65 for 65 – managing Long Covid

65 for 65 – managing Long Covid

As the world continues to grapple with the consequences of the COVID-19 pandemic, many individuals are finding themselves dealing with a condition known as Long Covid. This is estimated to affect around 65 million people globally, and presents a complex array of symptoms that can linger for months or even years after the initial infection.

Robin McNelis is a Clinical Specialist Physiotherapist who also has lived experience of Long Covid since March 2020. He has put together 65 useful pieces of information for managing the condition.
 

Understanding Long Covid

Long Covid is characterised by a range of symptoms that can include fatigue, shortness of breath, cognitive difficulties, and more. These symptoms can vary widely from person to person, making it crucial for those affected to receive tailored support. Physiotherapy, led by trained professionals like Clinical Specialist Physiotherapist Robin McNelis, can play a vital role in managing these symptoms and guiding individuals through their recovery.
 

The Role of Physiotherapy in Recovery

1. Pacing and Planning:

One of the cornerstone principles of recovery from Long Covid is pacing. This involves understanding your limits and finding a balance between activity and rest. Robin emphasises the importance of not overexerting oneself, which can lead to a “boom and bust” cycle where symptoms flare up after periods of increased activity. By setting realistic goals and gradually increasing activity levels, individuals can avoid exacerbating their symptoms.

2. Recognising Different Exertions:

Long Covid affects not only physical capabilities but also cognitive and emotional well-being. Physiotherapists can help patients identify various forms of exertion—physical, cognitive, emotional, social, and sensory—and teach them how to manage these effectively. Understanding how each category impacts energy levels allows patients to tailor their daily activities, reducing the risk of symptom flare-ups.

3. Breathing Techniques:

Many individuals recovering from Long Covid experience breathing difficulties. Physiotherapy can assist in retraining breathing patterns to ensure more efficient oxygen intake. Good breathing techniques include using the diaphragm, maintaining a calm rhythm, and ensuring even breaths. By practising these techniques, patients can alleviate some of the respiratory distress associated with Long Covid.

4. Sleep Hygiene:

Quality sleep is vital for recovery, yet many individuals with Long Covid struggle with insomnia or disrupted sleep patterns. Physiotherapists can advise on sleep hygiene practices, such as limiting screen time before bed, creating a conducive sleeping environment, and establishing a relaxing bedtime routine. These steps can significantly improve the quality of rest and overall recovery.

5. Rest – Restorative Practices:

In the context of Long Covid, the concept of “rest” takes on new significance. Physiotherapy emphasises different forms of rest that are essential for recovery:

• Physical Rest: This can involve gentle activities like stretching or easy walking within one’s limits. It doesn’t necessarily mean complete inactivity but rather engaging in low-impact exercises that do not exacerbate symptoms.

• Mental Rest: Mindfulness and meditation techniques can help calm the mind and reduce cognitive fatigue, which is common in Long Covid patients. These practices enable individuals to find moments of peace amidst the overwhelming nature of their symptoms.

• Emotional and Sensory Rest: Talking through emotions with a therapist or close friend can provide relief. Additionally, taking breaks from overwhelming sensory stimuli—like bright lights or loud noises—can help prevent emotional fatigue.

• Social Rest: While social interactions are important for well-being, they can also be draining. Finding a balance between engaging with others and taking time for oneself is crucial.

6. Managing POTS Symptoms:

For those experiencing Postural Orthostatic Tachycardia Syndrome (POTS), which is common among Long Covid patients, physiotherapy can provide strategies to manage symptoms effectively. This includes:

• Increased Fluid and Salt Intake: Staying hydrated and ensuring adequate salt consumption can help manage blood pressure and improve symptoms related to POTS. However, it’s important to consult a healthcare provider before making significant dietary changes.

• Compression Garments: Wearing compression stockings can help improve blood flow and reduce symptoms when standing.

• Dietary Adjustments: Some patients benefit from a low-carbohydrate diet, which can help manage energy levels and reduce symptoms.

• Cold Water Therapy: Simple methods like running hands under cold water or taking cool showers can provide relief and help manage POTS symptoms.
 

7. Resetting Techniques:

Throughout the recovery process, it’s important to take time to reset both physically and mentally. Techniques such as:

• Breathing Exercises: Simple breathing techniques can help calm the nervous system and reduce stress.

• Mindfulness Practices: Engaging in mindfulness or meditation can help individuals reconnect with their body and mind.

• Gentle Movements: Activities like singing, humming, or even light self-massage can serve as enjoyable ways to reset during the day.
 

8. Lactate Threshold Testing:

Understanding one’s limits is essential for pacing activities effectively. Physiotherapy can guide patients through lactate threshold testing methods to help identify safe exertion levels. This is particularly important for those using heart rate monitoring as a guide. Some methods include:

• Sub-maximal Tests: Conducted with specialised equipment (such as a Cardiopulmonary Exercise Test), these tests assess how hard the body can work before lactate builds up in the blood, which can indicate when to slow down during activities.

• Heart Rate Calculations: A simple way to estimate a safe exercise threshold is to subtract your age from 220 (for maximum heart rate) or to add 15 beats to your resting heart rate. Keeping activity within these thresholds can help avoid overexertion.

These assessments empower patients by providing clear guidelines on how to manage their activity levels effectively, allowing for a more structured approach to recovery.
 

9. Utilising Resources:

Navigating Long Covid recovery can be daunting, but numerous resources are available to support individuals on their journey. Physiotherapists can provide guidance on reputable organisations and websites that offer advice, exercises, and community support.

Some notable resources include (external links below will open in a new browser tab or window):

• Long Covid Physio: A platform offering a wealth of information from expert clinicians who understand Long Covid’s challenges.

• Workwell Foundation: Focuses on research-based resources for managing Long Covid and related conditions.

• Physios for ME : This group has been instrumental in drawing parallels between ME/CFS and Long Covid, providing valuable insights.

Accessing these resources can help individuals feel less isolated and more informed as they navigate their recovery.
 

10. Seeking Professional Support:

Lastly, one of the most crucial aspects of managing Long Covid is recognising when to seek professional help. Physiotherapists, alongside other healthcare providers, can offer tailored interventions based on individual needs. This collaboration ensures that patients receive comprehensive care that addresses their physical, cognitive, and emotional challenges.
 

Conclusion

Physiotherapy offers a holistic approach to managing Long Covid, emphasising the importance of pacing, mindfulness, and tailored interventions. By understanding the various dimensions of exertion and employing effective strategies to manage symptoms, individuals can take significant steps toward recovery. While the journey may be long and complex, the support of physiotherapists like Robin McNelis and a community of resources can empower those affected to reclaim their lives.

Bella MacDonald created the 65for65 challenge to try to raise as much awareness for Long Covid as possible. The challenge asks you to do something 65 times for the 65 million people worldwide that have Long Covid.

You can download the 65 for 65 Long Covid Recovery e-book by clicking here (PDF will open in a new browser tab or window)

 

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Further reading and resources

Rehab at Home – useful information from Robin McNelis

Robin McNelis works in Essex/London borders – you can reach him through his website www.RobinThePhysio.co.uk (external link will open in a new browser tab or window) or by phone 0790 579 8021.

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