Header for Alicia Mutch | Poppies Reaching Towards the Sky | Hypnotherapy and Massage Therapy | Healdsburg, California

Receiving Massage Therapy after COVID-19

Massage after COVID-19The Omicron wave of COVID-19 in the spring impacted so many people that an estimated 70% of the population has caught it now in one form or another (here’s an article on WebMD with that information). Ok, so you’ve just recovered from a COVID-19 infection. Maybe it was mild, like the sniffles. Maybe you felt terrible for several days and you’re feeling better now. Either way, you’re ready to schedule your next therapeutic massage. So, when is it safe to receive a massage after COVID? Based on what we know about COVID-19 and how it impacts the body, even in the mildest cases, a conservative approach is to wait a full 90 days after you recover to schedule your next massage. Wait, what? 90 days???!!!! I know, that’s three months. It seems like a long time, doesn’t it? Well, bear with me while I explain the reasoning.

COVID-19 Increases Your Risk of Heart Damage

COVID-19 has been shown to have an inflammatory effect on the heart, even in mild cases. Actually, it impacts all of the organs, but for the sake of massage, I’m most concerned about the heart and the blood vessels. In an article published in Nature Medicine on September 5, 2022 and titled, “Long-term cardiac pathology in individuals with mild initial COVID-19 illness,” 73% of the 346 participants in the study who had contracted mild COVID-19 reported cardiac symptoms that weren’t present before their illness. 38% had mild cardiac symptoms, 33% had moderate symptoms, and 3% had severe symptoms. These symptoms included shortness of breath, heart palpitations, atypical chest pain, and fainting. Anywhere between 274 and 383 days later, cardiac symptoms were still present in 57% of the participants. Yikes!

Here’s another research study published in Nature Medicine on February 7, 2022 and titled: “Long-term cardiovascular outcomes of COVID-19.” This was a research study conducted by the US Department of Veterans Affairs. The participants in the study suffered from mild to severe COVID-19 infections, and the abstract of the study states that: “Our results provide evidence that the risk and 1-year burden of cardiovascular disease in survivors of acute COVID-19 are substantial.”

Why does this matter for massage? Well, an hour Swedish massage has the same impact on the circulatory system as going on a 5-mile hike. It moves blood and lymph from the extremities back up to the heart very effectively. If I were concerned about possible heart damage, I wouldn’t go on a 5-mile hike and I would certainly avoid a full-body massage for a while. You want your heart muscle to rest and recover after COVID. And your heart and other organs could take up to a year to heal. Take your time returning to activities that will place a greater workload on your cardiovascular system. No massage therapist wants to be the one with a client experiencing a heart attack on their massage table. That would suck.

COVID-19 Increases Your Risk of Stroke

Here’s the other scary bit. Having a mild case of COVID-19 (meaning, you weren’t hospitalized) increases your risk of blood clotting disorders. On page 16 of the Washington State Massage Therapy Association’s Interim Guidance on Practice Guidelines, it states that “blood clotting can occur in people over 30 days past the point of when they were deemed COVID-19 free and can cause a stroke, heart attack, pulmonary embolism or thrombosis anywhere in the circulatory system.”

Here’s an article from WebMD about blood clots with mild COVID-19 cases. Those post-COVID blood clots could be lurking anywhere in your body after a COVID-19 infection. They might be silent, with no symptoms. You have the greatest risk of throwing a blood clot for the first three months after your COVID-19 infection. That’s where the 90-day massage avoidance recommendation comes in. Yes, you can throw a clot for up to a year after the COVID-19 infection, but the risk diminishes the further away you get from the illness.

The areas of the body where a massage therapist is most likely to loosen blood clots include the legs, arms, armpits, and iliopsoas region (read this for more information about the psoas).While we’re still having COVID surges, a massage therapist should be cautious around those regions and avoid deep tissue work for post-COVID clients.

Symptoms of a Possible Blood Clot in a Vein or Artery

Before you schedule that massage, pay attention to your body. The most common symptoms of a blood clot in a leg or arm vein are swelling or cramping, pain, warmth, and change of color in the area that contains the clot. You might also experience itchiness or notice a skin rash in that area. And you might not notice any symptoms at all. Deep vein thrombosis can be a silent killer. Let your massage therapist and also your doctor know if you notice any of those symptoms.

This article from WebMD is incredibly informative about all the possible symptoms of blood clots that could be anywhere in the body, not just the arms and legs.

Recommendations for Massage Therapy After COVID-19

Some of these recommendations were taken from page 22 of the Washington State Massage Therapy Association’s Interim Guidance on Practice Guidelines. Others are common sense. My hope is that both massage therapists and massage clients will read this and increase their awareness and mindfulness around post-COVID massage therapy.

  1. Wait for at least 90 days after recovering from COVID-19 before you schedule a full body massage. If you’re experiencing any cardiac symptoms, go see your doctor. You’ll need a doctor’s clearance before you get that massage. And the cardiac symptoms need to be resolved.
  2. If you can’t wait 90 days for your next massage because of injuries, surgeries, or chronic pain, here’s what you can do:
    1. Spot massage treatments here and there are ok. Just avoid full body massage.
    2. Especially avoid receiving deep massage on the legs, arms, armpits, psoas and neck (where the risk of throwing a clot is the highest).
    3. Energy work, like Reiki, is fine. And lighter massage on the arms and legs and neck should be fine, too.
  3. If you’re a massage therapist, treat all post-COVID massage clients with caution, and act like every single one of them has a hidden blood clot that you might dislodge with the work you’re doing.

Here’s to your health and continued well-being! I know that this is an uncomfortable and scary topic (and I don’t want to scare you away from massage!), but knowledge is power. And therapeutic massage has incredible benefits that accelerate your healing and alleviate stress (here are the top 10 benefits of massage). We’re all doing the best we can to return to a sense of normalcy after this pandemic. Let’s do it mindfully.

Massage Therapy and Vaccinations

Vaccinations and Massage TherapySo, you just received your annual flu vaccination or your COVID-19 booster shot. Now what? When is it safe to get your next full body therapeutic massage? I have some thoughts about it that I’d like to share with you. First of all, plan on getting a massage BEFORE your vaccine, rather than right afterwards. A day or two beforehand is great. This will stimulate your immune system and set you up well for your body’s response to the vaccine. Next, please avoid massage for about two days after a flu vaccine and nine days after receiving a shingles or COVID-19 vaccination. I made up that number. You won’t find it online. I looked. But here’s where I got it. The Center for Disease Control (CDC) states that side effects for the COVID-19 vaccine show up within seven days. I added two days to make sure your massage is well out of the side effect time period. Read an overview of COVID-19 Vaccinations here.

Don’t Get a Massage Right After Your Vaccine

Over the years, I’ve had numerous clients show up for their massage appointments and announce that they just stopped by the pharmacy to get a vaccination right before coming in to see me. For each of them, I apologize and ask them to reschedule their massage. This issue is becoming more and more prevalent as we’re stepping into both flu season AND the beginning of the next COVID-19 surge. When you receive a vaccine, your body perceives the contents of the vaccine as an invader and mounts an immune response. The more robust the response, the more your body is producing antibodies against the illness. It can take a few weeks for your body to make all of the T-lymphocytes and B-lymphocytes needed to fight off an illness. Right after a vaccine, treat your body as if you have the illness you’ve been vaccinated against. Keep in mind that an hour Swedish massage has the same effect on your circulatory system as going on a five-mile hike. Massage moves a lot of blood and lymph around the body! If you had the flu, would you go out and get a massage? I hope not! Here’s an article from the Center for Disease Control on how vaccines work in the body.

Don’t Get a Massage While You’re Having Negative Symptoms from a Vaccine

Ruth Werner is a highly respected massage professional who wrote “A Massage Therapist’s Guide to Pathology.” In an article she wrote for the Associated Bodywork and Massage Professionals (ABMP) on January 1, 2021, she recommends waiting at least two days after each COVID-19 vaccine injection to make sure you don’t have a negative reaction to the vaccine before receiving massage. If you have a negative reaction to the vaccine, wait until your symptoms are gone before you get the massage. Read the entire article here. I prefer to err on the conservative side, which is why I added an extra week to her recommendation.

Wait Until Your Risk of Blood Clots Has Decreased

The Johnson & Johnson and AstraZeneca COVID-19 vaccines have a window of time for four to twenty-eight days after the vaccination where a very small percentage of people develop blood clots (vaccine-inducted thrombotic thrombocytopenia). Read the article here. Although this risk is very small, massage increases your risk of throwing a blood clot within than twenty-eight day time window. I definitely don’t want to be the massage therapist that sends you to the emergency room. So, if you’re using the Johnson & Johnson COVID-19 vaccine, please delay your next therapeutic massage for twenty-eight days.

Massage Can Slow Down Your Immune Response to Vaccines

It’s really hard to find research studies on vaccinations and massage! But here’s one I found on PubMed. A 2012 research study looked at massage therapy and antibody responses to a Hepatitis B vaccination. In the study, the group receiving the massages after the vaccine had a lower antibody response to the vaccine than the control group. Since we really want the vaccinations to kick up our antibody responses to the illness, it appears from this study that massage interferes with antibody production. Since we want a robust immune response to vaccines, this study seems to indicate that delaying massage after vaccines is beneficial. Read the PubMed article here.

In Conclusion

If you choose to get vaccinated, go get your vaccine! Schedule your regular massage for a day or two before your vaccine and then avoid massage for two days (after a flu shot) to nine days (after a COVID-19 vaccine) afterwards. While you’re waiting for your body to mount an immune response to the vaccine, take great care of yourself. Drink plenty of water. Ice your arm, massage the injection site lightly and make sure you’re moving that arm around. Get plenty of rest. Avoid hard core, strenuous exercise for a few days. And then schedule your next therapeutic massage.

Here are 9 things to do after receiving your COVID-19 vaccine



HypnoBirthing — Time to Take a Break

HypnoBirthing classes in Sonoma County, CaliforniaIt’s October of 2022, and I’ve been teaching the Morgan Method of HypnoBirthing® childbirth classes to hundreds of couples since January of 2001. I just wrapped up a private HypnoBirthing® class and a group class in September. Now that my daughter is 9, it’s time to step down from teaching and focus on family time in the evenings and on the weekends. It’s been an amazing journey and I love the birth stories that I keep hearing from my moms and couples. Thank you for including me in your birth journeys! If you’re looking for a nearby practitioner, visit the HypnoBirthing® Institute’s Find an Educator page.

The Iliopsoas Muscle — an Under-Appreciated Cause of Low Back Pain

Low Back Pain — The Three-Dimensional Picture

Iliopsoas MuscleI would estimate that seventy percent of the clients who seek me out for massage have low back pain as either a main or secondary complaint. Maybe they’ve injured themselves or maybe they’re just getting older and experiencing their bodies breaking down slowly. If I just work on their low backs and hips, I’m not getting at the whole picture. You see, we live in a three-dimensional body. The low back has a front, two sides, and a back to it. Most massage therapists work on the back of the low back and hope for the best. But let’s look at the front of the low back.

The Iliopsoas

Meet the iliopsoas – a two-part muscle made up of the psoas major and iliacus muscles. It lives in the front of the back on both the right and left sides of the body. The psoas major originates between the last thoracic vertebra and every single lumbar vertebra. The iliacus begins in the front of your pelvic bone. Both of them weave together at your hip and attach to the front inside of your upper leg. The iliopsoas is a powerful hip flexor, meaning that it helps you bend over to tie your shoes or bring your knee up to your chest. However, when it’s tight, it pulls down and forward on your low back vertebrae, making them feel tighter and tighter, until you’re walking around with a chronic low back ache and a feeling like you’re wearing a belt of tightness and pain around your waist. How does it get tight? Oh, the usual things that we do way too much of: sitting in front of a computer, sitting and watching tv, and more sitting in the car. The iliopsoas hates couch (and desk) potatoes.

Massage Techniques for the Psoas

Psoas massage is an advanced technique. If you’re looking for this for yourself, seek out an orthopedic massage therapist or a physical therapist. I sink right down into the abdomen when I massage the psoas. The intestines and mesentery move reflexively out of the way, so I don’t worry about compressing them. There are some serious endangerment points, like the aorta, the vena cava, the colon and the ovaries, so you shouldn’t do this on yourself. I’ll do a combination of cross fiber friction and pin and stretch technique along the length of the right and left psoas, as well as trigger point massage and pin and stretch technique on the right and left iliacus. Then I ask my client to straighten their legs fully on the table and tell me how their low back feels. Iliopsoas massage done well should make the low back feel like it has relaxed. The low back curve will be straighter and you will actually get the feeling that your low back has dropped down and is contacting the massage table more. For clients with chronic low back pain, the lengthening and straightening of their lumbar spine can feel like a miracle and give incredible pain relief. Results can be long-lasting, but unless you stop your sedentary lifestyle, the iliopsoas will generally tighten right back up again.

A Visual Description of the Psoas

Here is a great descriptive video of the iliopsoas from Kenhub:

For more information on the iliopsoas, here is another helpful link from Dr. Christiane Northrup’s website:

Why Your Psoas Muscle Is The Most Vital Muscle in Your Body, by Christiane Northrup, M.D.

Microbiome and Health | Midwifery Today Article

Click here to read: Microbiome and Health | Midwifery Today

The above article appeared in Midwifery Today, Issue 120, Winter 2016. I love the topic: gut flora! This article addresses the microbiome, that fascinating slurry of bacteria, viruses and fungi that live in our bodies. We are just at the tip of the iceberg for discovering how this microbiome dramatically affects the health of all of us, but this article begins by delving into the microbiome of our babies.

Here are some of the major takeaways from this article:

  1. The placenta has its own microbiome that comes from a mother’s oral bacteria. Wow!
  2.  The baby’s gut is first colonized with bacteria when it passes through the birth path, skin-to-skin contact after birth, and bacteria from the home, hospital or birthing center.
  3. Towards the end of pregnancy, the microbiome in a mother’s birth path starts to change, with increasing colonies of Lactobacillus (a great probiotic).
  4. Breast milk is rich and dense in probiotics (it’s dense in prebiotics too, by the way).
  5. Research shows that “a disruption of our microbiome will strongly influence whether we will experience different diseases such as asthma, allergies, ADHD, personality disorders and chronic autoimmune diseases.”
  6. High cesarean rates and the use of antibiotics in mothers and newborns are changing babies’ microbiomes.
  7. Breastfeeding is essential for populating a baby’s gut with beneficial bacteria.

How to Best Support Your Baby’s Microbiome:

  1. Try to avoid antibiotics in pregnancy and while breastfeeding
  2. Eat foods that support your own gut flora
  3. Do your very best to avoid a cesarean birth if at all possible
  4. Breastfeed your baby

Book Review: “The Vaccine-Friendly Plan,” by Paul Thomas, M.D., and Jennifer Margulis, Ph.D.

Have you ever felt confused by the vast amount of information about vaccines that’s floating around on the internet? On the one hand, in California at least, a child isn’t allowed to go to preschool or kindergarten without vaccinations or a medical exemption. On the other hand, we really don’t want to cause inadvertent harm to our children by overwhelming their immune systems with too much aluminum, formaldehyde, thimerosal, and other vaccine ingredients. We have populations of anti-vaxxers who say “No way am I injecting anything like that into my child.” And then we have the pro-vaxxers, who say, “Follow the recommended schedule because herd immunity is very important to our society.” What if you’re somewhere in the middle of those two groups, wanting your child to be protected from childhood illnesses but also being wary about possible longterm side effects of vaccines?

This is where I highly recommend “The Vaccine-Friendly Plan,” by Paul Thomas, M.D. It was just published in 2016, so it has very current, relevant information in it. He writes from the unique perspective of growing up in Rhodesia (now Zimbabwe) in a missionary family with a mother who was a nurse. He saw the immediate benefits that vaccines had on the lives of the poverty-stricken and malnourished people there. When he returned to the United States and became a doctor, he saw the miraculous effects of vaccines like the Hib (Haemophilus influenza B) vaccine that essentially saved thousands of children’s lives from meningitis. But he also saw a new rise of chronic health conditions, including “food allergies, attention deficit disorders, childhood anxiety, childhood asthma, childhood depression, eczema, gastroesophageal reflux, headaches, ear infections, neurological disorders, sinus infections, lung infections like pneumonia, urinary tract infections, and virulent strep throat.” He speculates that the toxins in our world, including but not limited to childhood vaccines, can be contributing to these chronic conditions. “The Vaccine-Friendly Plan” is a “comprehensive guide to childhood health and well-being, offering parents not only balanced information about vaccines but also everything else you need to know to keep your child safe and healthy.”

I love the way this book is organized. Dr. Thomas writes thoughtfully and concisely. Chapter 1 is about the toxins that are ever-present in our world, including acetaminophen, aluminum, aspartame, endocrine disruptors, flurried, methanol, and mercury, and how to mitigate them in our children’s lives. And then the following chapters are organized by the age of your child: from your pregnancy to the first hours of life outside the womb, the first two weeks of life, the two-month well-baby checkup, the first nine months, the one-year mark, the toddler and preschool years, elementary school, and the teenage years. He writes about vaccines and his recommended vaccine schedule that he uses with his patients, but there is so much more information that you didn’t even know you were looking for. He includes a summary of recommendations at the end of each chapter with answers to frequently asked questions that come up in his practice. Whatever the age of your child, you can go immediately to the relevant chapter and begin reading. Chapter 11 is a cheat sheet about the best ways to support your child’s immune system, and then the Appendixes have things like recommended reading lists, a comparison of the CDC (Center for Disease Control) vaccine schedules in 1983 and 2016, “ten questions to ask when looking for a pediatrician,” lists of vaccine ingredients, and clinical data from his practice.

The major selling point of this book, in my opinion, is the study from Appendix E. Dr. Thomas has followed 2,230 children over the ago of two and under the age of seven in his clinic. He compares children who followed his recommended vaccine plan with a group of unvaccinated children and a third group who were vaccinated according to the CDC (Center for Disease Control) vaccination guidelines. The rate of autism in the United States is 1 in 50 children, so, theoretically, the children from all three study groups “should” have had the same autism rate. No children who followed his recommended vaccination plan developed autism. There “should” have been 22 cases of autism in the first group. No children who were unvaccinated developed autism (there “should” have been 4 cases), and 15 children who followed the CDC vaccination schedule developed autism (a rate of 1/60), which follows the national average. This data blows my mind. Mindful vaccination can dramatically reduce autism in our children. Think about that!

Anyway, if you get a chance, pick up this book, read it, recommend it to others, and keep it in your reference library.

A Lovely HypnoBirthing® Home Birth Story from Mothering Magazine

Click here to read: “My HypnoBirthing Experience: An Unexpected Miracle”

The above link is an article I found from March 16, 2018 in Mothering Magazine about a woman’s story with HypnoBirthing®. Kathleen Fleury writes about how HypnoBirthing® appealed to her: she liked the idea of learning to “breathe, visualize, relax, and tone your mind and body to anticipate a calm, easy birthing experience.” She writes about creating a “cave” for herself for her birth and fantasizing about a pain-free labor. Then she gives us a reality check by saying she didn’t actually make it to the cave. She was busy watching “Return of the Jedi” with her three-year-old and relaxing while feeling her uterine surges come and go. Her baby was born on the living room floor. She says that she didn’t achieve a pain-free birth, but from her description, her labor was shorter and more comfortable than her first two births, she deeply relaxed in between uterine surges, and she was able to cope with her surges much better. This is HypnoBirthing® in a nutshell!

Plan for Success in Your Birth

Kathleen does a great job of explaining the HypnoBirthing® philosophy. She quotes Christiane Northrup, who says that our culture has already been hypnotized to expect birth to be a “horrendous emergency.” HypnoBirthing® is about planning for success and visualizing the gentle, calm birth of your dreams. She even quotes Mickey Mongan, the founder of HypnoBirthing®:

“Why do we plan on the flaws in birth?” asks Mongan. “When you plan a vacation the travel agent doesn’t say ‘it’s going to rain every day and here are the statistics for airplane crashes.’ Birth is the best journey that a woman will ever take. We want to help them turn their greatest fear into their greatest achievement.”

Easier, Safer, More Comfortable Labors with HypnoBirthing®

What I’d like to say about HypnoBirthing® is that any HypnoBirthing® instructor who promises you a pain-free labor is setting you up for disappointment in your birth. HypnoBirthing® never promises a pain-free or even a sensation-free labor. What it promises is a shorter, easier, more comfortable labor when you relax, trust your body to birth, and tune into your body’s natural birth instincts, which is exactly what this birthing mom did, in spite of having two children running around, a full-time job, and a hectic lifestyle. Kudos to you, Kathleen Fleury.

The Consciousness of Your Baby Before Birth

This video shows the importance of slowing down your life and being mindful of the physical and mental state you are experiencing as you are carrying your baby. Stress during pregnancy has a profound effect on your developing baby’s brain as well as the development of its internal organs and systems.

“A mother’s emotional state enters into as one of the participating causes of the shape, size, function and characteristics of the brain in her infant in her womb and that if she’s given a safe, nurturing environment herself, her infant will be born with a totally different brain than it will otherwise. This is huge news.”

~Joseph Chilton Pierce, author of “Magical Child”


Contact Alicia: