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What comes to mind when you think of the circulatory system? For many people, it’s blood and the means by which it moves throughout the body. But there’s so much more going on.

Circulation, a primary function of the circulatory system, delivers oxygen and nutrients via blood to each of your body’s 50 trillion cells while also ushering away toxins. Known interchangeably as your cardiovascular system, the circulatory system includes not just the heart but also 60,000 miles of blood vessels. It’s essential for keeping you alive.

This intricate network, increasingly considered by some experts to be an organ in its own right, leaves no cell or body system untouched. It powers your brain, lungs, stomach, intestines, liver, waste and lymph systems, and muscles in important ways. Healthy circulation allows you to not only survive but thrive.

While there are many factors that affect the circulatory system (including genetics and lifestyle factors, such as nutrition), exercise is notably effective. Movement of all kinds keeps your heart pumping well and your vascular system strong and clear. In a beautiful cycle, the better your circulatory system works, the better you move — and perform — in the gym and in life.

“The circulatory system loves exercise,” says Donald Dengel, PhD, director of the Laboratory of Integrative Human Physiology at the University of Minnesota in Minneapolis. He explains that exercise makes the circulatory system stronger, more flexible, and more expansive — all at the same time. A healthy circulatory system then returns the favor by boosting athletic performance.

Still, we often overlook how circulatory health and exercise benefit one another. While we can see and feel the effects of our fitness efforts as we lose fat, gain strength, and build endurance, improvements in our circulation aren’t as visible. Unless there is a problem — be it a blocked artery that leads to a heart attack or stroke, or impaired blood flow that leaves feet cold or tingly — it’s a system that hums along quietly, a diligent but silent worker that doesn’t ask for much in order to give a great deal in return.

Just because it’s quiet, however, doesn’t mean the circulatory system doesn’t deserve some attention when you hit the gym. Let’s explore this intersection of exercise and blood flow, and discover how small changes to your fitness routine can make a measurable, long-term impact.

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How Your Circulatory System Works

The circulatory system is often thought of as a static network of tubes that simply shuttles blood around the body — but it’s so much more. Also called the cardiovascular system (or sometimes just the vascular system), it’s composed of the lungs, lymph tissue, heart, and blood vessels, and it works in concert with your liver, stomach, intestines, and other organs. Moreover, the circulatory system is metabolically active, supports optimal immune function, and serves as an important waste-removal system.

circulatory system illustration

1. Heart

This muscular pump contracts and relaxes some 80 times a minute on average (depending on a person’s genetic profile and fitness level), moving enriched blood through your arteries to your brain, organs, tissues, and bones. The oxygen and nutrients it delivers fuels every cell in your body. Regular exercise helps strengthen and enlarge the heart.

2. Lungs

When you inhale, your lungs fill with oxygen. Then, in a process known as gas exchange, oxygen crosses over from the lung tissue to the bloodstream via a web of capillaries. Exercise has been shown to improve the efficiency of gas exchange. This newly oxygenated blood then flows into the left side of the heart.

3. Blood Vessels

This network of arteries, capillaries, and veins reaches every nook and cranny of your body. Blood travels the whole loop — from the heart to every cell and back to the heart again — in about one minute. The 5 to 6 quarts of blood in your system accounts for as much as 7 percent of your body weight. Those who exercise regularly tend to have greater blood volume.

4. Liver

Your liver detoxifies your body, filtering waste via your blood and bile. Exercising regularly improves blood flow by strengthening the heart and blood vessels, bolstering this filtration system. In turn, overall energy and well-being — including athletic performance — are improved if your body’s natural detox method is functioning well.

5. Stomach and Intestines

Your blood absorbs nutrients from digested food via capillaries in your gastrointestinal system; your blood vessels then distribute these nutrients throughout your body. Exercise not only increases the formation of “collateral” blood vessels, which improves nutrient delivery — regular movement also improves digestion and makes you more regular.

6. Waste System

In addition to delivering oxygen and nutrients to your body’s tissues, your blood picks up waste products, like carbon dioxide and lactic acid. Exercise boosts overall circulation, which moves waste out of the body through the capillaries. Blood then travels back to the heart and lungs, where the cycle starts all over again.

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Exercise RX

A solid fitness regimen benefits your entire body by boosting your circulation in surprisingly varied and vital ways, which makes sense when you remember how much of your body is touched by your vascular system. These are some of the key ways working out can improve your circulatory health.

1. Exercise promotes blood-vessel health.

A healthy vascular system can be measured in two ways: structure and function.

“Arteries are like tubes, with an outer wall and inner wall, and we can talk about both pieces being in good or bad health,” explains Dengel. “In terms of wall thickness, being too thick is not structurally sound — we don’t want stiff vessels. We want them to be very flexible.”

That leads directly to function. When vessels are flexible, they have elastic properties, like the ability to constrict and dilate when presented with changes in volume and pressure. Elasticity is the definition of a healthy artery.

Exercise boosts vessel flexibility because “blood pressure goes up temporarily when we exercise, which forces the blood to flow faster and creates turbulence against the wall of the artery,” he says. “It is like the artery itself is exercising.”

It’s especially important to maintain vessel flexibility in middle age and beyond.

“Vessels are very plastic and can take a lot of abuse when we’re young,” says Dengel. “As we age, unhealthy lifestyle habits — consuming a lot of low-quality fats and sugary food and drinks, for instance — have more effect. Our vessels become more rigid.”

A wealth of research supports the idea that exercise helps prevent — and can even correct — some of that arterial damage. A 1993 study published in the journal Circulation examined 146 men and women, ages 21 to 96. Researchers found that higher physical-conditioning status, determined by VO2 max, was associated with reduced arterial stiffness.

Another study found that the reduction of stiffness was associated with improvement of insulin resistance in type 2 diabetics.

In addition to keeping blood vessels bendy, regular exercise has been shown to reduce arterial inflammation and reduce the dangerous buildup of arterial plaque.

In a 2009 study of mice, researchers found that a consistent daily exercise program over six months helped make existing plaques stronger and less likely to rupture (plaque ruptures can cause a heart attack or stroke).

Regular exercise has also been shown to prevent and dissolve blood clots by enhancing fibrinolysis, a process by which enzymes break down fibrin, a component of blood clots.

2. Exercise helps inoculate against chronic disease.

Vascular endothelial cells line every surface of the circulatory system, sheathing the heart, veins, arteries, and capillaries. These cells were once thought to be nothing more than a sort of biological cellophane wrapper, with only one function: to let a bit of water and some electrolytes pass through to tissues.

Researchers now know that these cells play a major role in maintaining optimal health. Damage to the endothelial lining has been linked to cardiovascular disease, stroke, insulin resistance, diabetes, kidney failure, and cancer.

Exercise puts pressure on the vascular endothelium — and that’s a good thing. Experts believe the various types of stresses exercise induces prepare the endothelial cells to withstand everyday threats, whether it’s inflammation from eating too much sugar or damage to the lung tissue from breathing smoggy air.

3.  Exercise reduces heart-disease risk.

Movement improves vascular hormone production. In as little as a few weeks, exercise has been found to increase the production of atrial natriuretic peptide (ANP), the vascular hormone that counterbalances high blood pressure.

“Research has shown that older individuals who engage in exercise over the long term can see blood pressure improvements” similar to results from ACE inhibitors prescribed for hypertension, says Brad Dieter, PhD, research fellow at Providence Medical Research Center in Spokane, Wash.

High circulating levels of the vascular hormone brain natriuretic peptide (BNP), on the other hand, have been associated with increased risk for heart failure. According to a 2012 study published in the Journal of Cardiovascular Disease Research, endurance exercise, in particular, was found to reduce circulating concentrations of BNP. 

4. Exercise bolsters athletic performance.

A stronger heart pumps more blood, more efficiently, to your lungs and throughout your body. The result? More oxygenated blood reaches your muscle tissue — and when muscles have more oxygen for fuel, they can work harder, improving athletic performance.

Over time, this higher volume of blood widens the blood vessels (another benefit) and builds new ones. “When you exercise, you create collateral vessels,” says Dengel. So not only is more oxygen-rich blood being pumped by a stronger heart, but that blood has more routes to reach muscle tissue.

At the same time, aerobic activity improves lung capacity — and greater lung capacity means more staying power in your favorite game or activity.

5. Exercise improves lymphatic function.

The lymph system — an extensive network of tissues, organs, and vessels that transport lymph fluid throughout the body — has two primary functions: balancing the fluids in the body and producing white blood cells that help fight off infection. The lymph system works in close concert with the blood vessels, and the robust circulation of lymph fluid is essential for optimal health.

Certain exercises promote the flow of lymph fluid. Jumping on a trampoline for just 10 minutes can enhance lymphatic activity. Inversions, like shoulder stands in some yoga practices, help drain lymph fluid and accelerate the rate at which lymph fluid is cleansed and filtered.

6. Exercise makes the heart bigger and stronger.

“Endurance training — like running or rowing — provides specific benefits to the heart,” says Dieter. “The chambers of the heart get bigger.”

That process is called eccentric remodeling, and it allows the amount of blood being pumped out of the heart to increase with each heartbeat. That’s why endurance athletes’ resting heart rates are so low. Their hearts don’t have to beat as often because each contraction pumps out a higher volume of blood.

Strength training has a different effect on the heart. “If you’re weightlifting, your heart will increase in size, but the chamber won’t get bigger. That’s called concentric remodeling,” he explains.

Concentric remodeling increases pressure across the chamber of the heart, so the heart wall gets thicker.

“The heart is a muscle, so just like other muscles, weightlifting makes the heart muscle get stronger,” he says.

(To learn about the possible cardiac risks of extreme, high-intensity endurance training, visit “Out of Rhythm“.)

While strength and endurance training may confer different specific benefits, experts agree that any fitness regimen is a win for the circulatory system. “There is a baseline benefit to any type of movement,” says cardiologist Mimi Guarneri, MD, FACC, author of The Heart Speaks: A Cardiologist Reveals the Secret Language of Healing.

The simple advice to move more — no matter what type of movement you choose — recalls the old saying that the best exercise is the one you will actually do. So whether your passion is golf, doing cartwheels, or Olympic lifting, the fact that you are moving is what matters. Movement is medicine for circulatory health.

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The Truth About Circulation

Can exercise help varicose veins? Are there quick fixes for cold hands? Learn what’s true, and what’s false, when it comes to circulation.

Q | Can certain exercises cure varicose veins? 

A | Not really, says osteopathic doctor Spencer Nadolsky, DO, of Olney, Md. Varicose veins are largely genetic and exercise only does so much. If your legs ache and feel heavy, which can accompany varicose veins, elevating your legs might help. Try doing legs-up-the-wall, for example. (For directions, go to “The Restorative Workout“.) People who stand or sit for many consecutive hours are more likely to develop varicose veins. Compression socks may also help with discomfort.

Q | Will compression socks aid my circulation and improve my athletic performance?

A | Yes and no, says University of Minnesota exercise physiologist Donald Dengel, PhD. Compression socks and sleeves might improve circulation when you sit for a long time on a plane, for example, and they support the healthy movement of lymph fluid throughout the body. But research is scarce on their performance-enhancing ability. (For more on compression socks, see “Expert Answers: Does compression gear work?“)

Q | Are cold hands and feet due to poor circulation? 

A |  “Yes, it very well could be,” says Brad Dieter, PhD, a research fellow at Providence Medical Research Center. Exercise improves blood flow, both in the moment (do enough burpees and dead bugs and your whole body will heat up, even your fingers and toes) and over the long term, thanks to the creation of collateral blood vessels, which pump more blood and oxygen to your extremities.

Q | Does massage improve circulation? 

A | Yes. Researchers at the University of Illinois, Chicago, found that massage improves blood flow and vascular function in both regular exercisers and sedentary individuals. But don’t use this as license to skip your workout and rely solely on massage for blood-flow benefits; exercise has unique circulatory benefits that can’t be replicated.

That said, there is a specific type of massage, called manual lymph drainage, that is thought to improve lymph circulation. While some practitioners believe that manual lymph drainage has little benefit for those who have not undergone lymph-node removal or other chest surgery, others say that it can help the lymph flow in all individuals, aiding the body’s ability to fight infections and detoxify.

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Beyond Blood

In recent years, researchers have learned more about some unexpected functions of the circulatory system.

The lymphatic system, for one, is an ancillary part of the circulatory system. Its intricate web of nodes, vessels, and lymph fluid is critical to effective immune function and fluid balance (imbalances can be fatal). It’s also a key player in the body’s innate ability to detoxify.

Additionally, in the early 1980s, scientists discovered that the circulatory system secretes its own hormones — ANP and BNP. These vascular hormones help regulate critical body functions, including blood pressure, and are so vital to human physiology that they earned the heart dual classification as an endocrine organ, alongside the thyroid, adrenals, pituitary gland, and pancreas.

Finally, the circulatory system is rich in metabolically active endothelial cells, which have been shown to play key roles in many physiological processes, such as the growth of new blood vessels and healthy immune-system function. At the same time, unhealthy endothelial cells are often implicated in chronic diseases, either as a cause or a result of collateral damage.

All told, the far-reaching circulatory system keeps us up and running by supplying fuel, eliminating toxins, regulating blood pressure, maintaining fluid balance, and bolstering immunity. Exercise helps improve all of these functions.

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Exercises to Improve Circulation

1. Standing Joint Mobility

Featured Exercise: Standing Spinal Roll

This exercise allows for increased oxygen movement to most major joint complexes, including the spine, pelvis, hips, shoulders, knees, ankles, feet, elbows, wrists, and hands.

  • Stand up straight, arms loosely at your sides.
  • Starting at the crown of your head, begin to roll your head — then neck and back — down slowly toward your ankles going vertebra by vertebra. Take time to assess each joint, using movement and range of motion as your gauge. Allow 30 seconds to roll all the way to a full forward fold.
  • At the lowest point of the movement, roll back to standing by reversing the motion, moving vertebra by vertebra from the pelvis up. Keep head and hands heavy during the movement. Complete 10 reps.

Option: Pause in the lowest position of the movement (the forward fold) and focus on gently shifting weight into the heels and then back into the toes. Repeat several times, making a slight rocking motion. This allows a greater degree of stretch and release in the back.

2. Ground-Based Mobility

Featured Exercise: Windshield Wipers With Shinbox Extensions

Using the ground as resistance is a great way to not only challenge the capacity to move, but also to make the heart work harder.

  • Sit on the floor with your knees bent at chest level and feet slightly wider than hip width.
  • Rotate knees to the right and onto the floor so that they form a right angle with your shins. Sit up straight.
  • Squeeze your glutes and push knees and shins into the floor to rise up, keeping your tailbone tucked in.
  • With control, reverse the motion and bring your glutes back to the floor. Rotate your knees 180 degrees to the left and repeat the motion. Complete five reps on each side.

Option: Make it harder by holding a kettlebell at chest height. Make sure to keep elbows close to your sides and wrists straight.

3. Decompression — Thoracic Mobility

Featured Exercise: Thoracic Rib Pulls

Create the space for your breath and heart to do its work naturally. This exercise is a great way to improve thoracic mobility, which also offers the lungs and heart a greater degree of expansion.

Lay on your right side with your right arm extended directly in front of your chest with your palm up. Place your left hand across your right rib cage.

  • Bend your left leg 90 degrees at the knee and rest your knee, shin, and foot on a foam roller. This helps to lock the lumbar and reduce torque on the lower back.
  • Slowly twist your upper torso and look to the left, expanding your ribs and gliding your left shoulder in the direction of the floor. Slowly return to the start position. Complete 10 repetitions on each side.

Option: Extend the motion into a Bow & Arrow by getting into the same start position, but instead of grabbing the ribs with the left hand, extend your left arm out to meet your right arm with palms touching. Then, as you rotate to the left, bend your left elbow and bring your left hand across your body and to the right, fully extending your arm on your right side at the furthest point of rotation. Reverse the movement and come back to start.

4. Myofascial Release — Foam Rolling

Featured Exercise: Shoulders and upper back pressure points

Myofascial release via foam rolling can stimulate the lymphatic system and help move toxins out of the body.

  • Sit on the floor with your knees bent at chest level and feet slightly wider than hip width.
  • Lean back onto a foam roller that is perpendicular to the body and aligned with your shoulder blades.
  • Put your hands behind your head and your elbows out to the sides. Take a few deep breaths, then push your feet into the ground to move your body back across the foam roller about 6 inches (so the roller stops around midback).
  • Then use your hip muscles to pull your body back toward your feet, returning your shoulders to the starting position. Throughout the motion, keep your spine neutral and your hips relaxed.

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Circulation by the Numbers

2.5: Number of times the 60,000 miles of arteries, capillaries, and veins in your body would wrap around the circumference of the earth.

42, 048, 000: Number of times your heart beats each year — about 4,800 times an hour and 115,200 times a day.

23,000: Number of breaths the average person typically takes every day — about 8.4 million a year.

145: Gallons of oxygen you breathe into your lungs daily. Your lungs boast a total surface area the size of a tennis court to facilitate oxygen transfer to your blood.

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This appeared as “Pumped Up: How Exercise Affects Circulation (and Vice Versa)” in the June 2017 print issue of Experience Life.

Illustration by: Stuart Briers

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