While society seems to have moved on from COVID, some patients still battle with it. These “long-haulers” face a unique set of symptoms. According to medical journal The Lancet, long-haul COVID symptoms usually last for more than seven months. Let’s define long-haul COVID (formally known as post-COVID syndrome), examine common symptoms, and review how massage therapy can help. We’ll also include suggestions for therapists hoping to serve clients with long-haul COVID.

What is long-haul Covid or Post-COVID Syndrome?

According to the September 2021 Journal of the American Medical Association, about 10% of those who are infected with COVID will become long-haulers. That number could be even higher—a University of Washington study found that 30% of COVID sufferers experience long-term symptoms and “worse health and quality of life.” Moreover, 8% of respondents in that study reported that they were no longer able to do everyday tasks, such as “lift heavy objects, or stand or walk unassisted for more than a short period of time.” In contrast with most who contract the disease, those with long-haul COVID (AKA “long-haulers”) suffer symptoms for months or even years. Some studies suggest up to half of all those who catch COVID will experience at least one long-term symptom. As published in The Lancet, 91% of online respondents who suffer post-COVID syndrome require more than 35 weeks to recover. Let’s take a look at their most common symptoms.

Common Symptoms of Massage Clients with long-haul Covid
While the range of symptoms among long-haulers is broad, long-term inflammation, memory loss/brain fog, and decreased physical ability are typical. Secondary mental health complications—such as anxiety, depression, PTSD, and panic attacks—may follow.

Additionally, those with long COVID are likely to present on the massage table with:

  • Extreme fatigue
  • Inability to engage in activities such as exercise
  • Short-windedness, breathlessness
  • Pain in joints and muscles
  • Insomnia
  • Digestion/GI tract issues
  • Heart palpitations
  • Mood changes
  • Dizziness
  • Headaches
  • Loss of smell and taste that won’t resolve 
  • Coughing

These are only the most common symptoms of long-haul COVID. Chronic pain is a predominant symptom for long-haulers; some may find it impossible at times to get out of bed as a result. 

How Massage Therapy can Help those with long-haul Covid
In many ways, long-haul COVID remains a mystery to researchers, who are still unsure why some people experience mild, lingering symptoms such as headaches and muscle/joint pain, while others have more debilitating symptoms. Writing for Massage Magazine, LMT David Weintraub relays his experience treating 40 massage clients with long-term COVID. He has found that massage therapy can ease headaches and muscle/joint pain in this population. He speculates that massage therapy can also ameliorate respiratory, digestive, and cognitive symptoms by “reteaching the client’s nervous system” to release its protective response against COVID. 

Further, Mr. Weintraub points out that massage therapy can provide quick relief for functional symptoms such as coughing stemming from tight sternocleidomastoid muscles. However, physical therapy or other specialist treatment may be required before massage therapy can help with structural symptoms, such as headaches due to neurological degeneration. He focuses particularly on efficient breathing following COVID infection, as the disease often causes the body to rely on secondary breathing muscles. Massage therapists can help clients return to efficient, diaphragmatic breathing by gently compressing abdominal muscles, assuming the client’s body and mind are relaxed enough to avoid a stress response.

Tips for Massage Therapists on how to best serve clients with Long-Haul Covid

Your massage therapy training probably didn’t include information on how to assist clients with long-haul COVID, but at this point it’s likely you’ll treat someone meeting this description. Here are a few ways to cater your treatment to long-haulers.

  • Include relevant questions in your intake form. Among conditions, you may choose to include a tick box for long-haul COVID, as its varying symptoms can make it tricky to detect. Strong client communication is key, as so many different symptoms fall under the umbrella of post-COVID syndrome.
  • Don’t over-treat. Recall that long-haul COVID can cause exhaustion, even following everyday activities. While a client may feel all right during treatment, they may be tired that evening or the next day, and this weariness may be accompanied by an outburst of other symptoms. Prevent exhaustion and symptom flare-ups by going slowly in your massage therapy treatment. Limit intensity, duration, frequency and treatment type, gradually increasing these metrics over time. Leave days between treatments.  Remember that the pain of long-haul COVID has different mechanisms than typical muscular-skeletal pain.
  • Activate a Parasympathetic Response. Even clients who never contracted COVID may display symptoms of being stuck in a stress response. After all, we all lived through a frightening time of uncertainty during the pandemic. Long-haulers are likewise prone to these stress response symptoms, which are similar to those who have suffered PTSD, and include muscular hypertension, digestive problems, brain fog, and headaches. Effective massage techniques for releasing an overactive stress response will help relax muscles, increase circulation, and signal safety to the nervous system.  More advanced techniques may target the diaphragm, psoas, and ancillary breathing muscles. 

If you’re an LMT, think back to your graduation from massage school. At that time, could you have anticipated the changes the COVID pandemic would bring to the massage industry? Probably not. Ours is an ever-changing field, so consistent, up-to-date massage therapy training is critical. East West College of the Healing Arts offers a range of CE courses each semester for professionals in massage. Portland’s education district is our home, making classes conveniently accessible by multiple public transit lines or by car. You’re sure to find something to pique your interest among our massage therapy training options. To review our current CE offerings, please visit our website at EastWestCollege.edu and select Continuing Education, or call us at 503-233-6500.