The instinct of a physiotherapist is to help in rehabilitation and prescribe exercises but this is a cautionary tale following my own experience of recovery from illness. Normally, I am a fit and active physiotherapist but, as I write this article, I am recovering from pneumonia. Over the past months, I have been on a rollercoaster patient journey and have experienced unusual symptoms whilst recovering. My personal search for answers to my symptoms led me to research long COVID which shares similar characteristics. Please read on even if you have not suffered from COVID-19 or long COVID; perhaps you know someone who has and could offer support and understanding.
Much has been written about long COVID but I should like to share some of my personal findings, particularly about how the condition is impacted by exercise and exertion.
What is long COVID?
The acute COVID-19 infection usually lasts for up to four weeks. Some COVID patients, however, continue to experience signs and symptoms after 12 weeks, with no medical explanation. This has been dubbed long COVID by those living with the condition.
Long COVID is unpredictable in its nature, affects various systems of the body and causes different levels of disability for varying amounts of time. This makes it challenging for the patient, family and friends and supporting healthcare professionals.
What are the symptoms?
Hundreds of symptoms have been reported by those living with long COVID and each patient will report a cluster of different symptoms. The most common symptom is fatigue. The fatigue is sporadic in the months after infection and everyone appears to experience their own journey.
What causes long COVID and how is it managed?
This remains unknown, but a vast amount of research is taking place and initial theories attribute it to the reaction of the immune system. There is currently insufficient data to clearly recommend the best and most effective interventions for managing long COVID.
Exercise and long COVID
A great deal of knowledge and understanding exists concerning post-viral fatigue syndrome and myalgic encephalomyelitis (ME). When it comes to exercise and exertion, specialists are observing that long COVID patients may experience a similar reaction to those with post-viral fatigue.
The National Institute for Health & Care Excellence (NICE) has already cautioned against the use of graded exercise programmes for managing post-viral fatigue. This is due to post-exertional malaise (PEM), whereby exertion triggers a worsening of post-viral symptoms. PEM has been found in more than 70% of patients with long COVID. Whether you are living with long-COVID or you are a friend or service provider to a sufferer please be mindful to avoid triggering symptoms and relapses by suggesting or prescribing inappropriate exercise or exertion. Patients should seek medical advice before taking up exercise whilst in recovery but strategies deemed likely to be safe are pacing, activity management and heart rate monitoring. Basically, activity should be built up gradually to avoid exertion.
I feel sure that most people understand the concept of pacing exercise activities and not overdoing things. Actually adhering to this advice in real life, however, may be problematic. I appreciate how tricky it is to ensure balance in real life; with two kids homeschooling, a husband working from home and a growing list of domestic jobs, taking it easy has proved a real challenge. Celebrating little steps has been key.
As I have come to understand my body’s reaction to infection and fatigue, I have been able to pace myself, slow down and build up gradually. Exercise should always be take place under the guidance of a healthcare professional once a doctor has deemed it appropriate and safe.
Resources
New information concerning COVID-19 and its long term effects is emerging daily. If you would like to learn more I recommend the resources at www.longcovid.physio or www.physiosforme.com
Please be kind and supportive to those with long COVID, post-viral fatigue or ME. If you need any support in your own recovery journey, please get in touch with the clinic to see how we can help.
