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Massage May be an Answer for Those Struggling with Long COVID

By Marcy Prendergast, LMT

Several years into the pandemic, and it seems that COVID is still able to throw some curve balls our way. From new variants like "Kraken" that seem to have a knack for spreading quickly, to a growing number of survivors struggling with lingering symptoms being deemed "Long COVID", there is clearly still a lot about this virus we have yet to learn.

I've gathered some details about what we do know so far, and how a massage might be just what the doctor ordered if you think you may be suffering from Long COVID.

Since Long COVID Syndrome is a relatively new arrival to the scene, medical professionals have not been able to organize and conduct many studies on it at this point - these things take lots of time and participants to be done properly. One study, from the University of Washington, states that close to one-third of the COVID survivors they interviewed reported “worse health and quality of life” than before their COVID diagnosis, while about 8% said their lingering symptoms are severe enough to interfere with basic tasks like lifting objects and walking. Researchers are finding that this syndrome affects a lot of people, but at this point, the number is still difficult to accurately gauge, with some experts estimating it is around 10%, and others saying it is closer to 30-40%. This is largely because the condition itself manifests with such a wide variety of symptoms and therefore is difficult to define. There are no agreed-upon diagnostic criteria to help identify who has long COVID versus symptoms caused by other health issues. Furthermore, the pathophysiology (what goes wrong with our body processes due to a disease) of this condition is still not fully understood. What we do know about Long COVID so far is, therefore, mostly from anecdotal evidence - what doctors and other health and wellness providers have observed and what trends they have noticed - as opposed to evidence-based research.

Long COVID is a post-viral syndrome that develops in some COVID survivors weeks or even months after their initial infection.

Why do symptoms vary so much?

COVID-19 involves a viral attack, usually by way of the respiratory system. The virus is capable of invading any cell with a membrane marker called an ACE-2 receptor. This is bad news, because many different types of cells in our bodies have this marker. ACE-2 receptors are found in the lungs, heart, the gastrointestinal tract, the liver, the pancreas, the kidneys, and, perhaps most alarmingly, in blood vessels and in neurons of the central nervous system (it is alarming because when COVID crosses the blood-brain barrier, it can cause inflammation in the brain, leading to many other issues). So, any of these tissues with ACE-2 receptors are vulnerable to being invaded by the COVID virus, which may then lead to serious repercussions. This is why sufferers of COVID and Long COVID are reporting such a wide variety of symptoms, and often, why treatment is limited to the management of these symptoms.

Since at this point there is no widely agreed-upon treatment protocol for Long COVID, sufferers, often referred to as “long haulers”, are typically sent to specialists with expertise for the specific kind of organ damage they are dealing with. But, depending on the number of symptoms an individual is experiencing, it may be difficult to find one provider equipped to treat it all. Beyond that, it’s mainly a matter of finding coping mechanisms that will help improve function and quality of life while they ride this out for weeks, months, or even years.

According to the CDC, Long-COVID symptoms may include:

• Anxiety

• Chronic cough

• Depression

• Digestive and gastrointestinal issues

• Dizziness on standing

• Dysautonomia (a disorder of the Autonomic Nervous System affecting involuntary functions like breathing, sweating, swallowing...)

• Fatigue - mild to debilitating

• Fever

• Hair loss

• Headaches

• Joint and muscle pain

• Loss of smell and taste

• Memory loss or brain fog

• Menstrual cycle changes

• Mood changes

• Numbness, paresthesia in the extremities

• Post-exertional malaise (easily getting exhausted or short of breath)

• Skin issues like rashes and petechiae

• Sleeping problems

• Stomach pain

• Swollen lymph nodes

• Tinnitus

Among others… See why it is so difficult to diagnose?

Long COVID and Massage Therapy

There is a plethora of evidence that supports the use of massage therapy for alleviating pain and improving sleep, mood disorders (like depression, anxiety, and PTSD), and reducing fatigue. This could be good news for Long-Haulers.

Will massage therapy solve the problem of Long COVID? Probably not—our work is unlikely to help with structural sources of Long COVID symptoms (think, difficulty breathing due to damaged lung tissue). Might massage therapy help certain aspects of Long COVID, especially those centered on fatigue and quality of life? That seems likely! Massage can help calm the nervous system and alleviate stress responses like muscle spasms from guarding and headaches, and can help with functional sources of Long COVID symptoms (like breathing difficulties due to overtired diaphragm and intercostal muscles).

That said, massage therapists cannot claim that we have a cure for Long COVID sufferers, but we are glad that we can use our expertise to help our patients manage many of their symptoms. Before scheduling with one of our LMTs to help with symptoms you think could be related to Long COVID, consider the following:

Potential Risks of Massage for Long-Haulers:

• Overwhelming a compromised system

• Interaction with medications, especially anticoagulants and anti-inflammatories

Benefits of Massage for Long-Haulers:

• Support during a difficult time - due to the confusing nature of Long COVID, some sufferers feel failed or ignored by medical professionals

• Reflection of improvement over time

• Reduction of fatigue, shortness of breath, pain, sleeplessness, headaches, and other symptoms (depending on the client’s goals)

• Activation of the parasympathetic nervous system - rest and digest - and calming of the sympathetic nervous system, which is responsible for stress responses

In a Massage & Bodywork Magazine article "Unpacking the Long-Haul", Ruth Werner (NCBTMB-approved continuing education provider and author of "A Massage Therapist's Guide to Pathology") sums up the potential for massage therapists to aid Long-COVID sufferers well by saying, "The role of massage therapy for people with long COVID is promising but unstudied. The work we can do for mood, fatigue, ease of breathing, and a general sense of self-efficacy and resilience are exciting options to pursue."


Marcy Prendergast, LMT, specializes in Deep Tissue, Sports Massage, Trigger Point Therapy, Cupping, and Active and Passive Release Techniques. She is also a FAKTR Certified Provider. She enjoys working with patients to find the root of their pain and dysfunction and get them feeling and moving better.


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