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The Long Covid Syndrome – How To Self-Manage Your Symptoms?

Long Covid Rehabilitation

What Is The Long COVID?

It’s been 2 years in the pandemic of the Covid-19. The impact has been disastrous in so many levels. While most people who had the COVID-19 recover completely within a few weeks. Some people continue to experience symptoms after their initial recovery. How many of you have heard of the Long Covid (aka Covid Long Haulers)?

Long Covid is a post-acute sequel of COVID-19 in which the person appears to sustain long-term symptoms of the virus (between 4 weeks to 1 year or more). We can call it chronic COVID syndrome as well. The long COVID can affect organs such as the heart, skin, guts, the brain and can have a profound impact on the respiratory system and the nervous system. Not to forget as well the impact of the physical aspect of the body such as muscle weakness.

Based on reports, it seems there are more female suffering from the Long Covid than male. While older people and people with medical conditions are most likely to experience lingering symptoms, young and healthy people have complained to feel unwell for weeks, months and more after infection.

What Are the Symptoms Of The Long Covid?

Researchers think there are three possibilities for long-term symptoms: lingering virus infection in reservoirs organs or fragments of viral genome triggering an uncontrolled immune response, or the virus is cleared but the immune response is altered.

Common signs and symptoms can include:

  • Brain fog
  • Fatigue
  • Shortness of breath and chest pain
  • Skin condition or rash
  • Joint pain
  • Memory, concentration
  • Sleep issues
  • Muscle pain
  • Headache
  • Fast or pounding heartbeat
  • Loss of smell or taste
  • Depression or anxiety
  • Sound in the ear
  • Dizziness

How To Self-Manage The Long Covid Symptoms?

To avoid any confusion, I will separate some areas affected so it’s clearer and hopefully more practical to read. I won’t list every possible recommendation but the most important ones. It’s important to note that it is always preferred to get a proper assessment with a health practitioner in relation to the long covid symptoms.

At Pillars of Wellness, we offer an in-clinic program which include physiotherapy, speech therapy, naturopathy and nutrition, occupational therapy, yoga therapy, acupuncture, and counselling. Visit our website for more information

cognitive and communication difficulties

  • Prompt yourself with a to do lists and alerts that can remind you of things you need to do.
  • Break down activities into individual steps to avoid feeling overwhelmed.
  • Give yourself extra time to complete everyday tasks.
  • Get organized. Establish a place for things that are easily misplaced.
  • Don’t postponed what supposed to be done in that time.
  • Complete cognitive tasks when you are feeling the most alert.
  • Complete tasks for short periods of time and take frequent breaks.
  • Set up a structure for yourself. Develop a daily routine and try to stick to it.
  • Use a journal to keep track of important symptoms, medical appointments, positive thoughts, goals that you want to achieve and accomplish.
  • Limit distractions and modify your environment to be quieter and more peaceful.
  • Monitor your cognitive skills and level of fatigue. Check in with yourself and even consider giving yourself a rating between 1-5.
  • Ask for support from loved ones, caregivers, and colleagues when necessary.
  • Prepare ahead for important conversations by reviewing key vocabulary. You may want to prepare a script to help you recall the main points.
Covid-19 Rehabilitation And Recovery Program

Improving your sleep

  • Use a blue light exposure. It decreases the hormone melatonin that is essential for deep REM sleep.
  • Maintain a regular sleep / wake cycle.
  • Ensure the room is quiet and dark.
  • Get fresh air and light during the day.
  • Weighted blankets. It’s effective in calming the nervous system to aid with deep sleep.
  • Create a bedtime routine: have a bath, warm tea, diffuse lavender oils, & meditate.
  • Avoid daytime napping if possible. Resting is ok, just not sleep.
  • Limit caffeine intake, avoid after 3:00pm.
  • Use of supplements.
  • Regular exercise! (Within tolerances).
  • Avoid over stimulation in daytime. The nervous becomes unregulated.
  • Nightly task planning.
  • Journaling at bedside.

How much is too much sleep? 11 hours might be limiting the quality sleep you need, whereas 8 hours might make your sleep more effective.

Respiratory Issues due to then Long Covid

When it comes to improving your respiratory system due to breathing difficulties. I am going to recommend some breathing exercises that can be an effective way to improve lung capacity and decrease feelings of chest tightness and discomfort. However, in the initial phases of the virus, or if someone is significantly breathless, breathing exercises should only be prescribed by an appropriate health care professional during an individualized assessment. For those who are not breathless, the following exercises can be performed.

It is recommended to complete 2 repetitions of each exercise, then breathe normally for 5-10 breaths to prevent lightheadedness, dizziness, or shortness of breath. Then repeat this process 3 times per exercise (i.e., 2 reps x 3 sets with breaks).

1. Pursed Lip Breathing

  • Inhale slowly through your nose for a count of 2.
  • Purse your lips, as if blowing out candles.
  • Breathe out slowly through pursed lips for 4-5 seconds.

2. Forced Expiratory Technique or “Huffing”

  • Inhale through your nose.
  • Hold your hand 2-3 inches away from your mouth, open your mouth wide.
  • Exhale with some force as if you were fogging up an imaginary mirror.
  • You may feel the need to cough afterwards.

3. Diaphragmatic Breathing

  • Sit comfortably, place your hand over your abdomen.
  • Breathe in deeply through your nose, allowing the air to reach the bottom-most part of the lungs. Your belly should fill with air and your hand should rise.
  • Exhale through your mouth, the air should leave your lungs, and your belly should flatten.
Shortness of Breath Due To Covid

Yoga and Meditation

Late last year, researchers at the Loma Linda University School of Medicine in California did a meta-analysis of effective pulmonary, or lung, rehabilitation treatments and determined that breathing exercises that strengthen the diaphragm (like three-part breathing) and stretching (asana or gentle movement coordinated with the breath) are important for recovery.

Their study, published in the journal Physical Medicine & Rehabilitation, recommends a series of breathing exercises depending on the severity of symptoms—all designed to rebuild respiratory muscles that have taken a hit from COVID-19.


Meditation is the technique to bring attention or awareness; it helps to control your attention or your mind. Meditation has been practicing for thousands of years in many cultures around the world. Meditation can take many forms, but they are two main types of meditation:

  • Concentrative meditation: is to bring your attention to a specific object, a sound, mantra, a specific word, etc.
  • Mindfulness meditation: is being aware of the present. It can be different things at the same time. It is to put your mind in what you are doing.


Yoga is a mind and body practice that originated in ancient India. Yoga is derived from the Sanskrit root yuj, meaning “to yoke,” or “to unite”. It is the practice of the union between body, mind and spirit, through the breath, is the combination of physical postures, breathing techniques, and meditation or relaxation.

Yoga can also use as a therapeutic tool for many physical and mental conditions. Research is now demonstrating its effectiveness as a treatment for chronic pain, anxiety, depression, cardiovascular disease, and diabetes, to name but a few.

Activity pacing

Activity pacing is another strategy that can help tremendously. Especially if you often feel tired.

Step 1: Rate your overall condition, choose a number from 0 to 10 that describes how you feel. Consider ALL your symptoms; physical, cognitive, emotional, pain, mood, etc.

Activity Pacing Long Covid

Step 2: During your activity (walking, housework, computer/phone use, socializing, etc), monitor your score closely. When your score has increased by THREE points, consider taking a rest to prevent significant exacerbation of your symptoms. This equates to a 30% increase in your symptoms, which is enough to have challenged your body systems, but not so much that it will leave you debilitated for the rest of the day.

Pacing Chart For Exercises, Long Covid

Step 3: Rest, or significantly alter your activity level, until your symptom score has decreased back to its original number, or very close to. (For example, if you started at a 2/10, and stopped your activity at a 5/10, rest until your symptoms have eased back to a 2 or 3/10). Once you are feeling better, you can consider resuming your activity, or select a different activity. Over time, it will take you longer to hit your symptom threshold, and you will recover faster. This will allow you to complete more activities during the day!

Remember to always: STOP what you’re doing, THINK about your symptoms, and DECIDE to continue or take a rest.

In addition, I would like to share some ideas on how to conserve energy. Everybody gets exhausted and worn out sometimes. But fatigue, disability or aging can really interfere with the ability to function independently. If you find that fatigue is holding you back and keeping you from doing things in your life, energy conservation exercises and techniques may help you.

Energy conservations involves looking at your daily routines to find ways to reduce the amount of effort needed to perform certain tasks, eliminating other tasks, and building more rest throughout the day.

Remember to consider that not every technique will work for you. The following are suggestions you can use to adapt and find the right fit for you. You have only so much energy, so think about what you want to spend it on!

Organization, Planning and Prioritizing

Rearrange Your Environment

  • Keep frequently used items easily accessible.
  • Replace existing heavy items with lighter ones.
  • Install long handles on faucets and doorknobs.
  • Adjust workspace by raising a tabletop, eliminate awkward positions.
  • Improve your posture. Bad posture drains energy.
  • Install swing-out or pull-out shelving in cabinets.
  • Wear an apron with pockets to carry around cooking utensils or cleaning tools.
  • Consider moving your bed to the first floor of your home to eliminate stairs climbing.

Eliminate Unnecessary Effort

  • Sit whenever possible: while preparing meals, washing dishes, ironing, etc.
  • Use adaptive equipment to make tasks easier.
  • Soak your dishes before washing, let them air dry or use paper plates and napkins.
  • Use prepared foods when possible.
  • Get a rolling cart to transport things around the house.
  • See if your grocery store will deliver to your home.
  • Use store-provided wheelchairs or scooters when you are shopping.

Plan Ahead

  • Before starting a task, gather all the supplies your need for the project.
  • Call ahead to the stores to make sure the items are available.
  • Cook in larger quantities and refrigerate or freeze extra portions for later.
  • Incorporate rest breaks into your activities.
  • Schedule enough time for activities. Rushing will take up more energy.
  • Try keeping a daily activity journal for a few weeks to track and identify times of day or certain tasks that result in more fatigue.


  • Eliminate or reduce tasks that aren’t important to you.
  • Delegate tasks to friends or family who offer to help.
  • Consider hiring professionals, such as cleaning or lawn services.

Energy Conservation Techniques

Energy conservation and work simplification techniques are used widely. Although they can be restrictive, most people find them helpful in managing fatigue. To be able to conserve your energy you need to be able to understand and predict your fatigue levels. Once you have done this you can implement some simple techniques.

1. Be aware of the duration of fatigue and the time of day that it occurs. Where possible it is advisable to structure the day so that the rests/napping can occur during periods of fatigue.

2. Plan the day around rest breaks, so there is enough time to recover after an activity. Ensure enough time for the completion of tasks so you don’t have to be rushed which will increase a sense of fatigue.

3. Before starting a task or activity, think about how important it is that you complete it. Remember to prioritize the activities that are most important to you.

4. Delegate tasks to someone else wherever possible to save your energy for things you need and want to do.

5. When energy is available, try to pace yourself to conserve it. Rushing through tasks, trying to do everything quickly before your energy runs out, should be avoided. As mentioned previously, this will increase a sense of fatigue.

6. Respect any signs of fatigue that you may experience. Some of these may include muscle soreness, weakness, tiredness, reduced quality of movement, jaw clenching, and facial grimacing. Ensure that you stop an activity if it is causing your symptoms.


Consider the use of a mobility aid if walking is becoming increasingly difficult. If one is already in use you may have to consider a more supportive device for long or frequent journeys.

Inquire into whether you are eligible for a disabled parking permit to reduce the distances that you have to walk. When planning a trip out perhaps, do it during a quieter period of the day. This will reduce the crowds, the amount of time spending in lines, and increaser the availability of benches for resting.


At work consider altering your start and finish times to accommodate fatigue levels at specific periods in the day. If you are more tired in the mornings, you could work in the evening and vice versa.

Arrange to be home from work on 1-2 days per week to save the energy of having to wake up early and make your way into the office. Ensure that your workstation is set up conveniently and comfortably as poor posture and work practices can increase fatigue levels significantly.

Living Healthy Lifestyle

Balance Difficulties

Balance Difficulties Long Covid

Stress and Trauma

Having the Long Covid for months can have a strong impact on your mental health. Many people lost their jobs or cannot do simple tasks due to their symptoms. After a while, it can cause trauma and hyper stress.

The stress of a traumatic or otherwise negative event may have the effect of “pushing” a person out of their window of tolerance. ... As a result of their experiences, they may come to believe the world is unsafe and may operate with a window of tolerance that has become more narrow or inflexible as a result.

How can trauma affect you?

Initial reactions to trauma can include exhaustion, confusion, sadness, anxiety, agitation, numbness, dissociation, confusion, physical arousal, and blunted affect. Most responses are normal in that they affect most survivors and are socially acceptable, psychologically effective, and self-limited.

How do you get to a state of hyper-arousal?

There are healthy alternatives to addictions or other destructive ways of coping that can help you to return to your window of tolerance.

  • 1. Breath work and grounding. Bring yourself into the present moment by taking a few deep breaths.
  • 2. Check your thoughts.
  • 3. Self-care.
  • 4. Connection with loved ones.

Below is a more visual description of the different state of trauma.

Window Of Tolerance For Trauma Long Covid

Self-Manage your digestion system by implementing better nutrition intake

    Foods to eat:

  • Meats/fatty fish: salmon, sardines, herring, mackerel, anchovies, lean chicken, turkey.
  • Leafy greens/ cruciferous vegetables: kale, spinach, swiss chard, arugula, collard greens, dandelion, broccoli, cauliflower, cabbage, garden cress, bok choy, Brussels sprouts.
  • Fruits: pineapple, strawberries, blueberries, blackberries, apples, oranges, cherries peaches, lemons, nectarines, grapefruit, red grapes, plums, pomegranates, pears.
  • Vegetables/legumes: tomatoes, asparagus, carrots, beets, black beans. lentils, chickpeas, sweet potatoes, butternut squash, onion, avocado, celery, cucumber, turnip, mushrooms, zucchini, olives (olive oil) .
  • Nuts and seeds: walnuts, almonds, macadamia nuts, brazil nuts, cashews, pumpkin seeds, flax seeds, sesame seeds, sunflower seeds, psyllium seeds and chia seeds.
  • Whole grains: brown rice, quinoa, buckwheat, oats, amaranth, millet.
  • Spices: ginger, turmeric, cinnamon, garlic, cayenne, black pepper, clove, rosemary.

    Foods to avoid:

  • Refined sugar/carbohydrates: high-fructose corn syrup, candy, white flour (bread, pasta, pastries, cookies, cakes), soft drinks.
  • Processed meats: sausage, bacon, ham, smoked meat, beef jerky.
  • Unhealthy fats: dairy, red meat, margarines, peanuts, fried foods, vegetable oils (except avocado oil for cooking and olive oil for salads).
  • Any artificial sweeteners: aspartame, sucralose, saccharin, acesulfame, processed or packaged foods.
  • Alcohol: except a glass of organic red wine-rarely.
  • Caffeine: decrease to 1 cup of black coffee per day.
Different nutrients for good nutrition

First Choice To Help With The Covid Long Syndrome

Enough information for you? The Long Covid syndrome is obviously very new to people and to the medical world but with an integrated care approach, most symptoms can be reduced and managed accordingly.

In order to get optimal results, I strongly recommend contacting registered and trained health professionals that has already such program in place. At Pillars of Wellness, we have been treating COVID Long Haulers for a year now and provide webinar series to help people self-manage their symptoms while providing some educational resources on the subject.

Feel free to contact us at We are located at 100 Plains Road West, Burlington, Ontario. Our phone number is 905-637-4000.

Laurent Pinci
Laurent Pinci
Pillars of Wellness is a truly Integrated Healthcare Centre providing a high degree of collaboration and communication among health providers.