Rehabilitation, support, and education are key aspects to improving function and reducing disability in people with long COVID.

It is important to understand that long COVID is a systemic condition that can affect different organs or parts of the body. This means you can develop a broad range of signs and symptoms such as severe fatigue and exhaustion, brain fog, memory difficulty, exercise intolerance, etc. Additionally, a large percentage of people with long COVID will suffer from post-exertional symptom exacerbation (PESE) or post-exertional malaise (PEM).

Not only PESE makes your symptoms worse but also prologues long COVID over time. PESE can be triggered by stressful situations, as well as mental and physical (over) work. Interestingly (not!), PESE can occur immediately after the triggering situation, or 2-3 days after the trigger. This makes the trigger factors hard to identify. Furthermore, recovering from PESE can take days, weeks, or months!…making PESE really difficult to manage and very disabling. Avoiding these “body crashes” is paramount.

It is important to note that PESE is not due to poor fitness or deconditioning, but due to cellular (mitochondria) alterations to produce energy. PESE is also a characteristic feature in patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.

In these links, you can get some information about PESE, its assessment, and management:

Rehabilitation for long COVID

Energy conservation techniques are KEY to managing PESE. These include:

  • Understand your limits and listen to your body BEFORE you get tired.
  • Learn to say NO
  • Prioritize and take regular breaks (pacing)
  • Learn how to manage your crash
  • Understand your triggers
  • Gentle physical activities to maintain joints and muscles

For more resources read here:

Would you like support to manage long COVID?