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Breathing & recovery

Long COVID: a gentle lying and seated routine

Only use this routine if the post-exertional malaise (PEM) check in our long COVID guide doesn't point to PEM, or your long COVID team agrees, and after any chest pain, breathlessness or palpitations have been checked by a doctor. With PEM, pacing comes first. The routine starts lying down and stays seated for most of it, because many people with long COVID feel dizzy or breathless upright. Do less than you think you can, then see how you feel that evening, the next day and the day after: PEM usually shows 12 to 72 hours later. The doses are our editorial starting point.

12 minBeginner13 movesA bench or box · Something with weight · A wallHip flexors · Glutes · Calves · Quads · Shoulders · Chest
Follow along: a timer, a cue and the next move, one step at a time.

Lying (about 3 minutes)

  1. Slow breathing (6 breaths a minute)2 min
    Beginner · 3D demoOn your back, knees bent. Small, quiet breaths in through your nose, a little longer outEasier: Breath reachHarder: Crocodile Breathing (prone diaphragmatic breathing)
  2. Supine heel slide5 each leg
    Beginner · Hip flexors, Hamstrings, Quads · 3D demoSlow and easyHarder: Hip Windshield Wipers
  3. Glute bridge5
    Beginner · Glutes, Hamstrings, Abs · 3D demoLift only a littleEasier: Pelvic tilt into bridgeHarder: Glute kickback (quadruped hip extension)
  4. Ankle circles10 pumps, then 5 circles each way
    Beginner · Calves, Shins · 3D demoPoint your toes up and down, then circle

Sitting (about 4 minutes)

  1. Seated march1 min
    Beginner · Hip flexors, Quads, Abs · 3D demoSit up slowly and pause before you startHarder: Standing march
  2. Seated knee extension (chair)5 each leg
    Beginner · Quads · 3D demoNo weightEasier: Quad set (static quads)Harder: Leg extension
  3. Seated bent-knee calf raise (soleus raise)10
    Beginner · Calves · 3D demoSqueeze your calves: it helps blood back to your heartHarder: Slow calf raise
  4. Shoulder rolls5 each way
    Beginner · Shoulders, Back, Neck · 3D demoHarder: Shoulder CARs (controlled articular rotations)
  5. Thoracic rotation3 each side
    Beginner · 3D demoSitting, hips stillHarder: Reverse lunge with rotation

Standing, only if you're not dizzy (about 2 minutes)

  1. Sit to stand from a chair5
    Beginner · Quads, Glutes, Hamstrings · 3D demoStand up slowly. If you feel faint, sit straight back downHarder: Bodyweight squat
  2. Wall push-up5
    Beginner · Chest, Triceps, Shoulders · 3D demoHarder: Push-up
  3. Slow calf raise10
    Beginner · Calves · 3D demoHold a supportEasier: Seated bent-knee calf raise (soleus raise)Harder: Standing dumbbell calf raise

Cool-down (about 3 minutes)

  1. Slow breathing (6 breaths a minute)1 min
    Beginner · 3D demoSittingEasier: Breath reachHarder: Crocodile Breathing (prone diaphragmatic breathing)
  2. Legs up the wall (Viparita Karani)2 min
    Beginner · Hamstrings, Calves · 3D demoOr lie with your legs on cushions. Come up slowlyHarder: Plow pose (Halasana)

Tips

  • Only do this if the PEM check doesn't suggest post-exertional malaise, or your long COVID team agrees, and after any chest pain, breathlessness or palpitations have been checked. With PEM, pacing comes first.
  • Start with less than you think you can do: the lying block on its own is a full session, and PoTS UK says a starting point can be as little as 60 seconds.
  • Judge it over the next 2 to 3 days, not straight afterwards: PEM usually shows 12 to 72 hours later. If it comes, drop back and pace.
  • Keep the same amount for at least a week, and add one small thing only if nothing got worse (our editorial rule). Never add on a fixed schedule.
  • If you get dizzy upright, drink two glasses of water first, wait an hour after a meal, keep the room cool and change position slowly. If you feel faint, lie down and raise your legs.
  • Call 999 (911 in the US) for chest pain that feels tight or spreads to your arms, neck or jaw, or if you faint while exercising.

The doses are suggested starting points, not a prescription. Choose a range you can control and stop for sharp or increasing pain, numbness or tingling. Get individual advice after an injury or surgery, or if you are pregnant or managing a health condition.

Guides that recommend it

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Questions people ask

How long does the long covid: a gentle lying and seated routine take?

About 12 minutes, including any warm-up and cool-down listed. Shorten it by doing fewer rounds; lengthen it by adding one.

What equipment do I need?

You need: A bench or box, Something with weight, A wall. Each move links to its guide, where you can find an alternative if you are missing something.

Is it suitable for beginners?

It is written for beginners. 4 of its 13 moves have an easier option listed beside them if you need one.

How do I make it easier or harder?

Use the easier or harder option listed under each move, change the number of rounds, or adjust the rest. Progress one change at a time.