Podcast Episode 17: COVID Special for Clinicians
Podcast Episode 17: COVID Special for Clinicians and Health and Wellbeing Professionals with Emily Lockwood, Respiratory Physio
In the second part of our 2 part COVID special with Emily Lockwood, respiratory physio, we look at what clinicians should be looking out for and useful tips for getting people back into exercise after COVID.
We discuss the importance of listening to the patient, asking the right questions, and not just progressively trying to load someone. We also discuss the use of objective markers and where we should be starting patients, as well as how often we should be asking them to train!
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This podcast is also really useful for clinicians or health professionals to listen to as it has some great tips.
What Our Experts Say
The most important part of working with someone after COVID is not to assume that a standard progression will suit them. Objective information can be helpful, but it must sit alongside what the person tells us about their fatigue, breathlessness and response later that day or the following day. In Pilates, this means beginning with manageable, controlled movement and adapting each session rather than following a fixed timetable.
Natalia Barbosa – Clinical Pilates Instructor and Registered Nurse
Key Takeaways
- Listening to the patient comes first – The person’s symptoms and experience should guide clinical decisions rather than assuming everyone will follow the same recovery pathway.
- Asking the right questions helps shape rehabilitation – Understanding how someone responds during and after activity can help clinicians choose a more appropriate starting point.
- More exercise is not always the answer – Simply increasing the load at every session may not be suitable for someone recovering from COVID.
- Objective markers can support clinical judgement – Measurements can provide useful information about how a person is responding, but they should be considered alongside what the patient reports.
- Exercise frequency should be individualised – Where someone starts and how often they train should reflect their current capacity and response rather than a generic timetable.
FAQs
1. What is post-exertional symptom exacerbation?
Post-exertional symptom exacerbation, sometimes called post-exertional malaise, is a worsening of symptoms after physical or mental activity. The reaction can be delayed and may continue for several days or longer, even when the activity did not feel particularly demanding at the time.
2. Is it safe to exercise with long COVID?
Exercise may form part of an individual rehabilitation plan, but it should be guided by symptoms rather than automatically increased each week. NHS advice recommends speaking to a GP or specialist before restarting exercise and stopping if activity causes symptoms. Post-COVID rehabilitation services use symptom-titrated exercise support rather than a standard programme for everyone.
3. What checks may be used before prescribing exercise after COVID?
An assessment may include blood pressure, heart rate and oxygen-saturation measurements. Depending on the person’s symptoms, a clinician may also recommend blood tests, an ECG, an X-ray or a supervised exercise test that records breathlessness, heart rate and oxygen levels.
4. Can you feel breathless even when your oxygen levels are normal?
Yes. Breathlessness can have several contributing factors, so oxygen saturation is only one part of an assessment. Clinicians may also need to consider the heart and lungs, breathing patterns, anaemia, physical deconditioning and psychological factors.
5. Who can help with long COVID rehabilitation?
Support may involve several healthcare professionals depending on the symptoms experienced. This can include physiotherapists, respiratory specialists, occupational therapists, psychologists and other medical specialists. The rehabilitation plan may address fatigue, breathlessness, pain, sleep, activity and emotional wellbeing.
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Education is Key
These blogs are designed to give information to everyone, however, it is important to remember that everyone is different! If you have not seen one of our therapists and have any questions about injuries, what you have read or whether this may be useful to you, please just ask. We are more than happy to help anyone and point you in the right direction. Our biggest belief is that education is key. The more you understand about your injury, illness and movement, the more you are likely to improve.
If you are not sure whether this is for you, simply get in touch. We are here to help!
Published 9 Feb 2021 · Updated 3 Aug 2026