Massage Doesn't Just Feel Good—It Changes Gene Expression and Reduces Inflammation

By Sarah Zhang | February 3, 2012 9:52 am

spacing is important

What’s the News: If you’ve ever been told been that a massage is good for “releasing toxins”—or to sound more scientific, “lactic acid”—from your muscles, then you’ve been told wrong. Turns out muscle cells do like a good massage, but it has nothing to do with lactic acid.

In the first study on the cellular effects of massage post-exercise, researchers found that massage bolsters chemical signals reducing inflammation and promoting repair of muscle cells.

How the Heck:

  • Strenuous exercise actually tears your muscle fibers; that’s why an intense workout can leave you sore for days. (Don’t worry—it’s normal and it generally heals fine.) The researchers wanted to study how massage affects this muscle damage, so they made 11 healthy young men cycle to the point of exhaustion.
  • Then, finally, relief! Sort of. One leg on each man was randomly chosen for a 10-minute massage. Unfortunately more pain was then in store for these volunteers. A tissue sample was taken from the quadriceps muscle (often known simply as “quad”) of each leg 10 minutes and 2.5 hours after the massage.
  • Researchers looked at the level of different mRNA, or messenger RNA, transcripts in these tissue samples. mRNA carries the information for building proteins in the cell, so the level of a particular mRNA molecule can tell you how much of its corresponding protein is being made.
  • Compared to unmassaged muscle cells, the tissue from massaged legs had different levels of two key proteins: less NFkB and more PGC-1alpha. Lowering NFkB levels reduces inflammation and increasing PGC-1alpha levels leads to the creation of more mitochondria that generate energy for cell growth, so both these massage-induced changes are good news for healing muscle cells.

What’s the Context:

  • Massage is one of the most common forms of “alternative” medicine, and it’s been proven to reduce pain. Before this paper though, there was surprisingly little science on how massage actually works. And this study might finally kill the lactic acid myth that has persisted for so long.

Reference: Justin D. Crane et al. “Massage Therapy Attenuates Inflammatory Signaling After Exercise-Induced Muscle Damage.” Science Translational Medicine, published 1 February 2012. DOI: 10.1126/scitranslmed.3002882

CATEGORIZED UNDER: Health & Medicine, Top Posts
  • sports therapist

    “And this study might finally kill the lactic acid myth that has persisted for so long.”

    The article and research propose a novel mechanism for enhanced cellular repair, but that doesn’t mean the conventional explanation of benefitting from enhanced circulation is a “myth.”

  • Chris

    Good to see that massages will produce a happy ending.

  • John Lerch

    What about the notion that in fact all cellular hypertrophy requires damage? If we decrease inflammation won’t that also lower signals for muscle number increase? I.E. maybe the cells that are there will enlarge to accommodate more mitochondria; but there will still be the same #.

  • David

    Re: sports therapist – good point that this has absolutely nothing to do with the lactic acid myth. I think you’re right. But the lactic acid explanation is still most definitely a myth: there is literally zero evidence in favor of it, and plenty against. To take just one example of the many available, this study ( shows that massage actually reduces blood flow.

  • Nancy T

    The benefits of massage as well as other modalities are countless. A clearing of the tissue is one of them. It is good to hear that science is backing up what therapists have known for years…. massage works on many levels.

  • Guy

    “2. Chris Says:
    Good to see that massages will produce a happy ending.”

    Force that joke in bro, it’ll fit

  • Neal G.

    @sports therapist: Lactic acid clears itself from your muscles within an hour (i.e., it’s not what causes DOMS), and isn’t harmful. See the NYT article here: That’s the myth the article is referring to. Increased bloodflow is great, but I already get that from exercising. The beneficial effects being pointed out here are something else.

  • http://none biogradstudent21

    A massage increases circulation thereby increasing oxygen availability to cells. Increased oxygen stimulates the gene called PGC-1a, which controls the growth of mitochondria. But are these benefits only due to increased oxygen availability? By reading the abstract it appears that the study is also showing that the physical effect of massage by stretching muscles reduces inflammatory signaling pathways.

  • jasno

    Massage makes me need to urinate(LOL) – why? Is it pushing byproducts out of the cells? Is it moving stale blood to my kidneys where it’s cleansed? Is it pushing a bunch of NFkB into my blood and causing more general inflammation?

  • odoyle

    I’m skeptical to truly believe the results of this experiment based completely on the fact that there were only 11 test subjects for the test group. It wasn’t a double blind experiment either… which could lead to quite a bit of unintentional bias. I think before any true conclusions can be made a MUCH larger test sample must be taken too.

  • Clement

    Sports Therapist: The article and research propose a novel mechanism for enhanced cellular repair, but that doesn’t mean the conventional explanation of benefitting from enhanced circulation is a “myth.”

    True, but there are other studies that do that. Massage actually reduces circulation in the massaged area for some time after the massage, then it goes back to normal. Never does it increase circulation.

  • Maddy

    Recently had a muscle strain injury but wasn’t sure if massage would help or hinder its repair. Maybe later on, but surely not straight away, and if not, when?

  • Robby OCluasaigh

    John in hypertrophy the cells increase in size, the micro tearing to muscle encourages this while hperplasia the cells increase but remain same size. Inflammation encourages satellite cells to flood the muscle facilitating this precess. The signal for muscle number increase or motor recruitment comes thru the load demand on the muscle not the amount of inflammation. Massage won’t hinder this but rather encourage it by increase circulation to the area while stimulating override of any pain signals that my be incurred.
    As for Clements statement that massage reduces circulation this is false and many studies show the positive effect of massage on increasing blood flow and lymphatic drainage.
    (ref. example:

  • sports therapist

    Clement, thanks for the insight. My point was that dismissing conventional wisdom as mythical without a scientific reference is poor form for a science writer. The two mechanisms are not mutually exclusive, so the reader should be informed as to why their preexisting impression is false.

  • Jasmine

    Clement: do you have a source that shows massage reduces inflammation? I am very curious to read it!

  • Logicfit

    Jasmine, that source you wanted:

  • Becka G

    I’m surprised that this stuff isn’t just common sense. By massaging a muscle effectively and with certain intent, you are manipulating fascia and reducing hypertrophy thereby increasing blood flow and transport of nutrients. Lactic acid isn’t the only toxin produced by muscle and it’s never been a secret that by massaging these areas you are mechanically moving waste product from the tissue and into the venous return for elimination.

    I’m happy my field is getting more recognition for its cellular benefits but the number one factor of massage is human touch. We (the therapist) are but a tool, while the receiver of the massage is the star of the show. Self awareness is priceless, even on a cellular level. Tissues and organ systems (including the nervous and endocrine) are sometimes not aware of their neighbors unless they’re stimulated. Hypertrophy, impingement of nerves or impincement of vessels cut off their destinations from communicating with the rest of the body. Bodywork is focused to repair these issues thereby promoting harmony between systems. This research is more great news based on people who are at risk of muscle atrophy, in my opinion. I’d love to see more research done on that aspect (i.e. could frequent massage contribute to motor unit stimulation thereby preventing muscle cell death caused by lack of nervous system stimulation.)

    To John Lerch: You are born with same number of muscle cells you will have for life (permitting they don’t lose nerve stimulation and atrophy). Muscle and nerve fibers never increase in number. Muscle cells only increase in size. Those micro tears allow for more protein filament to fill the cell and make it bigger. The whole point of producing more mitochondria is to increase repair as it takes ATP to do so. This is great news for people who damage a muscle enough to put them out of the game and they want to repair it quicker and get back IN the game. :)

  • Jade

    Jasmine, the source is listed at the end of the article. “Massage Therapy Attenuates Inflammatory Signaling…”

  • jake3_14


    How would you conduct a double-blind study involving massage? I’d think it would be obvious to all involved whether or not someone is getting a massage.

  • Sarah Zhang

    @sports therapist — The study in question actually does address lactic acic: lactate acid levels in legs with and without massage were no different. Right after the post went live, I was thinking I should have added that detail, though I did link to other articles that talk about the latest scientific thinking on lactic acid.

    @odoyle Since the study was not attempting to see whether massage had a benefit, but simply to see if there was a difference in what was happening on a cellular level, the size is not actually as much of an issue as it might seem. In the same line, a double-blind design probably isn’t necessary here (and maybe also impossible when it comes to massage?). They are trying to get a sense of the potential mechanism, not figure out if massage is a good treatment for sore muscles”

  • RWileyCMT

    Now you get a massage! …but only on one leg, AAAAND we’re cutting a piece out too. Classic. Thanks for writing this, Sarah, it’s great to see some new massage research spotlighted.

  • exphys101

    I’ll be the first to admit that massage feels great, and likely has some therapeutic benefits. That being said, the bs that most massage therapists spout about lactic acid and “toxins” is pure rubbish.

  • scott

    Regardless, it feels great and you leave all relaxed. It’s been done for thousands of years. At the zoo the other day I all the chimps were sitting together, grooming, hanging out and one of them with a fist was lightly pounding up and down anothers back. Not sure if massage is a documented behavior with them, but it sure looked like it and deliberate.

  • Gabriel

    I would like to see a follow up study that looks into self massage. More specifically, does massaging my own leg produce the same effect as having it massaged by another person (of course normalizing technique as much as possible?) I suspect that, like with tickling, there is a difference between self and other stimulation.

    Also, is it theoretically possible to stimulate this behavior in the cell without massage. Could there be a massage drug? For those of us with low funds and chronic pain that could be a miracle.

  • Robin McDaniel

    Why do you make it almost impossible to use your site with all its cookie requests???

    Why cant I print part of the text that may be of interest to me?

  • dennis

    What about sitting in a whirlpool for 5 or 10 minutes after a workout? Does that work also?

  • Can

    This is a great ‘breakout’ study. Maybe it will stimulate a response to conduct further studies in this field.
    In my opinion, I think a study conducted to observe proteins present in skeletal muscle cells exposed to chronic inflammation may more relevant to Massage Therapy. As an RMT, I see many more chronic conditions than acute. And like @John Lerch pointed out, there is that notion of needing an inflammatory response to stimulate hyperplasia and hypertrophy of muscle fibres and their satellite cells.
    In terms of the general stigma that inflammation brings; it is the body’s natural way of quickly ‘healing’ itself, but excess inflammation brings scar tissue. In an acute situation, you need some ‘controlled’ inflammation present for that quick band aid but breaking it down later down the road via manual therapies is very important to regain range of motion, circulation and strength in the soft tissue.
    Chronic inflammation is the problem and, in a lot of cases, the disease causer.

  • ccqq



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