Receiving Massage Therapy after COVID-19

Updated October 2026 to reflect the evolving research and recommendations.

Ok, so you’ve just recovered from a COVID-19 infection. Maybe it was mild, like the sniffles. Maybe you felt terrible for a few 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?

The short answer is that it depends on how you’ve recovered, whether you’re experiencing any lingering symptoms, and whether you have underlying health conditions that could increase your risk of complications.

When I originally wrote this article, the Washington State Massage Therapy Association recommended waiting 90 days after recovering from COVID-19 before receiving a full-body massage. That recommendation reflected concerns about cardiovascular complications and blood clots, even in people who had experienced relatively mild infections.

Fortunately, we’ve learned a great deal more about COVID-19 since then.

That doesn’t mean we should ignore the potential risks. Let’s look at what we know and how to make informed decisions about returning to massage.

COVID-19 Increases Your Risk of Cardiovascular Complications

COVID-19 isn’t just a respiratory illness. It can also affect the cardiovascular system, including the heart and blood vessels. Research has shown that some people experience cardiovascular complications following infection, including inflammation of the heart muscle (myocarditis), inflammation of the lining surrounding the heart (pericarditis), and disturbances in heart rhythm. These complications can occur even after a relatively mild illness, although serious cardiovascular complications are much less common in people who weren’t hospitalized.

In a study published in Nature Medicine in September 2022, titled Long-term cardiac pathology in individuals with mild initial COVID-19 illness, researchers investigated 346 people who had experienced relatively mild COVID-19 infections but subsequently reported cardiac symptoms. Of these participants, 73% reported new cardiac symptoms following their infection, including shortness of breath, heart palpitations, atypical chest pain, and fainting. Approximately 57% continued to report symptoms nearly a year later.

Yikes! Those numbers certainly get your attention. But there’s an important distinction: the researchers studied people who were already experiencing symptoms, rather than a random sample of everyone who had recovered from COVID-19. So these findings don’t mean that 73% of all people with mild COVID-19 will develop heart problems. They do, however, illustrate that persistent cardiovascular symptoms can occur even after an initially mild infection.

Another study, Long-term cardiovascular outcomes of COVID-19, published in Nature Medicine in February 2022, examined health records from the U.S. Department of Veterans Affairs. Researchers found an increased risk of several cardiovascular conditions during the year following COVID-19, including heart rhythm disturbances, inflammatory heart disease, and blood clots. The increased risk was observed even among people who hadn’t required hospitalization, although it was generally greater among those who had experienced more severe illness.

It’s worth remembering that this study was based on a predominantly older, male veteran population, and the research was conducted earlier in the pandemic. Its findings may not apply equally to younger, healthier, or vaccinated individuals.

What Does This Mean for Massage Therapy?

Unlike vigorous exercise, massage therapy generally doesn’t place a substantial physical workload on the cardiovascular system. In fact, relaxation massage commonly produces a decrease in heart rate and blood pressure.

However, massage therapists need to be attentive to symptoms that could indicate an underlying cardiovascular problem.

If you’ve experienced chest pain, unexplained shortness of breath, fainting, or new or worsening heart palpitations following COVID-19, it’s important to seek medical evaluation before receiving massage.

And if you’ve been diagnosed with myocarditis, pericarditis, or another cardiovascular complication, your return to massage should be guided by your treating healthcare professional.

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 and the Risk of Blood Clots

Here’s another important consideration.

COVID-19 can increase the risk of developing blood clots, including deep vein thrombosis (DVT) and pulmonary embolism.

These complications are particularly concerning because a blood clot can sometimes develop without obvious symptoms.

But how common are blood clots following mild COVID-19?

A large study published in JAMA Network Open in March 2023, titled Assessment of the Risk of Venous Thromboembolism in Nonhospitalized Patients With COVID-19, examined nearly 400,000 adults who had COVID-19 without requiring hospitalization.

Researchers found that:

• The overall risk of venous blood clots was low.
• The risk was highest during the first 30 days after diagnosis.
• The risk decreased substantially after the first month.
• Certain individuals, including older adults and people with previous blood clots or clotting disorders, had higher risks.

Of the nearly 400,000 participants, approximately 0.1% experienced a diagnosed venous thromboembolic event during the study’s follow-up period.

That’s reassuring, although it doesn’t eliminate the need for appropriate precautions.

Can Massage Dislodge a Blood Clot?

This is where massage therapists need to exercise professional judgment. Massage is contraindicated over an area with a known or suspected deep vein thrombosis. Applying pressure or manipulating tissue around a clot could potentially contribute to a dangerous complication. However, there is insufficient evidence to conclude that routine massage dislodges previously undetected blood clots in otherwise healthy people recovering from COVID-19. The appropriate response is careful health screening, awareness of warning signs, and modifications or postponement when medically indicated.

Symptoms of a Possible Blood Clot in a Vein or Artery

Before scheduling a massage, pay attention to any unusual symptoms, particularly if you’ve recently recovered from COVID-19.

Symptoms of deep vein thrombosis may include:

• Swelling in one leg or arm, particularly when it’s noticeably different from the other side.
• Pain, tenderness, or cramping that doesn’t have an obvious explanation.
• Unusual warmth in the affected area.
• Redness or other changes in skin color.
• Itchiness or a skin rash in the affected area.

If you develop these symptoms, seek prompt medical evaluation rather than scheduling massage.

A pulmonary embolism occurs when a blood clot travels to the lungs. Symptoms may include sudden shortness of breath, chest pain (especially with breathing), rapid heartbeat, coughing up blood, or fainting. This is a medical emergency. Call 9-1-1.

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

1. If you had a mild, uncomplicated COVID-19 infection

If your symptoms have resolved or are substantially improving, you’re feeling well, and you haven’t experienced any concerning cardiovascular symptoms, you may be able to return to massage without waiting several months.

However, you should also consider whether you might still be contagious.

According to CDC respiratory virus guidance, people can generally resume normal activities once their symptoms have been improving for at least 24 hours and they’ve been fever-free for at least 24 hours without fever-reducing medication. Additional precautions are recommended for the following five days.

These are general public-health guidelines, not specific clearance recommendations for massage therapy.

Because massage involves prolonged close physical contact, I recommend postponing your appointment if you’re still experiencing active respiratory symptoms or may be contagious (i.e., Thank you for not spreading this to your massage therapist).

2. If you’re experiencing lingering symptoms

Some people continue to experience fatigue, dizziness, exercise intolerance, or other symptoms after their initial infection. If this sounds familiar, please let your massage therapist know. A shorter session, lighter pressure, adjustments in positioning, or additional rest breaks may be appropriate, depending on your symptoms. For people experiencing post-exertional malaise, including some individuals with Long COVID, even activities that seem gentle can sometimes worsen symptoms. Massage should be approached cautiously and tailored to individual tolerance. Persistent or unexplained symptoms should be evaluated by a healthcare professional.

3. If you had severe COVID-19 or were hospitalized

If your illness involved hospitalization, blood clots, cardiovascular complications, or significant respiratory problems, I recommend consulting your treating healthcare professional before returning to therapeutic massage. Your massage therapist should also be informed about any relevant diagnoses, medications, and ongoing restrictions.

4. The Bottom Line: Listen to Your Body

COVID-19 can affect people differently, and recovery isn’t always straightforward. Pay attention to how you’re feeling. Don’t ignore unusual symptoms. And be open with your massage therapist about your recent illness and medical history. Therapeutic massage can be a wonderful way to relax, ease muscle tension, and support your general well-being as you return to your regular activities. My goal is to help you enjoy those benefits while making your health and safety a priority.

Here’s to your continued health and well-being!