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Post-COVID Exercise Considerations for Long-Haulers

As a 45 year old women recovering from COVID-19 with no known prior health conditions beyond arthritis and a five-year period of post-traumatic stress build up deep in my tissues, I recently went for a chest x-ray to get to the bottom of increasing awareness of breathing strain and lightheadedness upon my return to more physically challenging exercise.

COVID struck me in early December with manageable symptoms that didn’t bring me to seek outside care. Since January, I have experienced untreatable headaches which have mostly subsided, fatigue that is slowly improving, lack of concentration and insomnia still very much present, increasing Parosmia - a smell disorder linked to viral infections in recovered acute COVID patients - and noticeably decreased lung capacity causing me to feel chronically short of breath. When I push my respiratory system to it's max, it leads to coughing fits and ensuing tingling sensations throughout my torso. I am now waiting on visits with both a Cardiovascular specialist and Pulmonologist for further testing. Being a yogi has taught me the vital skill of tuning into and listening to my body, which prompted me to reach out to my primary care physician when my internal conditions weren't improving. The initial discovery is left atrial enlargement, the side of the heart connected to the lungs. In the days since, my heart has increased its communication to my brain - sending me signals of constant subtle vibrations and trembling I can now feel even while in a rest-state. For the past few months I have been staying tuned into all the research I can find about post-COVID studies, listening to people’s individual experiences and trying to become better acquainted with all of the key variables involved in how COVID affects the vital functions of the human body, particularly the heart and lungs.

Here's a brief outline of how the our two most vital organs function together. The circulatory system supplies oxygen and nutrients to every cell of our body and removes wastes and carbon dioxide. The system consists of blood, which carries the nutrients and wastes; the heart, which pumps the blood; and a closed system of tubes (arteries + veins) that carries the blood to and from the body tissues. Large arteries provide direct “express” service to major areas of the body such as the brain, lungs, arms and abdomen. Press your finger against one of these arteries and you will feel the pump stroke or beat of the heart.

Our heart - a hollow muscle located to the left of the sternum between the second and fifth ribs - is the key organ to our circulatory system. Its upper and lower chambers are surrounded by the lungs (the respiration system), each which has a notch that the heart fits into. Pulmonary circulation is the movement of blood from the heart to the air sacs in the lungs and back to the heart. This circulation is necessary for blood to exchange carbon dioxide for oxygen.

Recent research is revealing the importance our lung capacity plays in our longevity. We know that movement and exercise are so important for keeping the body primed to avoid infection but post-COVID, your relationship to exercise might need to shift. Mine certainly has, although I felt mentally ready to get back to challenging my body physically after weeks of feeling fatigued. Two weeks ago I could sustain a moderate walking pace on my treadmill for 45 - 60 minutes at a time. Last night, at the same pace, I barely made it to 15 minutes.

Natural Medicine Journal recently conducted an interview with Naturopathic Physician Dr. Lisa Alschuler - of the University of Arizona College of Medicine - finding that even when COVID patients aren’t hospitalized some still face changing lung elasticity and internal inflammation that if left untreated, can lead to “long-hauler” syndrome or even pulmonary function issues.

While we know that regular exercise improves cardiovascular health in the long-term, each session of exercise stresses the heart and challenges the respiratory system - triggering COVID-19 patients on a wide degree of severity. If you have experienced COVID and are past a few weeks of experiencing symptom resolution, it is suggested to re-enter your normal exercise load gradually over the course of a month. For those still experiencing symptoms, like me, especially regarding the heart and lungs, more gentle and restorative movement and breath practices are a great way to support your health in the meantime while waiting to get back to more vigorous activities.

It is recommended that all COIVD positive persons maintain 2 to 3 weeks of rest after symptom resolution followed by a gradual return. The National Strength & Conditioning Association recommends volume for the first week is reduced by at least 50% of the normal exercise load, followed by 30%, 20% and 10% in the following 3 weeks if comfortable doing so at the end of each week. With athletes returning to sport, the recommendations are similar but include an evaluation with a healthcare specialist.

Overexercising too soon in the recovery process can be more damaging to the lungs and dampen the immune response. Sticking to more gentle movement practices and practicing building lung capacity to the degree that feels comfortable will feel more nourishing than engaging in movement that excites the heart and lungs beyond their ability to support you. Patient and deep breathing practices throughout recovery will enhance lung elasticity, which is so important to to all aspects of our health. As a byproduct to relaxed breathing practices, we’re also working on reducing all of the accumulated stress from the past year and beyond, which is key for coming out of chronic inflammatory states that can strain our hardworking vital organs. For those with compromised lung capacity, working slower and softer, and staying tuned in to the very beginning of the impulse to cough when coming to the end of your lung capacity can help you get a handle on how far you can take your breathing.

If you are recovering from COVID and still experiencing lingering symptoms, please connect with your primary care physician as soon as possible. With so much still unknown about COVID's long-term effects, it's important to stay ahead of any potential complications.

If you are someone looking for a supportive movement practice that directly but gently addresses improving lung elasticity and stress-reduction, you might consider joining one of my upcoming 8 Class Series happening in my Mayfield studio later this spring (mid-April). I have planned specific practices to support COVID patients - and those indirectly affected - in their healing journeys. Stay tuned to my website and social media pages for a forthcoming announcement.

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