December 2022
Despite the chronic nature of this pandemic, I have my ears open for good news stories! I have been paying attention to the research about integrative and complementary health approaches for COVID-19. I hope it will intrigue you to learn how you can help yourself and others stay healthy and well!
Early in the pandemic, the science was focused on prevention of COVID-19. This continues to be essential, as it is a first line of defense against COVID-19 and other airborne viruses. Yoga’s role in immunity is supported by numerous scientific studies. Yoga asana (postures), pranayama (breathing exercises), and meditation improve biochemical markers of immunity. Yoga also reduces negative effects of stress on the body by changing genes that cause inflammation, thereby reducing the risk of mental and physical illness. Improving immunity and reducing inflammation is key to preventing virus transmission and recovering from it.
As the pandemic progressed, research started to capture the toll on mental health.
In Canada, the results are striking, showing increased rates of PTSD, anxiety, and depression over a 2-year period. Severe mental health effects have also been shown among a high number of people whose loved one died with COVID. It is now clear that having COVID-19 can result a wide variety of neurological and psychiatric effects, including PTSD, depression, and anxiety.
One study from India (where the government has funded research about yoga during COVID-19) showed that compared to people not practicing yoga, yoga practitioners had greater strength and endurance, better ability to cope with the stress of lockdown and COVID and better mental health. A scoping review concluded that the benefits of yoga on immunity and respiratory health make it useful in both the prevention and treatment of COVID-19.
Well into the pandemic, we started to see a growing number of people with lingering symptoms of COVID-19 beyond 12 weeks. A new diagnosis was given to these individuals: ‘long haul COVID’ and more recently ‘post COVID-19 condition’.The infection has a systemic effect on the body, with a vast array of possible symptoms. The reported prevalence varies widely. A variety of causes have been proposed for post COVID-19 condition, including viral persistence causing cellular damage, persistent inflammation, autoimmunity, and microvascular clotting.
Without an effective treatment for post COVID, there is an increased interest in alternative treatments that decrease symptoms and improve quality of life.
This chart shows the incidence of various post COVID-19 symptoms. Past research has shown yoga can help many of these symptoms. The most common symptoms of post COVID-19 syndrome - fatigue, sleep disorder, anxiety, depression, and shortness of breath - can all be helped with yoga.
Photo credit: Ontario Science Table using data from Chen et al., 2022.
John Hopkins Medicine (JHM) has been a leader in rehabilitation research and practice for post COVID-19 condition. Recently, JHM published "Bouncing Back From COVID-19: Your Guide to Restoring Movement" with exercises to promote recovery from COVID-19 at different stages of the disease.
The premise is that movement and breathwork heals the body, restores the mind, and soothes emotions (this sounds like yoga!)
The five layers of movement described in the guide are:
1. Breathe deep (for the heart and lungs)
2. Turn on vestibular system (for balance and coordination)
3. Cross your body (for brain and thinking)
4. Build strength (for muscles and joints)
5. Gain endurance (cardio exercises for all of the above)
As soon as possible after becoming ill, JHM recommends starting gentle movement and deep breathing exercises, which can be done in bed. As a person recovers, they can perform exercises sitting and then standing. Deep breathing helps restore diaphragm function and lung capacity. It can also relieve anxiety and stress and help with sleep quality. Deep breathing stimulates the vagus nerve, which is important because COVID-19 has been associated with damage to the vagus nerve. One of the recommended breathing exercises is called Bhramari pranayama (Bee Breath). Bhramari pranayama has been found to have many benefits related to the production of nitric oxide, oxygenating the body and calming the nervous system.
Many of the other exercises found in the guide are traditional yogic practices, including all the breath work, eye, and neck exercises, rocking in different directions, Bird Dog and Chair Pose. What I would add to the guide (if I’d been consulted!) would be trauma-sensitive mindfulness and self-compassion activities, as well as a Savasana (five minutes of restorative rest) after doing the exercises. There is evidence that mindfulness meditation and self-compassion have physical and mental health benefits that could help relieve post COVID-19 symptoms. A few minutes of rest at the end, lying down with eyes closed, helps to switch the sympathetic nervous system (activated by physical exercise) to parasympathetic (for recovery). Of course, the ancient yogis knew this before research came along to prove it!
One of the things I really like about the John Hopkins Guide is that it encourages people to think about other exercises to engage all the body systems. For example, to harness the healing of Bee Breath plus deep breathing, you could sing and lift your spirits at the same time! Or you could challenge yourself with cross-body movements by reaching behind you to touch your opposite foot. How about moving your head or eyes while standing on one foot (with a chair or wall in reach)? I’m having fun just thinking about the possibilities!
Post COVID-19 is a new condition that we are still trying to understand. In the meantime, many people are suffering from a wide variety of symptoms that are having a great impact on their physical and mental health, ability to work, and quality of life.
Since ancient times, yoga has been used as a mind-body healing practice. Now research is supporting its use for post COVID-19 recovery, with minimal risk and significant benefits.
It takes about 17 years for research to be translated into clinical practice, which I think is too long to wait for all the people who can use the information now!
Please reach out if I can help you with a personalized home yoga practice to support your recovery from COVID-19 or other debilitating illness. The mind-body practice of yoga is intended to help you heal!
