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Management for Long Covid

The arrival of Covid-19 was a shock to the population worldwide, let alone when we heard that the term “Long Covid” was going to be part of our lives going forward.

The emergence of post-viral fatigue syndrome was a surprise to everyone; however, health care professionals were well aware that this syndrome will be an outcome of the ongoing pandemic.

Physiotherapists can provide support in the management of long Covid symptoms. The key focus point will be to reduce the impact of persistent symptoms due to the absence of a cure.

The most common long Covid presentation that we are seeing now is ongoing breathlessness, fatigue, dizziness (related to orthostatic positioning), joint pain and chronic coughing. The symptoms can also include dysfunctional breathing that can lead to a breathing pattern disorder in the future.

This might sound daunting and like an impossible hurdle to get over. However, don’t fear. We already have the necessary skills to support your management of these symptoms. Like mentioned before, the key focus point will be to decrease the impact of this ongoing symptoms.

Physiotherapists have the expertise to give you the necessary advice on when to return to exercise. As well as assisting you on the frequency, duration, and intensity of exercise.

In some people living with Long Covid the presence of post exertional symptom exacerbation (PESE) can put a complete halt to your exercise routine. According to research exercise is not recommended for people with PESE, as it can worsen symptoms.

We appreciate the fact that we do not know everything about long Covid yet, however, we know enough to be able to assist in alleviating some of your symptoms.

Physiotherapist will use specific screening tools going forward to assess for the presence of PESE, POTS (Postural orthostatic tachycardia syndrome) or any other cardiac involvement diagnosis to ensure the rehabilitation is appropriate for the specific individual. This could also include a referral to a cardiologist if needed.

Treatment of Long Covid will be patient specific to ensure that we get the desirable outcome. Out of experience we noticed that most patients suffering with Long Covid symptoms have one specific symptom that seems to rise above the rest. We see that breathlessness is common in most cases, resulting in dysfunctional breathing patterns. We can specifically assess this to ensure that we give you the correct tools to work through the breathlessness. Treatment will include breathing retraining, pacing, breathing cadence and sufficient rest periods.

The value of sufficient care for long Covid patients is to ensure that we follow a team approach. We will work with GP’s, personal trainers, and class instructors to ensure that we create a modified approach that fits the specific patient’s needs.

Even though it feels like we still have a long road ahead of us to get to the end of this ongoing pandemic, it is important to realise the progress we have already made and what we have learned about Covid in the past 2 and a half years.

Elzanne Myburgh (BHSc Physiotherapy)

Elzanne has a special interest in respiratory physio and based at

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