Long COVID and POTS: Massage for chronic conditions
Most of the time, recovery from a bout of illness is relatively straightforward — you get ill, then you rest, hydrate, sleep a lot, and fairly soon you’ll return to how things were before.
For those living with chronic conditions like long COVID or POTS, things look a little different.
Instead, recovery is not necessarily a straight line. Frustratingly it can be fragmented and uncertain. Energy comes and goes, symptoms fluctuate. Simple activities like standing up, walking around, concentrating on daily tasks can suddenly feel demanding.
Those living with chronic conditions are adjusting not just to physical symptoms of illness, but to the emotional weight of a life that now moves more slowly than it once did.
Long COVID and POTS: What are they?
Long COVID and POTS are different conditions, but they often feel similar to live with, particularly in how they affect day-to-day functioning and emotional wellbeing.
How they’re different
Long COVID is a broad post-viral condition. It describes ongoing symptoms that persist after a COVID-19 infection and can affect multiple systems within the body (energy, breathing, cognition, immune function, nervous system).
POTS (postural orthostatic tachycardia syndrome) is a specific autonomic nervous system disorder. It mainly affects heart rate and circulation, particularly when moving from lying or sitting to standing.
How they’re connected
POTS can develop after viral infections, and COVID-19 is one of them. A significant number of people with long COVID experience disruption to their autonomic nervous system, and some of those meet the diagnostic criteria for POTS.
Both conditions commonly involve exhaustion that is out of proportion to activity. Rest does not always feel restorative, and small tasks can require significant energy. Symptoms often vary from day to day or even hour to hour. This unpredictability can make planning difficult and contribute to anxiety, as people may not know how their body will respond to activity or stress.
Difficulty concentrating, slowed thinking, memory lapses and mental fatigue are often experienced, and activities that were once enjoyable or routine may now provoke symptom flare-ups, dizziness or exhaustion. This can lead to a sense of loss around previous hobbies, fitness or social engagement.
How they overlap in practice
Long COVID is the umbrella description for a range of conditions, and POTS can be one expression within it. Not everyone with long COVID has POTS, and it is also possible to have POTS independently, without a history of long COVID.
One of the most challenging aspects is that these symptoms are often invisible. From the outside, someone may look “fine”, while internally their nervous system is working overtime just to get through the day.
Validation matters
One positive shift since the pandemic is that long-term conditions, autoimmune responses and chronic pain are finally being taken more seriously. For people living with long COVID or POTS, validation alone can be deeply relieving.
If you’re dealing with chronic tiredness, dizziness, or an unpredictable body, it makes sense that this feels frustrating or unfair. Needing to rest more, adapt your hobbies, or live differently is not a personal failure — it’s a reasonable response to a changed nervous system.
Accepting change
Something that comes up again and again in conversations with my clients with chronic conditions is a feeling of loss or even a sort of grief.
Many were active before becoming unwell. They played sports at a high level, exercised regularly, ran marathons, worked long hours, and maintained busy social lives. Now, many of these life-defining activities aren’t possible at all, or must be carefully rationed.
It’s common to hear these clients say they struggle to stay present, because their thoughts drift to “when I’m better” or “when this is over”. While this hope is important, it can also mean life feels permanently on hold.
Learning to gently accept the present, without giving up on recovery, is a difficult balance.
How massage relates to chronic conditions
I want to be very clear that massage is not a cure for long COVID or POTS, and it does not treat the underlying condition.
However, practices like massage, mindfulness, meditation and self-compassion can be helpful, not as fixes, but as ways of reducing the constant internal pressure to “push through”. Massage can be an effective support tool within a wider approach to recovery, and can be part of how you care for yourself while navigating it.
Three things massage can help you do
Be present
Living with chronic tiredness or long COVID can make it difficult to stay grounded in the present, especially when thoughts are pulled towards how things used to be or how you hope they might be in the future. Massage can offer a quiet, contained space to reconnect with your body as it is right now, helping to gently anchor attention in the present moment rather than in anticipation or worry.Listen to your body
Learning to pace yourself and respect physical limits is essential but often challenging, particularly for those who were previously very active. Rather than pushing or striving, regular massage sessions can reinforce the idea that listening to subtle signals of fatigue or discomfort is not weakness, but an important part of self-care.Support nervous system regulation
Some specific massage approaches aim to support parasympathetic nervous system activity, which is closely linked to the vagus nerve. Gentle, slow, non-stimulating touch may help promote relaxation and a sense of safety in the body, without raising your heart rate. While this does not “fix” autonomic dysfunction, it can help create moments of nervous system settling, which many find beneficial alongside additional medical forms of support.
Massage as a tool for mindful recovery
If you’re exploring ways to support your recovery from long COVID or POTS, holistic massage may be one small piece of a much larger puzzle, especially when delivered by a therapist who understands chronic conditions and respects your boundaries.
Sessions can be adapted to suit your needs, for example: slower pacing, careful transitions on and off the table, and clear communication throughout.
I treat clients with a range of chronic conditions at my practice in Southville, Bristol, and I’d be more than happy to hear from you to discuss your specific situation and treatment options.
Find my contact details online to get in contact, or book a personal consultation.
