Hey docs,
What is your opinion about this kind of narrative? I know the topic is really complicated and the narrative could be true but I’ve seen people, who suffer really bad, going to bed rest after reading this .
Your link doesn’t seem to be working for me.
But I agree, this is a complicated issue. Post-viral syndromes are nothing new, and can be tough to manage, but I am concerned that we have – to an extent – “spoken this into existence”, to use a phrase from our Michael Ray. A mass population nocebo-type effect, in essence.
Austin, would this be considered an example of PNEI?
The link basically says that exercise is good for most, but for some with long covid it is harmful. Two quotes:
Consider a car crash survivor with severe multi-organ damage, you don’t tell them “look, every minute you’re lying in this bed you’re becoming unfit! Let’s get you on a treadmill”. That’s insane. Yet, many with #LongCOVID are being told this insanity daily
Let’s disentangle rehab in all this: specific protocols (such as autonomic rehab), can EASE #LongCOVID SYMPTOMS. They SOMETIMES involve exercise, but are categorically INEFFECTIVE AND HARMFUL if they do not take into account each person’s specific tolerances for PESE/PEM
A twitter thread from @PutrinoLabs
There is a critical need for the clinical world to move on from the misguided understanding that physical inactivity is harmful ABOVE ALL ELSE. Physical activity and exercise (even mild) is very clearly harmful for so many people with #LongCOVID. A thread (1/n)
Consider a car crash survivor with severe multi-organ damage, you don’t tell them “look, every minute you’re lying in this bed you’re becoming unfit! Let’s get you on a treadmill”. That’s insane. Yet, many with #LongCOVID are being told this insanity daily (2/n)
We know the multisystem benefits of exercise for those who have normative physiology. We get it. People with #LongCOVID no longer have normative physiology. We must solve the underlying issues causing #LongCOVID before clearing people to return to exercise if that’s a goal
Let’s disentangle rehab in all this: specific protocols (such as autonomic rehab), can EASE #LongCOVID SYMPTOMS. They SOMETIMES involve exercise, but are categorically INEFFECTIVE AND HARMFUL if they do not take into account each person’s specific tolerances for PESE/PEM (4/n)
As we navigate this space, clinicians must learn not to conflate rehabilitation and exercise in #LongCOVID recovery because these associations cause undue confusion, and are harmfully reductionist. This thread is by no means definitive, but I hope that it adds some value (end)
As we have stated many times before, all exercise interventions should take into account the individual’s starting abilities, limitations, preferences, and goals.
I do not see a compelling reason to make an enormous, public deal on this topic with respect to post-covid symptoms.
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