Massage & Bodywork

NOVEMBER | DECEMBER 2020

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References American Heart Association. "Ablation for Arrhythmias." Reviewed September 30, 2016. www.heart.org/en/health-topics/arrhythmia/ prevention-treatment-of-arrhythmia/ablation-for-arrhythmias. Cleveland Clinic. "Heart Beat." 2020. Accessed October 2020. https:// my.clevelandclinic.org/health/articles/17064-heart-beat. Couzin-Frankel, Jennifer. "From 'Brain Fog' to Heart Damage, COVID- 19's Lingering Problems Alarm Scientists." Science. July 31, 2020. www.sciencemag.org/news/2020/07/brain-fog-heart-damage- covid-19-s-lingering-problems-alarm-scientists. Gibson, C. Michael (Ed.). "Mechanism of Arrhythmias." WikiDoc. Updated August 2012. www.wikidoc.org/index.php/Mechanism_of_ arrhythmias. Klabunde, Richard E. "Cardiovascular Physiology Concepts: Arrhythmias." Revised October 2020. www.cvphysiology.com/ Arrhythmias/A008. Michos, Erin Donnelly (ed.). "Can Coronavirus Cause Heart Damage?" April 24, 2020. John Hopkins Medicine. www.hopkinsmedicine. org/health/conditions-and-diseases/coronavirus/can-coronavirus- cause-heart-damage. Moffitt, Mike. "Lasting Heart Damage Could Be COVID-19's Legacy for Some Non-Hospitalized Survivors." SFGate. July 27, 2020. www.sfgate.com/science/article/COVID-19-damage-of-the- heart-15437575.php. National Heart, Lung, and Blood Institute. "Arrhythmia." Accessed October 2020. www.nhlbi.nih.gov/health-topics/arrhythmia. Newman, Tim. "What to Know About Arrhythmia." Medical News Today. February 28, 2020. www.medicalnewstoday.com/ articles/8887. Pesheva, Ekaterina. "COVID-19's Consequences for the Heart." Harvard Gazette. April 14, 2020. https://news.harvard.edu/gazette/ story/2020/04/covid-19s-consequences-for-the-heart. Reddy, Vivek. "Cardiac Arrhythmias in Patients with Coronavirus Disease (COVID-19)." Clinical Trial Registration No. NCT04358029. Updated May 13, 2020. www.clinicaltrials.gov/ct2/show/ NCT04358029. Sheinin, Aaron Gould. "Hydroxychloroquine No COVID Cure, Experts Warn." WebMD. July 29, 2020. www.webmd.com/lung/ news/20200729/hydroxychloroquine-no-covid-cure-experts-warn. C h e c k o u t A B M P 's P o c k e t P a t h o l o g y a t w w w. a b m p . c o m / a b m p - p o c k e t - p a t h o l o g y - a p p . 41 PATHOLOGY PERSPECTIVES If they use medications that cause side effects (like anticoagulants that cause easy bruising) or drugs that affect the electrical conduction system that make them feel fatigued or dizzy, massage must be adjusted to accommodate those limitations. Use light pressure until you know what they can tolerate without bruising. Finish the massage with fast-paced strokes that help clients to feel alert and awake, and give them plenty of time to make the transition from the table back to full speed. Massage therapy is unlikely to have a significant effect on chronic arrhythmia problems, but sometimes these irregularities are exacerbated by stress. In these situations, we may be able to be a helpful part of a full coping strategy that may also include diet, exercise, medications, and other interventions. It still remains to be seen whether the aftermath of COVID-19 infections leaves a lot of people with long- term repercussions in the shape of arrhythmias and other challenges. It seems clear that at least some of the "long-haulers"—people with symptoms that persist for months, even if they are not severe enough to be hospitalized—are going to have this as a health concern at least for a while. They may well seek out massage therapy as part of the way they work to restore health. This means we must be ready with the most useful information to bring our best to the massage table. This article provides a starting place in that process, but heart problems with COVID-19 survivors is a developing topic that will require all of us to follow the science so we can provide evidence-informed practice for this population that needs our work. Notes 1. Rachael Rettner, "COVID-19 Linked to Heart Damage in Healthy People, Small Study Suggests," Live Science (July 2020), accessed October 2020, www.livescience.com/ covid-19-causes-heart-damage-healthy-people.html. 2. Anjali Bhatla et al., "COVID-19 and Cardiac Arrhythmias," Heart Rhythm 17, no. 9 (September 1, 2020): 1,439–44, https://doi.org/10.1016/j.hrthm.2020.06.016. 3. Stephanie M. Kochav et al., "Cardiac Arrhythmias in COVID-19 Infection," Circulation: Arrhythmia and Electrophysiology 13, no. 6 (May 2020): e008719, https://doi.org/10.1161/CIRCEP.120.008719. Ruth Werner is a former massage therapist, a writer, and an NCBTMB-approved continuing education provider. She wrote A Massage Therapist's Guide to Pathology (available at www.booksofdiscovery.com), now in its seventh edition, which is used in massage schools worldwide. Werner is available at www.ruthwerner.com or wernerworkshops@ruthwerner.com.

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