Issue link: https://www.massageandbodyworkdigital.com/i/1439667
n ot long after the initial onset of the COVID-19 pandemic, strange things began to happen to some people during their COVID-19 recovery. A lot of them lost their sense of taste or smell as part of their acute infection, but those senses didn't always return—at least not within several months. A lot of patients didn't get their energy back, and many developed entirely new symptoms—some involving the extremities, like numbness and tingling in the feet, and some involving internal organs, like scarring in the lungs, heart damage, and newly failing kidneys. Some people experienced abnormal blood clotting while they struggled with severe, acute infection, but sometimes that clotting abnormality followed them home from the hospital. And a lot of people experienced fatigue, weakness, brain fog, depression, anxiety, and other symptoms that were severe enough to be debilitating. And these problems are outlasting their initial infections by weeks, by months . . . and maybe longer. This phenomenon, which we now call long COVID or post-acute sequelae of COVID (PASC—we will use the terms interchangeably here), affects an unknown portion of the population for an unknown amount of time, but it is common enough and serious enough to draw the attention of many experts who specialize in chronic conditions. The self-identified label for these patients is "long haulers." The parameters of long COVID are still hazy. We can't determine how common it is until we agree on what it is. We can't determine a medical treatment protocol that is likely to be successful until we know how it comes about. But some aspects of long COVID are a great match for the benefits massage therapy can provide, so it behooves practitioners to learn what they can about this situation, in order to work safely in this context. In this article, we will address a very brief history of COVID-19, and then we will look at the phenomenon of PASC, given the limited information currently available. We will conclude with some suggestions about massage therapy as a safe and effective intervention. We all know that long COVID is a moving target. Ideas and theories about pathophysiology or conventional treatment strategies that are given here may well prove to be incorrect as we learn more. If that happens in a way that could impact clinical decisions for massage therapy, we promise to publish updates as quickly as possible. But 36 m a s s a g e & b o d y wo r k j a n u a r y/ fe b r u a r y 2 0 2 2 Author's note: People in the massage therapy community may be familiar with Michele Renee, DC, MAc. She was the president of the Alliance for Massage Therapy Education, the director of integrative care at Northwestern Health Sciences University, and a tireless advocate for the profession of massage therapy education. In September 2020, Michele developed all the symptoms of COVID-19. Because of restrictions in testing at the time, she never got a positive test, but her symptoms were typical of the disease. Then, in December, she began to experience a whole new range of challenges that have never resolved. She had to take an extended leave of absence from her work, and a year later she is still only back to 20 hours a week. Michele generously allowed me to interview her about her experiences with long COVID, and the quotations that appear in this article come from our conversation.