Right as Rain Massage

The Biomechanics of Massage: How Massage Therapy Changes the Tonicity of Muscles

Many people know that massage helps muscles relax, but few likely understand why. Massage is a science as well as an art. So while you may think your therapist has magic hands, she may just know a thing or two about the science behind therapeutic massage therapy.


Muscle tone is usually thought of in terms of fitness but really, tonicity refers to the level of tightness or flaccidity. Overuse can cause a muscle to be painfully tight while underuse can cause stiffening and shortening. Optimal tonicity is where muscles are able to return to a lengthened resting state after contraction. Massage affects muscles in specific, verifiable ways and it isn't really magic. If you are unfamiliar with some of the terms here (trigger points and fascia) please see my articles, "Myofascial Massage for the Sports Minded," and "The Pain Spasm Wheel," on my blog.


Reversal of Ischemia

When a muscle is in a contracture (a type of involuntary spasm) for a length of time, it can become tight and ischemic. Ischemia is a state in which blood delivery to muscle fibers is in short supply. Think of sweet corn.  You remove the green, supple husk before you cook the cob. If you were to take that husk and put it on your counter top for a week or two, what would happen? It would dry up, turn brown, shrink and shrivel. Muscles don't react quite that dramatically to a lessened blood supply, but they do suffer. Blood carries important nutrients and oxygen. Plus, blood brings little garbage men to take away wastes. When wastes are left in muscle fibers rather than taken away by a steady stream of blood, they gather to create a noxious environment. Wastes can cause trigger points to form and they can irritate nerves. Therefore, muscles can become tight and painful, just because of waste build-up.


If you were to put that dried-up husk into a bowl of fresh water, what would happen? It would likely start to hydrate and expand. It would not come back to life of course, but it would change its shape and size. In a similar way, massage helps muscles to improve by lengthening and broadening fibers. Part of it is the manual manipulation itself, like kneading bread dough. But much of it is the critical action of bringing blood to the area through the pressure which is sort of like bringing gasoline to the engine of your car when you press the accelerator with your foot. Blood floods in which infuses the fibers, supporting a change in tonicity.


Relaxation Response Signal

I was once told by a chiropractor that my first rib was high (out of place). She used a gun-like apparatus called an activator. A little bar of steel shot out and slammed into my rib. It was more like a tap and it did not hurt at all. I laughed and said, "Do you really think that moved my rib? I don't feel any difference." She replied, "Yes. It sent a message to your brain telling it to re-position your rib back down to where it is supposed to be." The same communication happens with muscles. When a muscle is tight or put in a shortened position for a long time, the brain can begin to believe that the muscle is supposed to be tight and supposed to be short. The brain can literally reset the tonicity and length of that muscle so that it stays that way permanently.


The good news is that just like that activator, manually pressing on a muscle can send a message to the brain stating, "We want this muscle to relax." If the brain interprets the message properly, it will relax the muscle and reset it to its normal, longer length after it has been lengthened by massage. This won't necessarily happen right away, however. Tight muscles can take a long time to relent. You will likely need multiple sessions depending on the degree of tightness. Plus, there are multiple layers of muscle to get through. The body and brain can eventually learn and remember with continued massage. People who get frequent bodywork typically find that their muscles loosen soon after the therapist starts working. Their muscles have been trained to respond to massage quickly.


Trigger Point Release and Fascial Lengthening

As much as tight muscles can encourage trigger point formation, trigger points keep muscles perpetually tight. It's like a feedback loop that keeps repeating. When the trigger point is released or dissolved, the muscle will be allowed to relax. Some trigger points are so powerful that they can be responsible for creating what is called "satellite" trigger points in other muscles. So not only do they cause pain in their own referral zones, they can cause other muscles to be tight through neural pathways and fascial connections. Sometimes when these "key" trigger points are released, satellite trigger points are released simultaneously without the therapist touching them. This is why it is so important that a therapist work thoroughly and not just where it hurts.


Along the same lines, tight fascia can keep muscles perpetually tight. Fascia that has been put in a shortened position for a too long (like the hips sitting in forward flexion at a desk all day) can affect the tone of connected muscle fibers. The fascia can tug at, bunch up with and adhere to muscle that it touches. Also, when fascia arranges itself into a jumbled formation in an overworked area such as your upper shoulder blade and begins to harden, then you may find what is known as a "knot" formed there. These painful areas are adhered fascia (essentially scar tissue) compromising the length, function and tension of the muscle fibers beneath. Lengthening fascia, breaking up fascial adhesions and releasing trigger points all contribute to muscles being better able to respond to massage and therefore experience change in tonicity.


Massage for maintenance is a good idea. Ask your therapist how often you should have a massage based on your condition. If you can begin to reverse some of the built-up tightness, you may get to a place of preventing it. Also, remember that the biggest contributor to muscle hyper tonicity (tightness) is repetitive motions such as working at a computer or driving long distances. If you continue with those patterns, your muscles will likely re-tighten. But if you can commit to a therapy program and improve upon some of your postural imbalances, there is hope for even the tightest muscles.


Emily Hagen BCTMB, CNMT

Board Certified Neuromuscular Therapist

Right as Rain Massage, LLC