References
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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_
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Klabunde, Richard E. "Cardiovascular Physiology Concepts:
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Michos, Erin Donnelly (ed.). "Can Coronavirus Cause Heart Damage?"
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Moffitt, Mike. "Lasting Heart Damage Could Be COVID-19's Legacy
for Some Non-Hospitalized Survivors." SFGate. July 27, 2020.
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heart-15437575.php.
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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.
