Long-COVID, a condition marked by the persistence of symptoms following a COVID-19 infection, presents a range of unique challenges for patients. These patients often experience a diverse range of symptoms that can include respiratory issues, fatigue, pain, cognitive difficulties, and mental health concerns. As Physiotherapists, we play a crucial role in supporting individuals with Long-COVID on their journey to recovery. In this blog post, we explore how physiotherapists can help patients with Long-COVID by addressing their unique challenges and facilitating their journey towards improved health and well-being.

Comprehensive Assessment:
Conducting a thorough assessment to understand the specific symptoms and limitations of each patient is the best place to start. This assessment may include evaluating respiratory function, cardiovascular endurance, muscular strength, joint mobility, and balance. By gaining a comprehensive understanding of the individual’s condition, physiotherapists can tailor treatment plans accordingly.
Respiratory function assessment is a key aspect of the comprehensive evaluation. Physiotherapists evaluate lung capacity, respiratory muscle strength, and breathing patterns to identify any impairments or abnormalities. This may involve measuring lung volumes, assessing respiratory muscle strength through tests such as spirometry or peak flow measurements, and observing breathing patterns during rest and activity.
Cardiovascular endurance evaluation is also important as COVID-19 can impact the cardiovascular system. You can assess cardiovascular fitness, heart rate response, and overall endurance levels through various tests such as the six-minute walk test or treadmill exercise test.
Muscular strength assessment involves evaluating the strength and function of different muscle groups throughout the body. You can use a combination of manual muscle testing and functional testing to identify areas of weakness.
Joint mobility assessment focuses on evaluating the range of motion and flexibility of joints. Physiotherapists examine the mobility of major joints such as the shoulders, elbows, wrists, hips, knees, and ankles. Assessing joint mobility helps identify any restrictions or limitations that may hinder movement and function.
Lastly, balance assessment is essential as Long-COVID patients may experience balance impairments and an increased risk of falls. You can employ various balance tests and functional assessments to evaluate balance control, postural stability, and proprioception.
Respiratory Rehabilitation:
Respiratory exercises are an essential component of physiotherapy intervention for COVID-19 patients. We can use a variety of exercises designed to promote deep breathing, enhance lung expansion, and improve overall respiratory function. These exercises may include diaphragmatic breathing, pursed-lip breathing, and segmental breathing techniques. By actively engaging in these exercises, patients can strengthen their respiratory muscles, increase lung capacity, and improve ventilation.
Breathing retraining is an essential component of physiotherapy for individuals recovering from COVID-19. Some patients may develop altered breathing patterns, such as shallow or rapid breathing, as a result of the infection or prolonged periods of inactivity during recovery. We can work with patients to retrain their breathing patterns, emphasising slower, deeper breaths, and promoting relaxation. By helping patients develop more efficient breathing patterns, we can alleviate patients’ breathing difficulties, reduce respiratory distress, and improve overall respiratory function.
Exercise Therapy:
Personalised exercise programs are essential in the physiotherapy management of individuals with Long-COVID. These programs are designed to address the specific needs, limitations, and energy levels of each patient, focusing on rebuilding strength, endurance, and mobility. We can guide patients through exercises that promote cardiovascular fitness, muscle strength, flexibility, and coordination, ultimately enhancing their overall physical well-being.
Rebuilding strength is a primary goal of exercise programs for Long-COVID patients. Prolonged illness and periods of inactivity can result in muscle weakness and loss of muscle mass. We can design exercises that target major muscle groups and gradually increase resistance to rebuild strength. These exercises may include resistance training, bodyweight exercises, and the use of resistance bands or weights. By incorporating progressive resistance training, patients can regain muscle strength, improve functional abilities, and enhance overall physical performance.
Fatigue Management:
Fatigue is a prevalent and often debilitating symptom experienced by individuals with Long-COVID. We can teach patients how to conserve and utilise their energy more efficiently throughout the day. We can provide practical tips and techniques, such as prioritising activities, breaking tasks into manageable segments, and delegating or seeking assistance when needed. By incorporating these strategies into their daily routines, patients can minimise unnecessary energy expenditure and maximise their energy reserves for essential tasks and activities.
Pacing techniques are another important aspect of fatigue management. Pacing involves balancing activity and rest periods to prevent overexertion and minimise the risk of exacerbating fatigue. We can guide patients in setting realistic goals and planning their activities in a way that avoids pushing beyond their limits. By incorporating planned rest breaks and spacing out activities throughout the day, patients can conserve energy and maintain a more sustainable level of activity without experiencing excessive fatigue.
Lifestyle modifications are also integral to managing fatigue in individuals with Long-COVID. We can work closely with patients to identify lifestyle factors that may contribute to fatigue and develop strategies to address them. This may include optimising sleep hygiene, implementing stress management techniques, and establishing healthy lifestyle habits such as regular exercise, balanced nutrition, and hydration. By addressing these aspects of daily living, patients can improve their overall energy levels and better cope with the challenges of fatigue.
Pain Management:
Pain management is a crucial aspect of physiotherapy for individuals with Long-COVID, as many patients experience persistent pain, including joint pain and muscle aches. One of the primary modalities we can use is manual therapy. Manual therapy techniques involve hands-on manipulation and mobilisation of soft tissues and joints to relieve pain, improve joint mobility, and restore normal tissue function. More specifically, we can use techniques such as joint mobilisations, soft tissue mobilisations, and myofascial release to address areas of pain and tension. By targeting specific areas of discomfort, manual therapy can help reduce pain levels, promote relaxation, and improve overall comfort.
Therapeutic exercises are also an essential component of pain management in Long-COVID patients. We can design exercise programs that target specific muscles, joints, and movement patterns to address pain and improve functional abilities. These exercises may include stretching, strengthening, and stabilisation exercises tailored to the individual’s needs. By gradually increasing strength, flexibility, and stability, therapeutic exercises can help alleviate pain, improve mobility, and enhance overall physical function.
In addition to manual therapy and therapeutic exercises, we can utilise pain-relieving techniques to provide immediate relief and comfort. These techniques may include the application of heat or cold therapy, transcutaneous electrical nerve stimulation (TENS), ultrasound therapy, or other modalities that can help reduce pain and promote relaxation. These pain-relieving interventions can be used in combination with other treatment approaches to provide comprehensive pain management for individuals with Long-COVID.
It is important to note that we should take a holistic approach to pain management, addressing not only the physical aspects but also the psychological and emotional factors associated with pain. By incorporating relaxation techniques, stress management strategies, and mindfulness practices, we can help patients reduce pain-related stress and anxiety, promoting a sense of overall well-being.