Can't Get Past That Post-COVID Fatigue?

Over the past two months, many people I know have gotten COVID, even two in my own household.  Luckily, most people are recovering quickly,  but what happens when symptoms persist over 4 weeks?
Throughout the pandemic, health care providers have recognized that some people continue to have symptoms long past the initial infection.  These symptoms are now recognized by many names, Post-COVID Syndrome, Long COVID, Long Haulers, PASC (Post Acute Sequalea SARS- CoV-2). Research shows that about 10% of people between ages 18-49 who have COVID -19 get Long COVID.  Those odds go up for those over 70 and those with other underlying medical conditions or those who were hospitalized for COVID.
Symptoms after acute COVID-19 are highly variable and wide ranging. The most commonly reported symptoms include (but are not limited to) the following: 

• Shortness of breath, cough
• Chest tightness
• Fatigue
• Racing Heart
• Cognitive Impairment or "brain fog"
• Inability to Complete Everyday Activities
• Headaches
• Sleep Disturbances
• Generalized joint and muscle pain
• Gastrointestinal Symptoms
• Poor Exercise Tolerance 

Treatment for Long COVID involves a multidisciplinary approach from your health care providers, including physical therapists.

What Can Physical Therapists Do To Help Long COVID?

1. Physical Therapists Take a Whole Body Approach​.  We look at your body's symptoms and their effects on your everyday life and ability to function.  We create an approach that is focused on returning to your work, home, and recreational activities.  We are mindful of mental health and how brain fog, fatigue, and depression can affect your day to day energy levels. We communicate with your physicians and health care providers to ensure a team approach.
2. Physical Therapists are Amazing Teachers.  Our focus is not only on your physical status, but we know you must understand what is going on with your body in order to fully recover.  We educate you on how to conserve energy, improve sleep, and find the balance between rest and activity. 
3. Physical Therapist Can Safely Push Your Activity Level to Improve Your Fitness.  As medical provider and movement experts, we can challenge your physical activity while closely monitoring your heart rate, blood pressure, and oxygen levels.  We are also very good at observation and noting when your body is fatigued and your movement patterns are changing.   Exercise is progressed safely and we provide guidance for your home activities.​

PEM - Post Exerctional Malaise

Fatigue from Long COVID is variable day to day. Some days energy levels are good, and the person is active and productive during the day.  Then after a good day (and possible overexertion) the next few days (or even a month)may present with disabling fatigue.  This leads to frustration, not knowing which each day will bring.   Our society, work and home expectations lead people to push through the fatigue, ignoring their bodies, until they physically just can't do it anymore and present with other complications.  These symptoms have been labeled as Post Exertional Malaise (PEM), and it can be caused by not just physical, but also mental activities.  Post-exertional symptom exacerbation is a feature of the inability to produce sufficient energy on demand. 

PEM has been a symptom that has been long identified with other chronic disorders such as Epstein Barr Virus, MS, and Chronic Fatigue Syndrome. One technique that has been used by those suffering from PEM is labeled "Stop, Rest, Pace". 

• STOP: When one has overexerted their body and is unable to function physically or mentally, the first response should be to STOP, not push through.
• REST: After PEM, you must acknowledge the fatigue and rest your body until it is back to normal levels.  That may mean one hour, or three days.  When recovering from PEM, you must be patient and rest, or else you will have another immediate set back.
• PACE: Return to activities slowly.  Pace yourself to get back to your normal level slowly, in order to protect yourself from another exacerbation.   

If you or someone you love is suffering from symptoms of Long COVID or Post-Exertional Malaise, reach out and talk to one of our physical therapist to get expert advice and direction on recovery.