Rehabilitation Strategies for Long COVID Symptoms

Fatigue, Pacing, and Activity Management

Our stories

Patients share what life with Long COVID has been like for them. They talk about symptoms, challenges, and what has helped them begin to recover.

What is Fatigue and Post-Exertional Malaise (PEM) in Long COVID

Patients and therapists explain the deep fatigue many people with Long COVID feel. They describe PEM, when symptoms get worse after too much activity.

Introduction to Pacing and Energy Conservation Strategies

Therapists explain pacing, a way to balance activity and rest. Patients share how pacing helped them manage symptoms and avoid crashes.

Key Strategies: Spoon Theory, the 4 P’s, and the Activities Stoplight

Therapists introduce simple tools to help manage energy. These strategies help patients decide what activities to do, plan their day, and avoid overdoing it.

Applying Pacing and Energy Conservation Strategies

Patients talk about how they use pacing in daily life. Therapists give examples of how to adjust tasks to save energy.

Why and How to Track Vital Signs and Steps at Home

Therapists explain why tracking heart rate, steps, and other signs can help guide recovery. Patients share how tracking helps them understand their limits.

Apps to Track Vital Signs and Steps

Patients and therapists discuss simple apps that can help track activity and symptoms. These tools can help patients stay within safe limits.

How and When to Increase or Decrease Activity

Therapists explain how to slowly build activity over time. Patients share how they learned to listen to their body and adjust their activity.

Finding the Right Activity Level

Patients describe the challenge of doing too much or too little. Therapists help explain how to find a safe and steady level of activity.

Mindfulness and Other Restorative Strategies

Patients and therapists discuss ways to help the body calm and recover. These may include breathing, relaxation, and quiet activities.

Brain Fog and Cognitive Skills

What is Brain Fog

Patients describe what brain fog feels like in daily life. Therapists explain why thinking, memory, and focus can be harder after Long COVID.

Setting Goals

Therapists explain how small goals can help recovery. Patients share how setting simple goals helped them move forward.

Living with Brain Fog

Patients talk about how brain fog affects work, home, and relationships. Therapists offer tips to make daily tasks easier.

How to Improve Attention

Therapists share ways to improve focus during tasks. Patients discuss strategies that help them stay on track.

How to Improve Memory

Patients and therapists discuss tools to help with memory problems. These include routines, reminders, and simple habits.

Memory Tools

Therapists introduce practical tools like lists, calendars, and phone reminders. Patients share how these tools help them stay organized.

How to Improve Word Recall

Patients talk about the frustration of not finding the right words. Therapists share exercises and strategies that can help.

Therapy and Next Steps

How to Access Individual and Group Therapy

Therapists explain different types of therapy available for Long COVID. Patients share how therapy helped them feel supported.

What to Expect from Therapy

Patients describe what therapy sessions may look like. Therapists explain how care is tailored to each person's symptoms and goals.

Physical Therapy

Physical therapists explain how they help patients safely rebuild strength and activity. Patients share what PT was like for them.

Occupational Therapy

Occupational therapists help patients manage daily tasks and save energy. Patients share how OT helped them return to everyday activities.

Speech Therapy

Speech therapists help with thinking, memory, and communication problems. Patients describe how therapy improved their brain fog and focus.

Lessons Learned

Patients reflect on what they learned during recovery. They share advice and encouragement for others living with Long COVID.

Goal setting worksheet

Click here to download a worksheet that can help you think through your goals and make a plan to work toward them.

Key strategies: Spoon theory, the 4 P’s, and the Activities stoplight

Spoon theory: To explain what Long COVID feels like

  • Imagine you have 20 spoonfuls of energy each day.
  • When you run out of spoons for the day, you’re out of energy until you rest.
  • Each activity costs a different number of spoonfuls.
  • With Long COVID, activities may cost more spoonfuls than they used to.

4 P’s for energy conservation:

  • Prioritizing
    • Focus on activities that truly need to get done
    • Identify which activities can be left un-done or can be pushed off until the next day or week
  • Planning
    • Space out activities across the day or across the week
  • Pacing
    • Break down a chore into steps
    • Incorporate rest breaks in between steps
  • Pleasure
    • Use your energy on activities that you enjoy

Activities Stoplight

Click here to download a worksheet that can help you plan your week and spread out high-energy tasks.

Mindfulness strategies

Sensory grounding: Think of…

  • 5 things you can see
  • 4 things you can touch
  • 3 things you can hear
  • 2 things you can smell
  • 1 thing you can taste

Box breathing

  • Sit or lie comfortably
  • Breathe in through your nose for a count of 4
  • Hold your breath for a count of 4
  • Breathe out slowly through your mouth for a count of 4
  • Hold your breath for a count of 4
  • Repeat as many times as desired

Examples of tools to practice guided mindfulness

  • Search online video platforms like YouTube or Netflix for guided meditations.
  • Examples of apps with free content: “Insight Timer”, “Medito”, “Wysa”, “Headspace”, and “Calm”

Tracking vital signs and activity

Step tracking

  • Step tracking can be helpful to identify if increased activity on one day leads to worsened symptoms the next day.
  • Even if your current activity level is triggering symptoms, you may find that you don’t need to decrease your total activity. Instead, you may be able to achieve your desired activity level by carefully planning and spacing out your activities evenly throughout the week.

If you are trying to increase your activity, it can be helpful to monitor your body’s:

  • Heart rate
  • Blood oxygen saturation
  • Blood pressure

Stop your activity and follow up with your doctor if the activity worsens your symptoms or causes significantly:

  • Increased heart rate
  • Increased or decreased blood pressure
  • Decreased oxygen saturation

Tools to monitor your body’s response:

  • Heart rate monitor
  • Pulse oximeter
  • Blood pressure cuff
  • Smart watch
  • Pedometer

Examples of apps to track activity and symptoms:

  • Visible
  • Welltory
  • Health Storylines

Activity and exercise

If you are trying to increase your activity level:

  • Start slow, and build up gradually
  • Set your activity level based on your symptoms, not based on a strict amount of time or intensity
  • Don’t push yourself to fatigue

During an exercise session:

  • Interval training is typically not well tolerated
    • (Interval training refers to intense bouts of activity followed by short periods of rest)
  • Instead, increase your intensity very gradually
    • Start with a warm-up
    • Increase your intensity a little bit
    • Then cool down slowly