Replenishing Prana After COVID: Breathing Tips for Long-HaulersMar 11, 2022
The information on this blog post is informed suggestion and may or may not be right for you. It should not be used as a substitute for medical care or the advice of your physician, psychotherapist, or other health care provider.
by Robin Rothenberg, C-IAYT
Long-COVID has disrupted the lives of literally millions of people, with incapacitating symptoms such as post-exertional malaise (depletion with even the smallest amount of physical exertion), dyspnea (breathlessness), and brain-fog. Additionally, some people experience POTS (Postural Orthostatic Hypo-tension) and other cardiac or neurological symptoms that further complicate their experience. For many long-haulers, basic functioning--such as tending to daily chores and errands and fulfilling work or child-care responsibilities--becomes intangible. Living on the edge of ‘normal’ adds significant emotional and financial burden to those who are already suffering. I have heard many with Long-COVID express a deep sense of abandonment by society as a whole, and specifically from the medical community.
While studies are in place to test various intervention and treatment plans, people need support now in navigating this new relationship with their body, mind, and energy levels. To that end, I offer these simple tips that can make a significant difference in reducing symptoms and assisting the healing process.
Whenever possible, practice nasal breathing – both inhale and exhale! The nasal cavity is the miraculous starting point for the immune system. The nose is designed to protect the lungs from foreign particles, including germs. It also warms and moistens the air which will help soothe irritated airways prone to coughing and keep them more hydrated. Inside the sinus cavities, there are pockets of Nitric Oxide, a potent anti-microbial gas that has been shown to have anti-viral capacities. Nitric Oxide helps to dilate the airways as well as reduce inflammation, both of which will making breathing more efficient with less effort. Exhaling through the mouth is dehydrating and leaches the body of much-needed carbon dioxide. Remember, the nose rules!
Try to breathe lightly. With the emotional stress and feelings of breathlessness people experience with Long-COVID, there is a tendency to grasp for bigger more satisfying breaths. Unfortunately, this will only create more tension. Although common lore says that when you feel nervous or upset that you should take a deep (implying BIG) breath, I’m going to suggest the opposite. Here’s why: big breathing stimulates your sympathetic nervous system. When we are relaxed, the breath is slow and soft. If your internal alarm system isn’t being fired off by hefty rounds of big breathing, your mind will calm as well. When you quiet your breathing, the nervous system resets into relaxation mode. This is key to the power behind yoga pranayama practices.
Breathe Slowly and Low
It’s not always easy, but the companion to a light breath is a slow, low, rhythmic breath. Fast breathing correlates with a higher heart rate and the fight or flight response. It tends to give rise to shallow, chest-generated breathing. For folks with Long-COVID this has particular implications in terms of cardio-vascular health. Try a gentle abdominal-diaphragmatic breath, with an inward hug on the exhale, and a relaxed, gentle inhale. This helps to release the neck, jaw and shoulders from the act of breathing, adding to the relaxation response. It also increases perfusion, gas-exchange, in the lower lobes of the lungs. Do your best to maintain a slow, light cadence. You might try the following: inhale for four seconds, exhale for six seconds, then pause for two. This can keep the mind from being hijacked by fear while reinforcing resilience. Learning to override the urge to breathe rapidly exhibits personal agency. If you're someone struggling with Long-COVID, you may appreciate this opportunity to feel empowered and in control.
One of the first things I recommend to my Long-COVID clients is to put themselves on a silent retreat (if possible) for two or three days. Talking is big breathing with sound, and it's one of the most pranically depleting activities one can do. This is particularly critical if you are recovering from a respiratory infection like COVID. I recommend clients carry a clipboard or use text to communicate to their loved ones and refrain from speaking. If total silence is impossible, try to pace yourself through the day, allowing for non-speaking periods between meetings or social gatherings. For all the reasons listed above, you might try to avoid breathing through the mouth, including while speaking. Additionally, big breathing depletes the body of carbon dioxide, a critically-important gas that maintains our pH and enables oxygenation of our tissues. The combination of light nasal breathing and staying quiet will help the body build up some of its CO2 reserves and may help your system move back towards homeostasis.
Do Less and Pace Yourself
The post-exertional malaise that accompanies Long-COVID is real and needs to be respected. This is not a matter of de-conditioning and rebuilding muscle. If you are a yoga teacher or therapist, model compassion and create an open environment for students to choose to practice from a chair, or even from the floor or bed if needed. Practitioners might try restorative poses as a way to rest deeply and as an alternative to active practice. Pace the sequence in such a way that allows for resting pauses between poses and even between sides of asymmetrical postures. Use these pauses and rest points as the means for the body and mind to replenish. Balance movement and 'doing' with resting and not-doing. In the rest periods, settle into your light, slow, nasal breathing and embrace the stillness. Choose to teach or practice fewer postures, and keep the practice simple so the brain doesn’t have to track complicated sequences--this is also a form of rest.
Robin Rothenberg, C-IAYT, is a long-time yoga therapist and yoga researcher. She serves as Chair of the Accreditation Committee for the International Association of Yoga Therapists (IAYT) as well as the Advisory Council. She has presented on lower back pain at SYTAR (Symposium for Yoga Therapy and Research) and is considered one of the foremost experts in the area of yoga therapy for lower back pain. Her ability to speak articulately to the way in which yoga impacts the nervous system, mind and emotions has led to her presenting at both NAMA (National Ayurvedic & Medical Association) and SYTAR on the subjects of anxiety and stress.
For the past three years, Robin has immersed herself in a personal study of the breath, of the ancient teachings on pranayama, and the science of respiratory physiology. The result of this inquiry has her calling for a “Breath Revolution” in the yoga community. Her new book, released in 2020, Restoring Prana: A Guide to Pranayama and Healing Through the Breath, suggests a serious re-evaluation of the ‘big breathing’ habit, and a scientifically-supported return to the roots of yoga which teach us to retain prana by minimizing breath while increasing breath suspensions. She is currently researching yoga for Long-COVID.
Want more from Robin Rothenberg?
Check out Robin's conversation with Jivana Heyman on the Accessible Yoga Podcast. In the episode, Robin talks more about her interest in pranayama, some common misconceptions about pranic practices, and the importance of CO2 levels in the body. Robin also leads Jivana through a short, demonstrative pranayama practice.
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