Massage manipulations can be applied in a systematic approach or plan to influence conditions that affect physical function.

Skeletal muscles respond with direct biomechanical effects. Within this response, biomechanical effects encourage or produce reflex reactions that involve the nervous system and chemical responses. A variety of responses are reached at many levels. The nervous system can respond through the reflex arc, secretion of endorphins and other neural chemicals, and the release of histamine and other cellular secretions. The release of chemicals substances affects a structure or system of the body directly or indirectly. 

The foundation for the benefits of massage therapy is understanding the nature of effects on circulation, elimination, and nervous system control. Circulation is primarily improved by direct biomechanical responses to manipulations. A secondary benefit is obtained through reflex responses encouraging chemical secretion, which affects nervous system control.

Circulation improvement occurs as nutrients, oxygen, and arterial blood components are delivered to the local area being manipulated or are distributed to the general circulation. The benefit of circulatory improvement is the secondary effect of improved filtration and elimination of carbon dioxide, metabolites, and biochemical  byproducts that are transported in  the venous blood, improved circulation, with its ability to affect elimination, generally enhances the abilities of the structures to benefit and support normal function. When nutrition is improved and elimination enhanced, the structures of localized areas, tissues and systems are given the opportunity to maximize the potential for normal function. 

Massage manipulations directly benefit restrictions to muscle tissue function. Mechanical benefits and reflex responses combine to help the muscular soft tissues respond through circulation improvement and elimination of byproducts. Mechanical effects on muscular tissues include influence on the stretching of the muscles fibers and changes in connective tissue structures. The reflex effects encourage relaxation of the tissues through change in motor nerve output and chemical secretions.

Clients receiving massage therapy report a variety of sensations, emotions, feelings and mental perceptions, that are subjective, difficult to measure, and unique to the individual.

Therapeutic massage benefits conditions by encouraging the body through the phases involved in rehabilitation, restoration, and normalization of anatomic and physiologic function and ability. Psychological benefits occur subjectively, according to the individual in response to therapy with secondary effects that influence sensation and pain perception. Objective and subjective result of therapy combine to create individual responses that affect the desired health outcome.