Feeling tired after a massage (or reflexology): what’s normal and why it happens

It’s quite common to feel sleepy, heavy, or emotionally washed out after a massage therapy session. For some people, this can come as a surprise — especially if they expected to feel energised — but it’s usually a normal and short-lived response.

Whilst it’s particularly common following therapeutic massage, the same response can also occur after reflexology, Manual Lymphatic Drainage and other hands-on bodywork, where the nervous system is given clear permission to slow down.

In most cases, post-treatment tiredness isn’t a sign that something has gone wrong. It’s a sign that the body has shifted into a deeper state of relaxation.

What’s going on in the body?

Massage therapy is well known for its effects on the autonomic nervous system, particularly its ability to encourage parasympathetic activity — often referred to as the body’s “rest and repair” mode.

When this system becomes more dominant:

• Heart rate and blood pressure may reduce slightly

• Muscle tone softens

• Breathing deepens

• Stress hormones begin to settle

For people who have been functioning under sustained stress — juggling long hours, pain, poor sleep, emotional load, or constant mental alertness — this shift can feel quite noticeable.

If your system has been running on adrenaline for a while, deep relaxation can register as fatigue. Rather than being a negative effect, it’s often the body finally stepping out of “push through” mode and allowing itself to rest.

Why massage can feel especially draining (at first)

Massage doesn’t just work on muscles; it works on the whole system.

Touch, pressure, and rhythmic movement all provide strong sensory input to the nervous system. For some people, especially those who are unused to slowing down, this can trigger a kind of physiological “exhale” — the moment the body realises it’s safe to stop holding everything together.

That release can feel:

• Sleepy

• Heavy

• Emotionally soft or teary

• Quietly depleted

These responses are generally temporary and often followed by improved sleep, reduced tension, or a greater sense of calm later the same day or the following day.

What does research suggest?

Research into massage therapy consistently shows changes associated with relaxation and nervous system regulation.

Studies have demonstrated that massage can:

• Increase parasympathetic nervous system activity

• Reduce stress hormone levels such as cortisol

• Improve heart rate variability (a marker of nervous system balance)

• Support improvements in perceived stress, mood, and sleep quality

These effects have been observed across a range of settings, including chronic stress, musculoskeletal pain, cancer care, and general wellbeing. While individual responses vary, the overall picture suggests that massage helps the body down-regulate from stress and move towards restoration.

Reflexology appears to produce similar relaxation-based effects for most people, which is why the post-treatment experience can feel comparable — though massage therapy remains the more widely researched modality.

It’s important to note that massage is considered a complementary therapy. It does not diagnose or treat medical conditions, and responses differ from person to person. It is best used alongside appropriate medical care where needed.

How to support yourself after a massage

If you feel tired after your session, a few simple steps can help support the process:

• Drink water as you normally would

• Avoid caffeine or alcohol for a short time afterwards

• Allow yourself to rest if possible — even a quiet hour without demands can be beneficial

Most people find that any tiredness passes naturally and is often followed by better sleep or a sense of grounded calm.

Why regular massage can be more effective than occasional sessions

One massage can help your body relax — but regular massage helps the nervous system learn how to relax more easily.

The nervous system adapts through repetition. Just as prolonged stress can condition the body to stay in a heightened “on” state, repeated experiences of safe, therapeutic touch can reinforce parasympathetic activity and reduce how quickly the body tips back into tension.

Research suggests the benefits of massage therapy are cumulative. Repeated sessions have been associated with more sustained reductions in stress hormones, improved heart rate variability, and longer-lasting improvements in mood, sleep, and pain compared with one-off treatments.

For people living with chronic stress, pain, disrupted sleep, or high emotional load, spacing massage sessions regularly — whether weekly, fortnightly, or monthly — can help the body maintain a more settled baseline rather than constantly needing to reset from scratch.

Over time, many clients notice that massage doesn’t just help them feel better after a session, but more resilient between sessions. In this sense, massage therapy works best when it’s part of ongoing care rather than an emergency measure — offering the nervous system repeated opportunities to rest, regulate, and recover.

Massage therapy is a complementary therapy and is not intended to replace medical treatment. Please continue to follow the advice of your GP or healthcare team.

References: Massage therapy and relaxation effects

Field, T. (2014). Massage therapy research review. Complementary Therapies in Clinical Practice, 20(4), 224–229.

Diego, M. A., & Field, T. (2009). Moderate pressure massage elicits a parasympathetic nervous system response. International Journal of Neuroscience, 119(5), 630–638.

Moyer, C. A., Rounds, J., & Hannum, J. W. (2004). A meta-analysis of massage therapy research. Psychological Bulletin, 130(1), 3–18.

Rapaport, M. H., Schettler, P., & Bresee, C. (2012). A preliminary study of the effects of repeated massage on hypothalamic–pituitary–adrenal and immune function in healthy individuals. Journal of Alternative and Complementary Medicine, 18(8), 789–797.

Weerapong, P., Hume, P. A., & Kolt, G. S. (2005). The mechanisms of massage and effects on performance, muscle recovery and injury prevention. Sports Medicine, 35(3), 235–256.