massage for covid 19 long haulers

Advanced Massage for Covid-19 Long Haulers: What symptoms can we help?

David Weintraub Licensed Massage Therapist and Owner at Bodyworks DW Advanced Massage Therapy

David Weintraub, owner of Bodyworks DW and expert LMT talks about working with clients experiencing long haul covid-19 symptoms. And how massage can help covid-19 recovery!

Estimated reading time: 8 minutes

I have now had the opportunity to work with dozens of clients who had previously tested positive for covid-19 antibodies. And have not fully recovered from their symptoms. These so called “covid-19 long haulers” are more common than we hear about. And can suffer effects of covid-19 for months after the virus leaves their bodies. Some are still experiencing symptoms including fatigue and shortness of breath nearly a year later. And while massage for covid-19 long haulers cannot “cure” them, it can offer much needed relief and improvements. And help shorten the pathway to recovery.

We have been open again for 7 months after the initial 4 month 2020 shutdown. Thankfully, we have been able to practice safely with zero transmissions at our studios. We have achieved this by using a combination of safety protocols based on NYS guidelines, CDC guidelines, OSHA guidelines. As well as some additional measures above and beyond those requirements. You can read our entire safety plan here.

What are Covid-19 Long Haulers?

The vast majority of people who contract covid-19 have what’s considered a “mild” case. The effects can range from asymptomatic cases to a couple of weeks of “the worst flu I’ve ever had” symptoms. Some 5-8% of cases have worse symptoms and require hospitalization. Initially, in early 2020, a large percentage of people hospitalized deteriorated further. And needed to be put in an ICU on a ventilator. Large numbers of these folks are no longer with us.

The lesser mentioned health crisis happening is the large number of cases of long haul covid-19 symptoms. Some newer studies have shown that about 10% of covid-19 patients seem to experience lingering symptoms (1).

These lingering symptoms can include any and all of the following (2):

  • shortness of breath
  • “brain fog”
  • fatigue
  • altered or lost senses of taste and smell
  • headaches
  • joint pain
  • cough
  • insomnia

Thankfully the medical community has learned of ways to treat hospitalized covid-19 patients so that there is a much higher chance of preventing the need for a ventilator. And for recovering even after being put on one. These include drugs such as dexamethasone and monoclonal antibody cocktails. As well as very old school ideas such as turning the patient over on their stomach. This allows for easier breathing and draining of lung fluids.

It was reading about this treatment that got me intrigued to explore massage for covid-19 long haulers’ symptoms.

Source: July 25 Covid-19 “Long-Hauler” Symptoms Survey Report, Indiana University School of Medicine and Survivor Corps (3)

Structural vs Functional Causes of Symptoms

A structural issue in the body is when a structure is injured in a way that it cannot function properly. Examples of this would be a broken bone, torn ligament, cartilage loss, damaged nerve, etc. These can stem from direct impact injuries and/or wear and tear injuries. Or from genetic systemic issues such as nervous system disorders like MS or connective tissue disorders like Marfan’s Syndrome. In general, structural issues need to be lived with and managed. As opposed to their being able to be “fixed.” In the cases stemming from impact injuries, 100% healing may be possible (a broken bone for instance) and/or surgery may be a viable option. In the cases where there is a systemic issue, the symptoms most likely need to be managed with a combination of lifestyle changes, medications, and self care including things like massage therapy, acupuncture, etc.

A functional issue can stem from a structural issue or exist on it’s own without an underlying structural issue.

Headache pain from migraines are a good example of the former. Migraines often have an underlying structural issue that creates a neurological trigger such as scent or light sensitivity. Massage can’t do anything to “fix” this. However, the migraine itself triggers a protective and functional response. This contracts jaw, neck, and head muscles, causing a powerful tension headache. It’s actually the tension headache that causes the debilitating pain that takes you out. This functional aspect of the migraine, the severe tension headache, is highly treatable with advanced massage therapy.

Massage won’t “fix” the initial neurological trigger. But a client who has cycles of migraines will find that the threshold for when they are triggered becomes lower. And lower still as the muscle tension mounts and doesn’t release. By relieving the functional tension headache side of things, the intensity of the migraines goes down and the frequency decreases. Many of my clients have gone from 2-3 migraines per week down to 1-2 per year.

When massage for covid-19 long haulers can make a difference

In covid-19 long haulers, some of the symptoms are due to structural aspects such as damaged lung tissue or neurological alterations. This is especially with clients who have lost or altered sense of taste and smell. And/or inflamed joint structures such as tendons, bursae, or ligaments. These all need time to recover and some symptoms may possibly be last years or be permanent.

However, a portion of these symptoms are due to functional aspects. And responses to pain and stress that massage can help relieve. If you look at the list of common lingering symptoms, many of these are issues we use massage to help with on a daily basis such as headaches and joint pain. If the cause is structural, massage can usually only help by managing symptoms. These functional responses to stress often linger around long after they are useful. In any injury to the body including covid-19. And these functional responses can often be vastly improved or even eliminated with massage therapy.

Examples of functional responses can include:

  • Overworked breathing muscles that are now stuck in tension
  • PTSD responses to the stress that include tightening muscles and not allowing true rest
  • Compensating muscle patterning due to fatigue, instability, or long bed rest
  • A body stuck in a sympathetic nervous system response (Fight or flight)

What symptoms massage can usually help with immediately

For shortness of breath, headaches, insomnia and fatigue, I’ve had a fair amount of success providing immediate and noticeable improvements. Usually with a series of 3-6 massage sessions. I’ve spent about the last 6 years of my career making a special focus of working on breathing issues. So I consider releasing ribcage restrictions and restoring more normal breathing patterns to be one of my specialities. I’ve worked with dozens of abuse victims to reset their fight or flight threshold to lessen PTSD symptoms. I’ve also worked with dozens of singers to improve their ranges and ease of holding notes. And even worked with several military vets on the same issues.

All of this experience has become invaluable when providing massage for covid-19 long haulers’ symptoms.

Covid-19 long haulers’ symptoms seem to have a large stress and PTSD component in the dozens of cases I’ve run across. Massage can’t completely eliminate them (damaged lung tissue still needs time to heal). But it can greatly improve them and also speed recovery time.

The same techniques I’ve used with survivors, singers, and vets have been working really well with long haul symptoms. Including shortness of breath, headaches, fatigue, joint pain, and insomnia. Sometimes I can even help with lingering coughing. Especially if this is being triggered by tight neck muscles as opposed to damaged lung tissue. For the anatomy curious, the big SCM muscles in the front of your neck can trigger a cough reflex when too tight.

Relieving the Functional Issue Speeds Recover of the Structural Issues

Most cases we see, whether covid related or due to other injuries, have both functional structural components to the issue. When the ratio leans heavily towards functional, massage therapy can generally provide a high degree of relief. And quickly. When the ratio leans heavily towards the structural, massage will have less of an impact. However, it can still provide some noticeable relief. And take pressure off of the body’s resources so that it can focus on more quickly healing the structural issues.

In the dozens of people I’ve worked with who have recovered from covid-19, the ratio leans towards functional issues. But is often split down the middle. Clients generally get fairly quick relief from shortness of breath and headaches. But take a bit longer for fatigue symptoms to change. Most have reported that the massage for covid-19 long haulers has allowed them to re-engage with exercise in a meaningful way. And feel that the frustratingly slow recovery pathway they were on has gotten far less steep. They will still have some work to do to get back to feeling 100% normal. But have hope again that this is possible!

If you are a covid-19 long hauler in the NYC area, we’d love to work with you!

And be a part of your recovery team! Book a massage for covid-19 long haulers today in either our Financial District or Midtown West studios. We recommend working with either me (David) or a lead or senior therapist at first. We have more training on ribcage and diaphragm work. This will be essential for most of you who have experience any breathing issues from your case.

We look forward to seeing you at the studio! – David


Further Reading

Here’s a good stress relief exercise to help get you in the meantime. Yes it says for back aches but it’s a good all around stress reliever!


  1. I’ve done massage for over 10 years and this doesn’t mention anything about the dangers involved. Blood clots for one are known to be one of many symptoms of covid (short term and long term). Receiving massage while having blood clots can put you at risk of having them move and ending in stroke or a heart attack and this IS contraindicated for any professional massage therapist to work with. Please inform your clients of this very realist risk.

  2. Hi, thank you for your comment on blood clots. These concerns were raised by many in the field last summer (2020) and examined with related experts. While we massage therapists were initially worried about possible adverse effects for massage on covid recovered clients, those concerns have proven to be unwarranted both in theory and in practice.

    Please read this synopsis by Ruth Werner, a leader in the field, and her conversation with Hematologist Dr. Yaser Diab on the AMBP blog (American Bodywork & Massage Professionals):

    The long and the short of it is that massage is not contraindicated (ie massage is safe to perform) for covid recovered clients that have no visual DVT (deep vein thrombosis) symptoms. In fact, any covid related symptoms that would make massage contraindicated are ones that massage therapists are already supposed to be screening for prior to covid. There is no new realistic risk of stroke, pulmonary embolism, or heart attack with massage for covid recovered clients if no DVT symptoms are present.

    I applaud your wanting to point out potential dangers to clients. However, please keep up to date on the latest information, and please express them in realistic terms so that clients can understand what the actual risks are. Your language is imprecise and could be misconstrued by many covid recovered clients that massage is inherently dangerous for them, causing them to miss out on a valuable modality for recovery. This is simply not accurate or true.

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