Covid-19 Supplementary Form

(Rationale: If the client has been cleared to return to work or to end self-isolation, then the risk of communicability should be over. If not, we need to delay, for their benefit and ours.)

(Rationale: If the client is advised to return to normal activity levels as soon as possible, then massage is more likely to be safe. However, if the client is advised to be careful about exercise—as might be seen with a cardiac or pulmonary rehabilitation program—then the intensity of massage therapy must also be scaled back.)

(Rationale: We need a clear sense of what kinds of physical challenges people put their bodies through on a daily basis. This might range from someone who is essentially sedentary but takes a hot shower each morning, to someone who walks a few times a week, to someone who is training for an event with newly scarred lungs or potentially inflamed blood vessels. Within these questions we must dig out the most specific information we can find: “walking for 20 minutes” might mean a leisurely stroll on a smooth sidewalk, or it might mean a quick jaunt up a hill that raises the heart rate. That makes a difference in a client’s ability to adapt to environmental challenges. Further, many COVID-19 survivors have widely varying and unpredictable levels of fatigue and energy. We must not risk overwhelming someone’s physical capacity with overenthusiastic massage.)

(Rationale: If yes, delay the session until these have cleared OR use very light work everywhere, and especially in the area of any discoloration—this may be a sign of microvascular clotting/ bleeding, especially if the lesions don’t blanch with finger pressure.)

(Rationale: If yes, do very light pressure work, and refer them to their primary care provider. This symptom might prompt people to seek massage, but it can be an indicator of acute inflammation, muscle damage, or poor tissue perfusion.)

(Rationale: We are looking most specifically for chest pain, shortness of breath, dizziness, headache, or cramping in a new pattern. If the answer is yes, refer them to their primary care provider, who should know about this, because it may be a sign of cardiovascular or respiratory distress.)

(Rationale: If yes, delay massage until this is finished, OR use very light work because of blood clotting and bruising risk.

(Rationale: This could include relapsing symptoms, kidney dysfunction, gut pain, headaches, heart problems, debilitating fatigue, seizures, PTSD related to the trauma of surviving a life-threatening infection, or things we haven’t even thought of yet. Decisions about bodywork must be made with these complications in mind, so you might want to have a decent pathology reference at hand.)