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Getting a massage is probably one of my top three favorite feelings in the world. (The other two being the first sip of my morning coffee and cuddling with my chihuahua mix, Barney.) Not exactly a hot take, I know—but I’ve had my fair share of massages over the years, and I generally know the drill. So I was surprised when, after a particularly intense deep-tissue session recently, I found myself feeling a little off. I was more tired than normal, had a headache, and even felt a bit sniffly—all in the hours after I left the spa. But by the next morning I felt fine.
My algorithm, as usual, knew what was up before I did. “I got a massage Friday night, and I woke up Saturday feeling awful,” user @wellwithsher shared last October while making a matcha. “It quite literally felt like I had the flu yesterday…I was like, what the hell is going on?” Naturally, commenters had a lot of opinions: It’s toxins being released. No, it’s an inflammation response in the muscles. No, it’s the movement of lymph in the body. So, yeah, what the hell is going on?
“Massage creates change,” says Izzy VanHall, licensed massage therapist and director of bodywork at Sage + Sound in New York City. “It changes muscle tone, increases local circulation, and gives your nervous system a completely different set of inputs than it’s been receiving all day. For some people that’s incredibly energizing. For others it’s an invitation for the body to finally slow down, and that can feel unfamiliar.”
That unusual feeling may be what leads some people (ahem, *raises hand*) to think they have the “massage flu.” But when done properly, massage should make you feel better, not worse. “Someone who gets regular massage, stays hydrated, and gets appropriate pressure usually feels nothing but good afterward,” says Nina Davis, licensed massage therapist at Nurture in Cincinnati.
Going to a skilled, trained practitioner who knows how to best take care of you matters too. “Make sure your therapist is licensed and certified—that’s the single biggest thing you can do to keep yourself safe,” says Davis. For example, “If you’re pregnant, seek out someone specifically certified in prenatal massage, because they’re trained in what’s safe and what isn’t.”
Still feeling nervous about the so-called massage flu? Keep reading for the pro point of view, plus tips for how to feel your best post-massage.
Is the massage flu real?
Officially, no. “I don’t use the term massage flu because it isn’t a recognized medical condition,” says VanHall. But don’t feel gaslit—you may be feeling, well, something. “What I do see is that some people have a temporary response to bodywork, especially if they’ve been carrying a lot of physical tension or living in a chronic state of stress.”
According to Emily Poirier, pelvic health physical therapist at Wave Physical Therapy & Pilates in Cincinnati, some clients do report feeling a bit off after a massage: “Maybe they have a headache, some fatigue, or some soreness. This does not mean that they are actually sick with a flu, but they are likely experiencing the effects of a more intense massage,” she explains. “Certain massage techniques can promote improved lymphatic drainage and cause temporary changes like increased circulation. This can result in some systemic effects that can feel a little like being sick.”
Contrary to what the TikTok comments may claim, the experts say the response is not due to the body “releasing toxins”: “What’s really happening is that your muscles were physically manipulated, your nervous system shifted into deep relaxation mode, and your body is simply responding to that,” says Davis.
Why do some people feel sick after getting a massage?
Most likely, they just feel a bit rundown. “If it’s your first massage, or your first in a long time, your tissues aren’t used to that kind of work, so soreness is more likely,” says Davis. VanHall adds that most reactions—if people have them—are mild. “The ones I hear about most often are feeling sleepy, slightly sore, thirsty, or incredibly relaxed,” she says. “Occasionally someone will notice a mild headache or feel a little more emotional than they expected.”
Stress can also play a role in how the body reacts to massage, says VanHall. “When you’ve been running on adrenaline for weeks or months, sometimes lying on a massage table is the first time your nervous system gets permission to downshift,” she explains. “That shift alone can leave someone feeling incredibly tired afterward.”
Davis says the style of massage can make a difference in how the body responds: “Deep-tissue and sports massage work muscles more intensely than a Swedish or relaxation massage, so there’s more of that ‘workout’ effect. Coming in dehydrated, tense, or worn out makes it worse.”
A lymphatic drainage massage, by definition, kick-starts the body’s lymphatic system, which can also lead to certain aftereffects. “Increased fluid movement and lymphatic drainage can contribute to things like increased sinus symptoms and sometimes headaches or soreness,” says Poirier.
Should you be concerned if you feel sick after a massage?
In general, no. “Mild soreness or fatigue after deeper bodywork isn’t unusual,” says VanHall. “What isn’t normal is leaving a massage in significant pain or feeling genuinely ill. Massage should support the body, not overwhelm it.”
Those symptoms should dissipate quickly. “For most people, any soreness or fatigue resolves within 24 to 48 hours, and often by the next morning,” says Davis. “If someone feels genuinely sick for longer than that with a fever, significant pain, or symptoms that keep getting worse, that’s not a normal massage response. They should check in with their doctor, because it’s likely an outside issue that needs to be addressed, not the massage itself.”
What to do before a massage
In order to feel your best after a massage, you can start prepping your body ahead of the appointment. Davis recommends drinking plenty of water that day and eating something light beforehand. “Arriving very hungry or right after a heavy meal can both leave you feeling off on the table,” she says.
Also, be sure to fill out any intake forms with important information. “Tell your therapist about any injuries, health conditions, medications, or areas you’d like avoided, including pregnancy, which changes how we position and work with you,” says Davis.
What to do during a massage
Throughout the treatment, communication with your massage therapist is key. Again, bring up any injuries or health conditions if needed. And don’t be afraid to say if something doesn’t feel right. “You can ask for more pressure, less pressure, extra attention somewhere, or to completely skip an area,” says VanHall. “Remember, you’re the expert on what you’re feeling. Tell them when the pressure feels productive and when it crosses into pain.”
What to do after a massage
Once the massage is (sadly) over, you can take steps to continue feeling better—not worse. Again, keep drinking plenty of water. “During a massage there is a lot of increased lymphatic drainage and circulation throughout the body, so adequate hydration and fluid intake is essential,” says Poirier. You can also extend the self-care vibes with a bath, if time allows. “A warm bath with Epsom salts if you have them, an ice pack, or a heating pad all help release the muscles further and ease any soreness,” says Davis.
If you usually do more intense workouts, like HIIT, consider taking the day off. “Give your body a quiet evening rather than heading straight into a hard workout,” says Davis, who notes that intensity is relative for everyone. “For our pregnant clients, that might mean skipping a demanding household chore, not just the gym.” If you want, you can do some gentle movement to keep your muscles warm. “A short walk or light stretching the next day eases any residual soreness,” says Davis.
And remember, massage is best as a cumulative practice. “When you come in regularly instead of only when something hurts, your body adapts and the post-massage soreness largely disappears,” says Davis. “And you get the cumulative benefits which are better sleep, lower stress, and muscles that recover faster.”
Post-massage essentials if you have the massage flu
- Electrolytes
Mix an electrolyte packet with at least 12 ounces of water for an added boost of hydration. I personally like Thorne Electrolytes because it is sugar-free and the flavors are great, too.
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2. A good water bottle
I speak from experience: Having a cute water bottle nearby—that actually keeps your bev cold—will make you way more likely to actually drink the recommended amount of water. I use a Stanley Straw Tumbler, but go with whatever will speak to you most.
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3. Epsom salts
Dr. Teal’s Relief & Relax Epsom Salts is still the GOAT for muscle-relaxing baths anytime, but especially after an intense massage or workout.
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4. A heating pad
I like the Warmies Hot-Pak Neck Wrap because there’s no plug needed. Just heat it in the microwave for 90 seconds, wrap it around your neck (or wherever you’re feeling tender), and let the lavender-scented soothing take over.
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