Long Covid & Rehabilitation

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Nearly 2 years into the global Covid-19 pandemic, we may be familiar with the vaccines and SOP’s that we all need to go through. But for some people who have contracted Covid-19, a small percentage of them suffer from symptoms that go beyond the standard 2-weeks recovery time and continue to affect their daily lives.


Have you heard of the term “Long Covid”?

Also known as “Post-Covid Syndrome”, Long Covid means Covid-19 symptoms continuing for more than 3 months after an infection — severe or mild — and can’t be explained by other causes.

“[A] study, carried out in collaboration with clinicians at the Royal Free London (RFL) and University College London Hospitals NHS Trust (UCLH), shows that 54 days after discharge, 69% of patients were still experiencing fatigue, 53% were suffering from persistent breathlessness, 34% still had a cough and 15% reported depression. In addition 38% of chest radiographs (X-rays) remained abnormal and 9% were getting worse…” (Source: UCL)

man wearing a face mask



What are the symptoms of “Long Covid”? Will it ever go away?

The most commonly reported symptoms of Long Covid are: 

  • Fatigue (being easily tired)
  • Shortness of breath (difficulty breathing)
  • Muscle aches, and 
  • Difficulty concentrating (“brain fog”)

It is also important to remember that Long Covid ISN’T “deconditioning” (not being strong enough). Exercise-based treatment can make a patient’s condition even worse.

“There is evidence that fragments of the virus, such as protein molecules, can persist for months, [and] disrupt the body in some way even if they cannot infect cells… A further possibility is that long COVID is caused by the immune system going haywire and attacking the rest of the body.” (Source: Nature)

Long Covid is very similar to Chronic Fatigue Syndrome (CFS), or Myalgic Encephalomyelitis (ME), which is usually triggered by a viral infection. Some patients recover from ME/CFS and others struggle for extended periods of time. Because Long Covid is more similar to an auto-immune disease instead of a musculoskeletal problem (like back or neck pain), we need to be careful when treating it.

woman wearing a face mask



Can rehabilitation help?

Every single person with Long Covid presents differently, but poor breathing patterns are the most common issue. This isn’t surprising as Covid-19 is an infection of the respiratory (breathing) system. A breathing pattern disorder can start after a viral illness, a chest infection, or a period of stress – and for a lot of people, having Covid-19 is a stressful event. Fatigue and the inability to handle daily activities like before (walking for long, house chores, etc.) is also related to reduced endurance of the lungs and the muscles of breathing after Covid-19, as well as the immune system responding to physical stress.

Physiotherapists that are trained in breathing pattern re-training will be able to assist in slowly helping a person to regain back respiratory muscle endurance and strength. Pacing and management of Post-Exertional Malaise (PEM) (extreme fatigue after physical activity) are key to helping people with this condition. Again, Long Covid rehabilitation is NOT addressing poor strength — it is helping people learn to physically cope as their immune system recovers.

There can be no one-size-fits-all approach to treating people with continuing symptoms, and each person should be assessed individually to see if physical rehabilitation can help. Contact us through our Chatbox with Kate to see if our physiotherapists can help!


*Resources for more information on Post-Exertional Malaise (PEM) and Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME): Read Here