Post-COVID Chronic Symptoms and What Physical Therapy Can Do To Help.

We are hearing more and more about “COVID long-hauler syndrome” as a description of the chronic symptoms that some people experience after a particularly bad bout of the coronavirus. This syndrome is mainly seen in older adults and in people who have significant underlying medical conditions. The Mayo Clinic describes the symptoms as a combination of fatigue, shortness of breath with activity, chest pain, chronic cough, and joint pain. In addition, some people may experience muscle pain, headaches, memory deficits, difficulty with attention, and a fast or pounding heart rate. The increased heart rate may also be indicative of postural orthostatic tachycardia syndrome (PTOS) which makes activity so difficult that even the smallest tasks require rest breaks. 


What can physical and occupational therapy do to help? We call it activity analysis and dosing. Activity analysis is a process that we study for years in school and use every day in practice. It involves breaking down an activity into its smallest subcomponents involving muscle control, strength, range of motion, endurance, focus, attention, and more. Activity dosing requires understanding of the tiniest steps from one activity to the next so the body’s response is positive and healing rather than difficult and frustrating. 


Imagine if I was having trouble putting my clothes away in the closet due to shortness of breath. I get fatigued so easily that I have to sit down to rest after only a few minutes of activity. Once I finally get the task completed, I’m worn out for the rest of the evening and miss out on important times with my family. Sometimes, I think it is easier just not to start the task but then I don’t seem to get anything done and I’m not sure that I’m getting any stronger. Seems like a downward spiral. 


An occupational or physical therapist helps break down the task into its smallest components through activity analysis and helps you pace it out through activity dosing. 

  • Some of those tasks require standing but others can be done in sitting. 
  • You might not be able to carry the clothes to the closet, but you could throw them over your shoulder. 
  • You could use metal hangers that are a little lighter in weight than the plastic ones. 
  • The therapist might recommend that you only do the task in the morning when you are rested and that you avoid days when you’ve got other big plans. 


Then as you accomplish one task, the therapist helps you to see which tasks are just a little tougher and then a little tougher and a little more. That kind of specialized activity dosing keeps the goal in mind while focusing on micro-successes to help you get there. 


Therapy is pretty amazing at helping you get back to the life that you want to live. Check us out on PT& for more information and to find a location near you. 


Mayo Clinic. (2020). COVID-19 long term effect. Retrieved Feb 17, 2021 from 


Wall Street Journal (2020). For COVID long-haulers, a little known diagnosis offers possible treatment – and new challenges. Retrieved Feb 17, 2021 from