(Bear with me here...) How Yoga Therapy Has Helped Me During My Long COVID Recovery

Yoga has helped me recondition my nervous system, and, over the course of a year, rebuild my physical stamina and fitness. The most gentle form worked without moving my body.

I’m not a doctor, nor a scientist, and the following is not intended as medical advice. I’m just one person who has (mostly) recovered from a severe version of Long COVID and has done a ton of research, sharing my experience and learnings. Please ask your medical providers what’s right for you, particularly if trying something new, and always, always listen to your body.

---

In the last weeks, I’ve started sharing tools across the three pillars of my recovery framework: nervous system reconditioning, rebuilding the body, and emotional recovery. Today I’m going to write about my experience with yoga in Long COVID recovery. I’m going to do that at the risk of being that person who asks ”Have you tried yoga?”. I couldn’t write it anywhere near as accurately (and funnily) as Amy over at The Tonic (emphasis mine):

how many times in your life have you been telling someone about a seemingly intractable physical or mental health concern, only to have them ask this enraging question? (You can also sub in acupuncture, Chinese medicine, meditation, sauna, cold plunges, or any other ‘alternative’ type treatment or activity that may have worked for them, their cousin, or their aunt’s pickleball partner who had a condition that shared maybe one or two symptoms with yours, but was otherwise nothing like what you’re going through).

You needn’t be a spoonie to have experienced this particular form of infuriation. The insinuation that laying or standing on a foamy mat doing sun salutations, downward facing dog, or cat-cow could possibly cure you of your chronic pain or depression seems at once ludicrous and dismissive. This is particularly true when you are at the depths of despair over your condition, when you have had to alter your life so significantly to make room for your illness that you are unable to work, parent, socialize, or engage in life the way you used to.

If the idea that some simple stretches and poses giving you energy or getting you back to work or parenting gives you violent thoughts toward the person who suggested it, you’re by no means alone (and a jury of your peers just might acquit you if you acted on those thoughts). There are memes galore around this very issue.

So, so true. I’ve been there myself¹, as I’m sure all of you have, too. And I’ve probably, admittedly, been on the other side without meaning to (ugh). And yet, I’ll talk about yoga today, at the risk of being that person (maybe again 😬).

So first of all— yoga does not cure Long COVID or ME/CFS. In fact, for most people suffering from those conditions, yoga, like other movement, can easily cause symptom increase (PEM), or even lead to a permanent worsening of the condition. I would not advise that. So why am I talking about yoga then?

Yoga, under certain conditions, can be another tool in the nervous system tool box. If done right, and appropriate to the individual condition and stage, it can also help rebuild the body. So here’s where it lives in the recovery framework:

Here’s the recovery framework post.

My Experience with Yoga before COVID

Yoga has been a part of my life since 2013. It all started with taking a work trip to San Francisco (I was living in Dublin, Ireland, then). Our SF office was really spectacular (oh hey, SF Tech in the 2010s! It was fun while it lasted, RIP chrome panda). I thought it was the coolest thing that there was an actual gym in the office. A gym! In the office! So American! So Tech! I wasn’t into exercise then (ha), but I decided to take a yoga class, mostly so that I could report back about this “crazy” office gym situation, once back in Europe. Yoga sounded easy enough, and you know— the things we do for small talk material ;) I ended up loving the class and the teacher, so I took several more classes during my stay, and started to practice yoga regularly back in Ireland, too.

Fast forward to 2016, I was by then living in San Francisco. I had gotten more deeply into yoga after that initial experience, and had decided to take a 200hr teacher training with the same teacher, Martin Scott (he’s the best! Hi Martin!). I didn’t know what to expect, and was a little nervous. On day 1, we were supposed to practice chanting. Chanting, WTF 🫠 That was not what I thought yoga teacher training was going to look like (I was thinking exercise, anatomy, …). It really, really freaked me out, and I had a bit of a meltdown inside my head. Maybe the whole yoga teacher training thing, which I had just committed a lot of time and money to, wasn’t for me, after all? Thankfully, I stuck with it. I can honestly say that yoga teacher training blew my mind, and changed my life (chanting included, even though that’s still not very much my thing, but I appreciate it now). Looking back, that was probably when I first started grasping how the mind and body are intertwined. Funny to think about that now, with my hard won perspective of the last year.

Teaching a dusty yoga class at Burning Man, 2022

How I Discovered Yoga as a Tool for Long COVID recovery

When I came down with COVID in early 2023, and wasn’t recovering as quickly as I thought I would, I was bummed that yoga, along with walks, or any other form of even the lightest exercise, were now off the table. In the first months, as I was initially slowly getting better, I tried some gentle yoga, keen to move my body, just a few minutes at home. It knocked me out. When, over the next months, my health kept declining until I was completely bedbound, it started looking unclear if I’d ever be able to do yoga again at all. Yoga, a core part of my routines for the last decade, and a source of joy, had become yet another thing that Long COVID had taken, along with almost everything else. It was heartbreaking (not the loss of yoga per se, but the loss of every other interest and part of my life over the course of months, with no improvement in sight). It was also really confusing.

A couple of months later, while confined to bed, I stumbled upon an episode of the Long Covid Podcast featuring an interview with Fiona Agombar, an expert in yoga therapy for chronic fatigue. Fiona's insights and experience using yoga to help the recovery from Long COVID and ME/CFS were an eye-opener. I looked up her classes on youtube and found them to be extremely gentle and not requiring much more than lying on my back, breathing, and slow movements. I could do some of that, at least on good days. I was excited! Here was a way to finally start incorporating yoga into my days again, despite my severe disability and limitations. Not going to lie, it was scary at the time. Previously, movement had repeatedly led to my condition getting worse. But I gave it a try when I had a little energy to spare, and it didn’t make me worse on the days after. I started practicing, very gently, lying on my back. I also got Fiona’s book on Yoga Therapy for ME/CFS, so I could understand better how to use yoga during my recovery. I started practicing every few days. I set a goal for myself to get well enough to also teach others on their recovery journey, and that was one of the things that kept me going.

Recovery yoga

Yoga as a Tool for Long COVID and ME/CFS Recovery

Yoga is an exceptional tool for long COVID and ME/CFS recovery for several reasons:

• It is adaptable to every stage of recovery, making it accessible regardless of someone’s current limitations, including while bedbound (see below)

• Many forms of yoga incorporate gentle movement, which helps rebuild the body, carefully (for those who are able & ready for that stage)

• The meditation aspect of yoga teaches us to listen to our bodies and respect its limits, a critical lesson for most of us (also see my no. 1 rule for Long COVID recovery for this)

• Yoga includes breathwork, which acts like a “remote control” for the nervous system (I’ll write more on this soon).

How exactly does yoga help recovery?

Since discovering yoga for my recovery journey, I’ve been really curious about how it works in the body, and have done a lot of reading (and practicing). So here’s the very short version:

A lot in Long COVID and ME/CFS recovery relates to the nervous system, even if other organ systems (like lungs, heart, digestive organs) are primarily impacted, as mentioned in my previous posts, too. Mindfulness and breathing exercises have been shown to help rebalance the autonomic nervous system (which is often dysregulated in ME/CFS / Long COVID) and strengthen the Vagus nerve, which can be inflamed from the virus (see my last post on tVNS, too). Yoga incorporates both of these— breathing exercises (in yoga, this is called “pranayama”, one of the “eight limbs”) and meditation (“dharana” and “dhyana”).

In addition, subtle movement (“asana”, if practiced very gently) helps to slowly recondition the body, as well as reactivate the endocrine system, which is also often impacted.

Resources

If you’re planning to use yoga in your recovery, I’d definitely start out with yoga specific to post-viral recovery or fatigue conditions. And a heads up— even those recovery specific practices can be too taxing. So please use caution, and always listen to your body, even if a class says “for Long COVID”. You’re the only expert on your body. If something feels taxing, or even close, it’s not right. Best to start low, and then slowly move up.

Here are some resources I’ve found helpful:

• Yoga Nidra (also called NSDR, or “non-sleep deep rest”)

  • This is a kind of yoga you can just listen to, and which induces deep rest. You don’t need to move or even engage your muscles at all, so you can do this when you’re bedbound (and h/t to my friend LJT for introducing me to it).

  • Here’s a great free yoga nidra resource (I particularly like this one). There are lots of others online for free, too. If you speak German, here’s another favorite of mine: Nidra practice in German. My breathwork coach Geeta also has a great Nidra episode on her podcast (in German, too).

• Gentle Yoga for Long COVID:

  • Fiona Agombar, already mentioned above - her live classes are great if you’re in Europe, and she has a few recordings on Youtube.

  • Suzy Bolt's Rest Repair Recover Yoga program is excellent. Most of her classes were way too physically demanding for where I was at the time, but the program does include classes with little to no movement too, like yoga nidra or breathwork, and they are clear about which recovery stage each class is suitable for. Suzy has classes on Youtube, too (I like this one)

• Knowledge:

  • If you’re a yoga teacher and/or you want to learn more, I highly recommend Fiona Agombar's book on Yoga Therapy for CFS. It's intended for yoga teachers, but it's very clearly written and accessible even for those newer to yoga. The section on how CFS (and Long COVID) works in the body - mitochondria dysfunction, nervous system states etc. - is excellent. Worth reading even if you just want to understand the mechanics in the body better, and particularly if you want to teach for Long COVID. I relied on this book a lot when I was experimenting with teaching a small weekly recovery yoga group for a few months (my teaching is far from the quality level of the resources above, but it was fun :))

Which Type of Yoga I Used During Each Stage of Recovery

As I navigated through my recovery journey, different types of yoga served me at different stages:

• 0-20% functionality (bedbound): Yoga Nidra

• 21-40% functionality (couch- or housebound): Gentle Yoga, mostly Fiona’s classes (and a few of Suzy’s that were gentle enough). The idea then was slow and gentle movements to start accustoming the body to safe movement again. At that point I was practicing mostly lying down due to POTS, and was very careful to not overtax (usually waiting a few days between the short sessions, to make sure I continued to stay stable and not develop PEM)

• 41-80% functionality (expanding my movement range): I was still practicing Gentle Yoga here, but starting to be a little more upright (cat/cow, seated poses, working my way towards standing poses and, eventually, even some very gentle, slow sun salutations). I was also in physical therapy for Long COVID towards the end of this stage, and my therapist helped me incorporate recovery exercises into my practice. I practiced about least 10 minutes at home every day.

• 81-100% functionality (mostly recovered): All of the above! I’m still practicing for 10 minutes every day, incorporating my physical therapy exercises. I still use yoga nidra when that feels right. I’ve also started going to regular classes again, once or twice a week. I’m back to Vinyasa and Power Yoga now, helping me regain my full strength, and it feels really awesome to be able to do that. On the other hand, I also went to a Jivamukti class last week, and did not feel right yet. Soon :)

Important: Don’t let yoga intimidate you!

As my teacher Martin says: “If you can breathe, you can do yoga”.

Here are a few sad things I’ve heard over and over for the last 10 years: “I’m not flexible enough for yoga”, “I don’t have the body for yoga”, “I’m too old for yoga”, etc. We’ve done this ancient health practice a massive disservice, by mostly associating it with young, strong, healthy-looking people twisting themselves into complex poses.

Yoga isn’t about that, and it has never been. It's about connecting with your body, listening to its needs, and providing it with the care it requires. That’s exactly what your body needs from you if you’re suffering from a post-viral condition.

If you're unsure where to start— first of all, remember it isn’t about achieving any kind of goals. Just breathe and do what you can comfortably do. That’s all there is. If the resources above don’t cut it for you, you can always seek help from a yoga instructor experienced in chronic conditions, ideally someone trained in Yoga Therapy. They can provide you with a tailored practice and support. You can find an accredited yoga therapist here. Ideally look for someone who has recovered from ME/CFS or related conditions themselves.

Conclusion

Looking back over my recovery, I feel very lucky l that I did that yoga teacher training back in 2016. It opened my mind to the mindbody connection, and helped me build a deep mindfulness practice for the next 8 years. If I hadn’t had that base, I’m not sure I would have trusted the mindbody tools last year, when I needed them. Leaning into all that fully and early, is one reason I was able to recover relatively quickly.

Another big lesson here for me is to always follow my interests— you never know what it’ll be good for! Yoga teacher training back then was not for any particular purpose. Until I suddenly really needed it last year. You can only ever connect the dots in hindsight. Partly due to that, I’m currently doing a 9 months-long training as a holistic breathwork coach. Never know what that’ll be good for, too :) I’ll share more of what I’m learning, soon. Specifically, I’m hoping to use that training to help others in post viral fatigue recovery, maybe with a breathwork course (I’ll see what feels right at the time).

I’m curious— what’s your yoga? Are there any tools or learnings you built prior to getting Long COVID or ME/CFS, that are helping you now? Are you using yoga for your recovery as well? If not, please let me know if you ever try it!

Lastly, some hope from the other side— last weekend I went away with friends for my good friend’s 40th birthday, and I guided a yoga & breathwork session for the group. It was lovely. I’m so grateful that I get to participate in life again, and do the things I love, and share them with others. I know you will, too.

Guiding a yoga & breathwork session for friends last weekend

Namaste my friends,

~ Nicole

PS - This week, I’m celebrating 1 year from my personal independence day (sorry America, I co-opted your day). I’ve been reflecting on all that has happened in the last 12 months (it’s been a WILD ride and I am grateful every single day). Celebrating by visiting a good friend in Switzerland this weekend!

PPS - One of you kindly shared another resource that has helped her (in German): Covid Neuro Training. They have a free webinar tomorrow, July 2. Sharing in case it might help someone (sounds like it was particularly helpful during the very severe stage where movement etc. wasn’t possible). Thanks for sharing Nuria!

1. This isn’t the space for the various hurtful suggestions I got during my illness. But here’s one that was so out there that it’s actually funny. Shoutout to my electrician who was very adamant about his cousin having been cured from a serious condition by baking soda, and who insisted that it would cure me, too (without even knowing what I had). I’m very happy for the cousin :)