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Yoga as Intervention for Long Covid

The arrival of Covid-19 has confronted many of us with uncertainty as we navigate these unprecedented times. As the virus has only been in existence for just over a year, its behaviour is still being understood, not only during infection, but also post-infection and its varying effects on individuals. In the recovery from Coronavirus, many people are relatively unaffected and can resume daily activities, whereas some experience life-altering effects and struggle to do the things they once took for granted.





Long Covid is becoming a growing issue amongst populations experiencing Covid 19 infection. Whilst many people who contract the virus recover immediately after the symptoms have subsided, some experience prolonged effects which continue months after the initial infection. In the UK and other countries Long Covid clinics are in the process of being rolled out across to offer tailored support to those suffering with ongoing symptoms, and provide a programme for the return to health.


The most common symptoms include but are not limited to:

  • fatigue

  • breathlessness

  • anxiety and depression

  • palpitations

  • chest pains

  • joint or muscle pain

  • not being able to think straight or focus (‘brain fog’)(1)

Objectives of Long Covid clinics

It is becoming clear that the post-viral effects of Coronavirus are leaving many sufferers unable to return to their pre-infection lives. Those struggling with Long Covid report feeling exhausted, whereby “each day was like being on a rollercoaster, but in the dark. I never knew what was going to happen the next day or how I’d feel.”(2) As such, the clinics will help to support sufferers return to health with the view to provide specialist, targeted care to help patients’ improve their quality of life, as well as gain a better understanding of the long-term effect of Covid-19.


It is strongly recommended people consult with their doctor or a Long Covid clinician to ascertain the diagnosis, rule out any underlying issues, and prescribed recovery steps before embarking on a specialist programme such as Yoga for Long Covid.


Yoga as an intervention

An ancient practice over 5,000 years old, Yoga is an increasingly popular modality in the West for improving and maintaining health and wellbeing. Involving targeted postures (Asana) and breathwork (Pranayama), Yoga is used as intervention for a number of conditions including but not limited to:

  • Asthma(3)

  • Cardiovascular disease(4)

  • Post Traumatic Stress Disorder(5)

  • Depression(6)

  • Anxiety(7)

  • ME and CFS(8)


In the practice of Yoga, practitioners focus their attention on breathing and on their moment to moment sensation. As it is practised at a slow to steady pace, the practitioner is able to notice more clearly the initiation and build-up of any given sensation whether this is physical, mental, or/and emotional. This noticing is the core ingredient of the practice as it fosters better awareness and self-regulation as students can improve their ability to notice then respond rather than react to sensation. As such, it is widely found that Yoga improves the practitioner’s felt sense of their body with this linked to better health and wellbeing.


For those struggling with Long Covid, diminished respiration, muscle strength, stability, and mobility, as well as increased stress and possibly heightened risk of depression and/or anxiety is likely.


Physical benefits of Yoga

Given the recent emergence of Covid-19, the effect of Yoga as an intervention is not yet researched. That said, the advice of medical professionals and organisations to practice light, gentle stretches and movements as part of Long Covid rehabilitation, as well as Yoga’s proven effects in the treatment of previously mentioned conditions, suggests that a targeted Yoga programme can play a positive role in the recovery from Long Covid.

Through a progressive course such as Yoga for Long Covid, participants can begin to mobilise stiff areas caused by immobility, breathlessness, and detrimental changes in posture caused by Covid. Under the guidance of a highly skilled Yoga teacher with experience in rehabilitation, students will practice safe and at times challenging movements to increase strength and stability in the key muscles needed to go about daily activities, as well as an emphasis on intentional relaxation to promote the regeneration of energy levels.

Through the focus on synchronising breath and movement, Yoga also has the capacity to improve focus and mental clarity as well as reducing fatigue.


Respiration

Yoga is known for its unique focus on breathing to improve mind-body connection. In the Yoga for Long Covid programme, Breathwork is a standalone practice led by medical doctor, Christoph Seiland. Breathlessness caused by Covid-19 infection is amongst the most common of symptoms both in the acute and post-infection phase due to the body’s anti-inflammation response. When a full inhale and exhale is compromised, this not only effects respiratory function, but also can lead to a dysregulated nervous system which can directly contribute towards brain fog, anxiety, muscles weakness, disrupted sleep and headaches.


By relearning to take a full breath in and a long breath out through targeted breathwork, we strengthen weakened respiratory muscles and rebalance the nervous system promoting greater ease and vitality in our daily lives which Dr.med. Christoph Seiland’s article briefly addresses.


PLEASE NOTE: We cannot overstate the importance of consultation with your GP before undertaking any rehabilitation programme, including Yoga for Long Covid, to ensure there are no other serious causes of breathlessness that the programme may worsen or mask.


This programme is for you if:

  • Your doctor has diagnosed you with Long Covid and;

  • Has ruled out any underlying causes therefore;

  • Recommends a phased return to health which includes light physical and breathing exercises.


Mind

The mental health fallout from Covid-19 is increasingly being understood, yet like all research in the area is still in its infancy. What is clear is from anecdotal accounts of those suffering from Long Covid is the increase in likelihood of anxiety, low mood, hopelessness, and difficulty in sleeping(9). Yoga has been shown in multiple studies (see the resources below) to improve mental health through the emphasis on the present moment, bringing awareness into the body, and focusing on breath and movement through improved nervous system regulation.


Delivered by experienced practitioners, Yoga for Long Covid is an accessible programme that encourages participants to meet themselves where they are, while simultaneously steadily increasing physical capabilities.


The objectives of the Long Covid Yoga Programme are:

  • To support a return to health following a GP’s diagnosis, ruling out of underlying causes, and a ‘self-management’ programme that includes physical and respiratory exercise

  • Improve strength, stability, and mobility

  • Increase respiratory capacity

  • Foster better mind, body, and emotional connection


The programme is progressive whereby each week builds upon the week before but with options for to remain with earlier variations as long as is necessary.


Conclusion

In a disease as encompassing as Coronavirus, which effects not only the body but also has consequences on the psychological state and mental outlook on life, Yoga can help to bridge the gap between those modalities that are purely physical, such as physiotherapy, or/and mental, such as talking therapies.


From personal experience and that of the many hundreds of practitioners we have taught, a debilitating illness often robs the person of the trust and confidence in their body, creating a deep mind/body division that is often at the root of many mental and emotional illnesses. When we are encouraged to accept where we are, and steadily increase a capabilities with kindness, trust grows in the body and mind’s capacity for change.


Alongside promoting Yoga as an intervention, The British Heart Foundation advises Long Covid sufferers to(10):

  • Be kind to yourself during your recovery – be prepared that some days will be worse than others

  • Connecting with other people can help you feel happier – make sure to reach out to family and friends.

  • Having a daily routine can be good for your mood and sense of stability.

  • Stay active – continuing to move will help release endorphins and improve your mood.


A carefully crafted Long Covid Yoga programme such as that offered by Yoga for Long Covid incorporates all of these elements and can be a powerful, accessible therapeutic treatment to holistically improve mind, body, and emotional health.


By Charlene McAuley


Footnotes


1 https://www.bhf.org.uk/informationsupport/heart-matters-magazine/news/coronavirus-and-your- health/long-covid#Heading4 2 https://www.bhf.org.uk/informationsupport/heart-matters-magazine/my-story/a-heart-patients- prolonged-coronavirus-journey 3 https://www.nhs.uk/news/lifestyle-and-exercise/yoga-probably-good-for-asthma-symptoms- and-quality-of-life/ 4 https://journals.sagepub.com/doi/full/10.1177/2047487314562741 5 https://pubmed.ncbi.nlm.nih.gov/25004196/ 6 https://www.health.harvard.edu/mind-and-mood/yoga-for-anxiety-and-depression

7 Ibid

8 https://www.verywellhealth.com/yoga-for-chronic-fatigue-syndrome-715790

9 https://www.bmj.com/content/370/bmj.m3026

10 https://www.bhf.org.uk/informationsupport/heart-matters-magazine/news/coronavirus-and-your-health/long-covid#Heading4

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