As we take stock of the past year and count our blessings for our good health and lessons learnt during the pandemic, the reality is becoming clear that recovery from this illness is – for some – a long and arduous struggle. Large numbers of people who have been infected with COVID-19 continue to experience a constellation of symptoms long past the time that they’ve recovered from the initial stages of the disease and suffer from what is now commonly referred to as ‘long-COVID’. We want to take a look at this difficult legacy of COVID-19 and answer some questions, namely “what is it?”, and “can yoga help?”
The exact nature of long-COVID, and the magnitude of the illness, is still being defined, but research from King’s College London has found that one in 20 people with coronavirus are likely to have symptoms for eight weeks or more. Sufferers of long-COVID have reported many different physical ailments including breathlessness, headaches, muscle pains, nausea, brain fog, sleep disorders and fatigue. These persisting symptoms can last for many months and can range from mild to almost completely incapacitating. In some cases, new symptoms can arise well after the time of initial infection or can evolve over time.
We do not know yet the scale of the problem of long-COVID but, given the number of individuals of all ages who have been, or indeed will be infected by COVID-19, it is safe to say that the public health impact could be profound.
The short answer to this is yes, but with a reminder to approach each and every session with great care, and to go slow.
Yoga teachers and yoga therapists in the United States have been working with patients with long-COVID to help them ease stress and pain, maintain mobility, and breathe easier, and there is evidence emerging that their approach is working.
COVID acts like an inflammatory disease, initiating an immune-system response in the body that kills off healthy cells. The inflammation is exacerbated by stress. Many of the symptoms of COVID can be the result of excess inflammation, particularly in the lungs, brain, and blood vessels, where the virus attaches via its ACE2 enzyme receptors.
There is evidence to suggest that yoga can help to decrease inflammation in general and breathwork and gentle yoga practice, such as vinyasa flow, can be used to alleviate stress and inflammation as well as be used for building the capacity to breathe easier post COVID infection.
This said, in some cases, yoga students with long-COVID experiencing severe breathing difficulties may find any kind of yoga too tiring to attempt and coming back to classes shouldn’t be encouraged until they feel strong enough to breathe without struggling. Yin yoga may be an option for those wanting to enjoy regular yoga classes as you hold the yoga poses for longer to allow deeper stretches.
The key thing to remember – particularly for anyone who is experiencing lung-related difficulties – is to avoid any poses which compromise breathing. Medical staff in some hospitals dealing with COVID patients have found that ‘proning’ patients – or turning them onto their tummies – helps them to breathe more easily.
With this in mind, any poses that involve lying flat on your back when you are struggling to breathe are likely to be unhelpful and uncomfortable. Supported poses that help the back of the body and lungs to open could be beneficial as a starting point. Examples of these are:
As the long-COVID sufferer gets stronger, they could build on these, but stick to simple poses and keep all practice slow. A restorative and gentle practice – such as My Life Tonic's Monday 8pm Yin class or the Tuesday 7pm Gentle vinyasa flow class would be a good place to start to rebuild strength, recapture the breath, and reduce inflammation and stress. You can view our full yoga class schedule here.
Yoga breathwork can indeed help to strengthen the lungs but should only be practised once breathing isn’t a struggle. COVID-19 can cause scarring to the lung tissue and overworking the lungs in strong breathing exercises may cause more damage. In the early stages ‘breath awareness’ is a practice that can be safely used and helps to lessen anxiety which may be triggered by the symptoms of long-COVID.
A review of post-acute COVID treatments, published in the journal BMJ last summer, recommends “breath control” techniques similar to Ujjayi and pranayama practices that use breath retention to help work through chronic coughing and breathlessness. In all our classes our yoga students are reminded to maintain steady, deliberate breathing. We often introduce variations of pranayama breathing at the beginning or end of the class. If lying on your back is uncomfortable, and you experience challenges breathing, we certainly recommend completing the class in a seated meditation pose or sitting on a chair, rather than lying on your back.
It has been shown that nasal breathing like that practised in YogatTonic UK's classes has many far-reaching health benefits which would assist in helping to recover from long-COVID - including dilating the pulmonary arteries and increasing blood flow through the lungs, dilating the airways and increasing oxygen delivery to the lungs and blood, and directly killing and inhibiting the growth and spread of viruses in the lungs. Try it with us – it really does bring vitality and energy.
Unfortunately, there is currently no way to predict how long recovery from long-COVID will take. This information will take time to fully emerge. It is also important to remember that this isn’t unique to COVID-19 – other viral illnesses can have lasting effects too. Experience from other viruses suggests that most symptoms should go within three months, while tiredness may last up to six months. But that may not apply to everyone.
While yoga isn’t a magical cure, a regular yoga practice does teach us to accept our new normal and any restorative yoga class which helps us feel like we are back in control and soothing ourselves with selfcare is going to help us recover. Our small and intimate classes at YogaTonic UK , available online are a perfect way to start your road to recovery. While practicing yoga may not help directly with all of the symptoms of long-COVID, our yoga classes may well help the anxiety that surrounds it and assist people who are suffering from a relentless illness that is not yet understood or even fully recognised medically.
Since the onset we have found several helpful resources that have helped us understand ways to help the recovery from Long Covid. We are certainly not medical experts, but have found the resources listed below helpful.