Since the onset of the COVID-19 pandemic, health care professionals have been learning about the symptoms, side effects and what recovering clients may be experiencing. Two well known symptoms presented with COVID-19 are fatigue and shortness of breath. These symptoms and others can persist in clients well after the viral infection has cleared. In a study, four to eight weeks following onset of COVID-19, large numbers of people continue to experience fatigue (69%), shortness of breath (53%), cough (34%) and depression (14%). Some will seek therapeutic assistance in their recovery. This is how massage therapy may be able to help. 

Anatomically and functionally, the primary muscle of respiration is the diaphragm. Any muscle that attaches to the sternum or ribs can act as an accessary muscle to respiration. Some of these muscles being those of the neck, the pectoralis muscles, and muscles that lie over and between the ribs assist in inhalation. While muscles that lie between the ribs – the intercostals and abdominals assist in exhalation. 

Massage therapy for muscles of the neck, shoulder and abdomen can be important for those with breathing difficulties because of persistent overuse of these muscles. While it will be beneficial to treat all of relative muscles, the primary attention would be to the diagram and ribs. Following proper draping of the abdomen, the massage therapist will then work with the client and their breathing through various techniques to help release adhesive tissue that is bonding muscles tightly, prohibited full mobility of the diaphragm and rib cage during respiration. 

These techniques could include –

1. Scooping and cupping of the diaphragm. The fingers of a cupped hand can be worked gently around the border and base of the ribs. Asking the client to inhale, then exhale allowing greater reach to the diaphragm, covering more of its surface.
2. Rib raking – where the fingers of the therapist are placed along the grooves of the ribs, providing a scooping motion towards the sternum addressing the intercostal muscles.
3. Rib springing – a compressive technique that is applied by the therapist during exhalation with added over pressure at the end of the exhale. The compression is then removed suddenly and the quick release encourages a deep inhalation. The deep inhalation promotes increase lung volumes and mobility of the rib sections. This also promotes movement of any residual secretions. 

These techniques are generally paired with treatment over the back and neck to help encourage mobility throughout the entire trunk and torso. None of these techniques are obliged in any treatment. The massage therapist will always discuss thoroughly to set the treatment plan within the client’s comforts. 

If you are struggling with these or other side effects in your recovery of COVID-19, these are few of the many techniques that may be applied to help in your recovery. For some, it may be the postural effects and pain due to working from home, others may have increased stress or mental health concerns. The COVID-19 pandemic has affected us all in many ways and massage therapy is just one of the many resources that can help in a recovery and moving forward.  

– Melissa Andre, RMT