• Shannon Sims, PhD

Breathing Exercises for Long Covid

Updated: Jul 12



Many people with long Covid report difficulties with their lungs following the acute phase of COVID-19 infection. For some, this can feel particularly present when attempting to engage in physical activity or exercise, which can lead to post-exertional malaise (PEM) and/or exacerbation of symptoms, like shortness of breath or elevated heart rate.


Breathing and Long Covid

Even if you didn’t experience severe lung issues with COVID, like pneumonia, your lungs may still have been impacted by the virus. Focused and intentional breathing can help the lungs recover after COVID-19. In addition to helping you cope with feelings of stress and anxiety, breathing practices re-balance the nervous system by calming the “fight or flight” stress response and restoring diaphragmatic function. The diaphragm is the large, dome-shaped muscle that expands and contracts the lungs as we breathe. It is also a key player in the body’s parasympathetic nervous system, aka our relaxation “rest and digest” system. When we take a slow, full breath, the diaphragm expands, increasing lung capacity as air is pulled deep down into the lungs. Slower and lower breathing means we are taking fewer breaths per minute. As the rate of breathing slows, oxygen demand is reduced. This can be really important for people living with long Covid who are already having issues getting enough oxygen to the body. Just as you would work out any other muscle to keep it in shape, the diaphragm muscle needs “working out”, too.


Why Breathing Matters

Intentional breathing allows us to re-regulate the nervous system. Most of us breathe very shallowly day in and day out, which doesn’t allow for a proper exchange of oxygen. COVID-19 can damage the lungs and lead to poor oxygenation, and when combined with shallow breathing, can lead to a worsening of long Covid symptoms. While there currently is no cure for long Covid, there are some things we can do to help repair COVID-19 lung damage, such as breathing exercises.


Engaging in breath-awareness practices has a whole host of benefits, including:


  • Lowering blood pressure

  • Reducing anxiety

  • Lowering heart rate

  • Boost immune system functioning

  • Improve memory and cognition

  • Increasing oxygen saturation

  • Lowering stress

  • Reducing inflammation

Breathing Exercises

Breathing should be somewhat effortless as you attempt to draw the air down into the bottom of your lungs. Try to not force or push too far beyond your limits. If it feels like you are working too hard, give yourself permission to back off a little. Being stressed out about your breathing will only work against any of the good benefits you’re trying to bring about.


Pro tip: Rather than focusing on the depth of your breath, see if you can simply slow down the breath. As you do this, you might find the breath naturally deepens on its own.


Here are a few breathing practices to try at your leisure.


Practice #1: Soft-Belly Breathing

  1. Find a comfortable position - seated, standing, or lying down

  2. Close your eyes, if this feels comfortable and safe

  3. Bring your focus to your breath - breathing in through the nose and out through the mouth

  4. Imagine you belly is soft (this will help to deepen the breath and relax the body)

  5. Say to yourself “soft” as you breath in and “belly” as you breathe out

  6. Breathe in this way for several minutes, or as long as feels comfortable


Practice #2: Stretch and Smile

This practice incorporates movement with the breath, which helps increase coordination and build strength in the shoulders and arms. It also helps to open up the muscles in your chest to give the diaphragm more space to expand.

  1. Take a comfortable seated position - on a bed, couch, or sturdy chair

  2. As you breathe in, reach your arms up towards the sky to create a nice, big stretch. Fill the lungs the best you can.

  3. As you exhale, slowly lower the arms back down by your side while you smile.

  4. Nice and slow, match your breath with the movement - stretching upwards on the inhale and smiling as you lower the arms down on the exhale.

  5. Repeat 10 times, or as long as feels comfortable


Practice #3: Humming Breath

You may choose to be seated or standing for this breathing practice. Choose to be in a way that feels comfortable.

  1. Allow yourself to in an upright position - in a sturdy chair, bed, or standing position

  2. Place both hands gently on your belly

  3. With closed or pursed lips, breathe in softly through your nose, feeling the belly expand

  4. Once your lungs are filled, keeping the lips closed, exhale slowly while making a humming noise. Feel the belly fall back as you exhale.

  5. Repeat several times through - inhale through the nose, belly expands, then exhale through the nose making a “hmmmmmm” sound, feeling belly fall back.

Bonus: Check out this video tutorial for a demonstration of these breathing practices by mind-body specialist, Shannon Sims, PhD. Watch now.


Looking for More?

Check out the Aila Health app for more breathing practices, including guided meditations and physical therapy breath training.


Caution: Do not begin these exercises if you are experiencing a fever, shortness of breath, difficulty breathing while resting, chest pain or palpitations, or new swelling in your legs. STOP breathing exercises immediately if you develop any of the following symptoms: dizziness, shortness of breath more than normal, chest pain, cool/clammy skin, excessive fatigue, irregular heartbeat, or any symptoms you consider an emergency.


Join a Community of Long Covid Warriors

Here at Aila Health, we support people in their Long Covid journey. Join our community and connect with other patients like you. Share your patient journey with others who truly understand what you are going through. Learn from other’s experiences and how they navigated their condition. Learn more.


Article written by: Shannon Sims, PhD


About the Author

Shannon Sims, PhD, is an integrative wellness coach and mind-body specialist with Aila Health where she focuses on supporting Long Covid and other chronic illness warriors in their journey to greater wellness. Dr. Sims is also a professor at Saybrook University’s College of Integrative Medicine and Health Sciences in the department of Mind-Body Medicine.





References:


Cho, J. L., Villacreses, R., Nagpal, P., Guo, J., Pezzulo, A. A., Thurman, A. L., ... & Comellas, A. P. (2022). Quantitative Chest CT Assessment of Small Airways Disease in Post-Acute SARS-CoV-2 Infection. Radiology, 212170.


Crook, H., Raza, S., Nowell, J., Young, M., & Edison, P. (2021). Long covid—Mechanisms, risk factors, and management. BMJ, 374.


Hopkins Medicine (2022). Coronavirus recovery breathing exercises.

https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/coronavirus-recovery-breathing-exercises


Hopkins Medicine (2022). COVID-19 lung damage. https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/what-coronavirus-does-to-the-lungs#:~:text=COVID%2D19%20can%20cause%20lung,the%20lungs%20and%20other%20organs.


Marini, J. J., & Gattinoni, L. (2020). Management of COVID-19 respiratory distress. JAMA, 323(22), 2329-2330.


The Center for Mind-Body Medicine (2022). Mind-body skills groups. https://cmbm.org/


Twomey, R., DeMars, J., Franklin, K., Culos-Reed, S. N., Weatherald, J., & Wrightson, J. G. (2022). Chronic Fatigue and Postexertional Malaise in People Living with Long COVID: An Observational Study. Physical Therapy.

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