A new study has shown how returning to exercise too soon can be harmful for long covid patients
"We very clearly show that excessive exercise – only 15 minutes, but this is excessive for the patients – causes a lot of damage," says Brent Appelman, a researcher at Amsterdam UMC.
The research has confirmed what many long covid patients have experienced while struggling to recover after their diagnosis. With symptoms such as muscle cramps, pain, fatigue, and even brain fog – lasting from anything from two days to two months, depending on the person.
"The crash that these patients experience is so severe that it can set their rehabilitation back for many months. And you can imagine that regular exercise of one hour, intense working days of eight hours, or social activities of two hours, can show similar effects."
These symptoms are similar to those of patients with ME/CFS and POTS, and are a form of post-exertional malaise. With the number of POTS diagnoses doubling since the covid pandemic, learning more about this could be the key to treating long covid.
What is Post-exertional Malaise (PEM)?
Post-exertional malaise is a worsening of symptoms after exercise, triggered by ordinary activities that healthy people can tolerate. PEM is a hallmark symptom of ME/CFS and is common in long covid. The crash caused by PEM can happen instantly, or take days to appear, with 12–48 hours being most common.
Tips for managing Post-Exertional Malaise
Keep a diary- With some symptoms taking days to appear, keeping a record of your activities and health can help you identify your triggers. With this information, you can make the adjustments you need to minimise your symptoms.
Make accommodations- For example, using a stool while cooking can alleviate the strain from standing for long periods of time. Camping stools are great if you are going somewhere that may not have many places to rest. If you know heat triggers your symptoms, taking a handheld fan out with you can also help lower the strain on your body.
Pace yourself- Pacing yourself is one of the most important adjustments you can make for many chronic illnesses. Taking things slowly can pay off in the long run, helping to stop burnout. This could mean planning places to stop and rest while out, or separating out your tasks so you don't do too much in one day.
Prioritise rest- When PEM does occur, it is often helpful to rest in a dark, quiet room. While resting, avoiding screens and other forms of stimulation can help to calm your nervous system. Many people with chronic illnesses often struggle with sleep or feel less rested when they wake up, so creating good sleeping habits can give your body the rest it needs.
Stress management- Many chronic illnesses are believed to be worsened by stress. Managing your stress may help you reduce chemicals like cortisol, a chemical known to make PEM worse, as well as interrupt sleep. Your body works best and is more resilient when you're relaxed. Some ways to combat stress are:
Learning to say "no" and limiting your commitments
Meditation, breathwork, and mindfulness techniques
Yoga, if you're able to tolerate the activity without triggering PEM
Delegating or asking for help with stressful tasks
Practice self-care- Everything on this list so far is a form self-care. Another important part of self-care is listening to your body. Stopping to have a break when you start feeling strained and not pushing through things can help to stop burnout; practicing this is a form of self-care that anyone with a chronic illness can benefit from.
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