Massage has physiological effects on multiple body systems. It affects the circulatory system by increasing blood flow, velocity and oxygen content while decreasing blood pressure and heart rate. The nervous system is impacted through the release of endorphins which reduces pain and lowers alpha motor neuron excitability. Massage excites muscle contraction and tone while improving fatigue and electroexcitability. It also boosts metabolic, respiratory, excretory and skin functions by enhancing blood flow, oxygen delivery, waste removal, relaxation and temperature regulation.