Regular application of a specialised massage sequence to leg muscles has been shown to promote motor skills in cerebral palsy (MacGregor et al., 2007) when assessed with the Gross Motor Function Measure-66 (Russell et al., 2000). It is proposed that the sequence acts by resolving localised imbalances of forces in the muscles at the level of sarcomeres, and that this resets sensory feedback from muscle receptors, permitting adaptive changes in motor control function. Since work against frictional forces would also liberate heat within muscles, possibly causing vasodilatation, this was investigated by monitoring surface temperatures and by near infra red spectroscopy (NIRS). 7 adolescents (3 males and 4 females) with cerebral palsy (CP) and a matching group of controls participated in the study. The adolescents gave their informed consent; permission for the study was obtained from their parents, doctors, and the local Ethics Committee. Skin temperatures over the medial gastrocnemius muscles were taken immediately before and after the massage sequence. The NIRS optodes were positioned over the upper part of these muscles. The optical path length determines the depth of recording from the skin surface. Since subcutaneous fat thickness varies, path lengths were chosen for each individual for which there was a maximal reduction in oxygenated haemoglobin during standardised isometric contractions of the calf muscles. The massage was applied to the lower part of the calf not covered by the optodes. Oxygenated, de-oxygenated and total haemoglobin were continuously monitored during, and for at least 2 minutes before and after the sequence. Before massage mean skin temperatures over the gastrocnemius muscles were significantly lower in the group with cerebral palsy (26.8 ± 0.2°C compared with 28.7 ± 0.2°C; P < 0.05; n=35). After massage there was no difference in mean temperatures (30.0°C). In 14 trials, in the control group there was a significant increase in total haemoglobin during the massage in 7 cases, a reduction in 4, and no effect in 3 cases. Increases in total haemoglobin were maintained after massage, and in 3 of the 4 cases in which it was reduced during massage there was a later increase. In participants with CP the total haemoglobin increased during massage in 11 cases, and the increase was maintained in 8 of them after massage. In one case total haemoglobin fell during massage, and there was no effect in two cases. Clearly the massage sequence can indeed increase muscle oxygenation in CP. However since motor performance improved in all adolescents with CP who received regular massage, the lack of consistency of local effects on oxygenation suggests that they cannot be held solely responsible.