.

Massage is best understood as a recovery-support strategy rather than a substitute for training.

The 2020 systematic review did not identify meaningful improvements in strength, sprinting, endurance or jumping immediately following massage. Those physical capacities are primarily developed through appropriate training.

A sports massage may still support the training process by helping someone manage soreness, recurring muscular tension or temporary movement restrictions. An athlete who feels more comfortable may find it easier to continue with an appropriate recovery or training plan.

Treatment timing matters. Focused work may be entirely appropriate when there is enough time for any tenderness to settle. Closer to competition, a familiar and less provocative approach may be selected.

The useful question is not whether massage makes every athlete perform better immediately. It is whether the treatment fits sensibly into that person’s larger training and recovery plan.

Sports massage may help a person become more aware of areas that feel unusually sensitive, restricted or overloaded. It may also help manage recurring tension that makes training less comfortable.

However, injury risk is affected by training load, previous injury, strength, fatigue, sleep, equipment and the demands of the activity. Massage is only one possible component of managing those demands.

It works best alongside appropriate training, rest and rehabilitation—not in place of them.

When symptoms include substantial swelling, sudden weakness, major bruising, difficulty bearing weight or loss of function, appropriate assessment is more important than attempting to massage through the problem.

Massage studies do not all investigate the same treatment.

One study may examine a ten-minute massage following exhaustive exercise. Another may study a longer general treatment, focused pressure on one limb or massage provided to people with a specific medical condition.

The participants may also differ in age, activity, health, previous massage experience and expectations. Researchers may measure soreness, heart rate, flexibility, blood flow, cellular markers or athletic performance—and those outcomes do not always change together.

Historical research illustrates this complexity. A 1970 study by Barr and Taslitz measured several autonomic functions during conventional back massage. Some measurements showed increased sympathetic activity rather than a uniform relaxation response.

The study was small and did not include inferential statistical analysis, but it demonstrated an important principle: massage can create measurable physiological responses, and those responses are not identical in every setting.

This is why a therapist should consider how the individual responds instead of assuming that one pressure level or technique is universally best.

Research provides useful boundaries, but a treatment still needs to be adapted to the individual.

An RMT may consider what type of activity the person performs, which areas are carrying the greatest load, whether the concern is familiar or new, how the person normally responds to massage and what they need to do afterward.

A person who has several recovery days available may tolerate focused treatment well. Someone who is competing soon may need a familiar approach that is less likely to produce tenderness.

The treatment can also change during the appointment. If an area becomes less sensitive and movement feels easier, the therapist may introduce assisted movement or address another contributing area. If the tissues remain highly reactive, the plan can be modified instead of forcing a predetermined technique.

This ability to assess, respond and adjust is where clinical reasoning becomes as important as the individual massage technique.

Sports massage can produce real sensory and physiological effects.

Research most consistently supports modest improvements in post-exercise soreness, flexibility and perceived recovery. Massage may also affect autonomic responses and cellular signalling, although these responses vary and their clinical significance continues to be studied.

These findings support using massage as part of a broader approach to recovery and movement—not as a miracle treatment and certainly not as a fraudulent one.

Its value lies in applying appropriate hands-on treatment to help someone feel more comfortable, move with less restriction and manage the physical demands of training or an active lifestyle.

1. Davis HL, Alabed S, Chico TJA. Effect of sports massage on performance and recovery: a systematic review and meta-analysis. BMJ Open Sport & Exercise Medicine. 2020;6:e000614.

https://bmjopensem.bmj.com/content/6/1/e000614

2. Hemmings B, Smith M, Graydon J, Dyson R. Effects of massage on physiological restoration, perceived recovery, and repeated sports performance. British Journal of Sports Medicine. 2000;34(2):109–114.

https://pmc.ncbi.nlm.nih.gov/articles/PMC1724183/

3. Wiltshire EV, Poitras V, Pak M, Hong T, Rayner J, Tschakovsky ME. Massage impairs postexercise muscle blood flow and “lactic acid” removal. Medicine & Science in Sports & Exercise. 2010;42(6):1062–1071.

https://pubmed.ncbi.nlm.nih.gov/19997015/

4. Crane JD, Ogborn DI, Cupido C, et al. Massage therapy attenuates inflammatory signalling after exercise-induced muscle damage. Science Translational Medicine. 2012;4(119):119ra13.

https://pubmed.ncbi.nlm.nih.gov/22301554/

5. Field T, Diego M, Hernandez-Reif M. Moderate pressure is essential for massage therapy effects. International Journal of Neuroscience. 2010;120(5):381–385.

https://pubmed.ncbi.nlm.nih.gov/20402578/

6. Adams R, White B, Beckett C. The effects of massage therapy on pain management in the acute care setting. International Journal of Therapeutic Massage & Bodywork. 2010;3(1):4–11.

https://pmc.ncbi.nlm.nih.gov/articles/PMC3091428/

7. Barr JS, Taslitz N. The influence of back massage on autonomic functions. Physical Therapy. 1970;50(12):1679–1691.

https://academic.oup.com/ptj/article/50/12/1679/4596409

8. Khojakulova U, Yessirkepov M, Zimba O, et al. Massage therapy in rheumatoid arthritis. Rheumatology International. 2025;45:76.

https://doi.org/10.1007/s00296-025-05833-3

9. Churchill AQ. Massage, its physiological effects. The American Journal of Nursing. 1915;15(8):635–640.

https://www.jstor.org/stable/3404077