Issue link: https://www.massageandbodyworkdigital.com/i/1439667
Benefits • Support during a difficult time • Reflection of improvement over time • Reduction of fatigue, shortness of breath, pain, sleeplessness, headaches, other symptoms (depending on the client's goals) "A very generous massage therapist gave me two long sessions of full-body relaxation massage. That was the best my body has felt since I got sick." Accommodations • Identify situations that limit the safety of massage therapy first (see "Long COVID Screening Questions" on page 45 for suggested screening questions) • Carefully control the room and equipment for overstimulation regarding light, sound, odors, and skin sensitivity • Emphasize functional goals ("What would you like to be able to do that I can help you with?") • Consult with the health-care team to be sure your goals are in alignment with theirs (see video in the digital edition or by scanning the QR code below for more on this communication) • Work conservatively for incremental change Where Does All This Leave Us? The American Academy of Physical Medicine and Rehabilitation 1 recommends these treatment options to address fatigue in people affected by PASC (emphasis mine): • Begin an individualized, structured, titrated return to activity program • Discuss energy conservation strategies • Encourage a healthy dietary program and hydration • Treat, in collaboration with appropriate specialists, underlying medical conditions such as pain, insomnia/sleep disorders, and mood issues that may be contributing to fatigue We have a strong depth of evidence that supports the use of massage therapy for pain, sleep, mood disorders (especially depression, anxiety, and PTSD), and fatigue. Will massage therapy solve the problem of PASC? Probably not—our work is unlikely to dissolve scar tissue in the lungs or restore damaged cells in the central nervous system. Might massage therapy help certain aspects of PASC, especially those centered on fatigue and quality of life? That seems like a safer prediction. Conservative estimates suggest that 5 percent of people who had COVID-19 will develop long-term symptoms or complications. With that lowest of all approximations, we are still looking at a population of over 2 million people in the US with long COVID who could benefit from our skills. More realistically, that number is probably closer to 10 million people who, as long haulers, will struggle with debilitating fatigue, poor sleep, pain, problems breathing, brain fog, depression, anxiety, and a myriad of other symptoms—in addition to their risks of substantial organ damage. 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. I encourage massage therapists who work with clients living with long COVID to carefully record their experiences so we can gather data in the form of case reports that form the basis for future research. "This illness doesn't have a timeline. When you go through cancer treatment, you know you have a certain number of treatments, and then you can see what's happened. But we don't know anything about this, and that creates a sense of helplessness and hopelessness." COVID is a scourge, a tragedy, a disaster unlike anything in this generation. We have the capacity to make it less so for the people who live with long-term consequences of this disease. I am eager to see massage therapists step up to this challenge. Note 1. Joseph E. Herrera et al., "Multidisciplinary Collaborative Consensus Guidance Statement on the Assessment and Treatment of Fatigue in Postacute Sequelae of SARS- Cov-2 Infection (PASC) Patients," PM&R 13, no. 9 (August 4, 2021): 1027–43, https://doi.org/10.1002/pmrj.12684. 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 booksofdiscovery.com), now in its seventh edition, which is used in massage schools worldwide. Werner is available at ruthwerner.com or wernerworkshops@ruthwerner.com. L i s te n to T h e A B M P Po d c a s t a t a b m p.co m /p o d c a s t s o r w h e reve r yo u a cce s s yo u r favo r i te p o d c a s t s 45