Whole-body and energy
Long COVID: pacing before progress
Long COVID is not one picture. What matters most is whether post-exertional symptoms are present, and screening for that comes before choosing what to do.
Created by Lee Albert, NMT · 8 August 2026
This isn’t a workout to push through. It watches how your body responds and adjusts as it goes.
“Vinys gives me something my body can actually do that day, even if it's just breathing on the floor.” Rina S. · Long COVID
Before you start
See a doctor about new or worsening chest pain, significant breathlessness, fainting, or a racing heart, rather than managing those with exercise, and get exertional desaturation and cardiac impairment ruled out before starting anything above rest.
Ready to stop guessing? Let your answers narrow the choices and shape your first session.
Start your first sessionWhat it is
Long COVID describes symptoms that continue or develop after a COVID-19 infection and are not explained by another diagnosis. It is not one thing. Some people have breathlessness and deconditioning that respond to gradual rebuilding; others have a picture that closely resembles ME/CFS, with post-exertional symptom exacerbation (PESE, also called post-exertional malaise or PEM) as the central feature; many have autonomic symptoms such as a racing heart and dizziness on standing. Those pictures need different handling, and current guidance asks for medical screening for exertional desaturation and cardiac impairment before anything else, followed by checking for PESE before choosing a direction.
How it behaves day to day
Fatigue, breathlessness, palpitations, difficulty concentrating, and symptoms that fluctuate week to week. The single most important thing to notice is what happens one to two days after activity, since a delayed disproportionate worsening changes the approach completely.
What tends to feed it
- Pushing through on a better day, with the cost arriving later
- Standing still for long periods, where autonomic symptoms are present
- Returning to previous activity levels all at once
- Progression driven by a calendar rather than by symptoms, or started before screening for PESE and cardiac or breathing red flags
What the research recommends
The World Health Organization's living guideline for clinical management of COVID-19, updated in 2025, asks for exertional desaturation and cardiac impairment to be ruled out before exercise is considered, then for screening for post-exertional symptom exacerbation, since it requires rehabilitation to be modified to avoid deterioration. Where PESE is present, the relevant guidance is the same shape as for ME/CFS: NICE NG206 no longer recommends programmes of fixed incremental increases in physical activity, and recommends person-led energy management covering physical, cognitive, emotional and social activity, staying within energy limits rather than pushing through symptoms. Where PESE is not present, gradual rebuilding by the dominant limitation, orthostatic intolerance, breathlessness, deconditioning, or a musculoskeletal issue, is more appropriate, which is why a single condition-wide sample does not fit this page.
Sources
- 1WHO Clinical Management of COVID-19: living guideline (June 2025)
Rules out exertional desaturation and cardiac impairment before exercise; screens for post-exertional symptom exacerbation and orthostatic intolerance, since either requires rehabilitation to be modified to prevent deterioration.
- 2NICE NG206, myalgic encephalomyelitis / chronic fatigue syndrome (2021)
Fixed incremental increases in physical activity are not recommended; person-led energy management within energy limits is, and it covers cognitive, emotional and social activity as well as physical.
Where Vinys is different
- There is no automatic progression. Vinys will not increase your session because time has passed, which is the mechanism that causes harm where PESE is present.
- The session is rebuilt daily from your own report, so a bad week produces smaller sessions without you having to change anything.
- Breath-led and supported sessions are available, which keeps something possible on days when movement is not.
- Positions that involve repeated changes between lying and standing are handled carefully where you report dizziness on standing.
- No streaks, no class, no keeping up. The pressure to push through is the specific risk here, so the product does not create any.
A short session to try
- 1
Extended exhale breathing, or nothing at all · Optional, a few minutes
For anyone with PESE present or uncertain: the lowest-cost option, useful in its own right where breathlessness is part of the picture, and skipping it is equally valid.
- 2
Dead bug, supine march · A few slow reps each side
One example for the orthostatic-intolerance branch, once PESE has been ruled out and cardiac or breathing red flags screened: leg and core work done lying down, without asking the circulation to manage a position change.
- 3
Cat-cow, small range · A few slow rounds
One example for the deconditioning or musculoskeletal branch, once PESE has been ruled out: gentle whole-spine movement, built up gradually rather than on a calendar.
Long COVID does not have one sample; these are examples from different branches, not a sequence to complete. Which branch fits depends on medical screening and whether PESE is present, and that judgment belongs with your clinician first. Judge whichever you choose by the next one to two days, not by how it feels at the time; a delayed crash means it was too big.
The full practice
This condition runs in stages, and the right practice is different for each. Pick the one that matches how you feel today.
Energy management comes first, following the same approach as ME/CFS. One optional low-cost movement, or full rest. Zero movement remains valid.
A few minutes, or none
Choose
- 1
Extended exhale breathing, or nothing at all · Optional
A low-cost option if today allows it. Skipping it entirely is just as valid a choice.
That session was written for everyone with this condition. Yours would be built around your answers.
Start your first sessionMovements often used for this
Breath · 180 to 300 seconds
Extended Exhale Breathing
Longer exhales deeply activate your body's calming response, reducing physiological arousal and pain sensitivity: particularly helpful for highly irritable or sensitive conditions.
Stability / Core · 30 to 60 seconds
Dead Bug: Supine March
A very accessible entry point for core training: alternating gentle foot lifts builds anti-extension motor control with minimal demand on your spine.
Spinal Mobility · 60 to 90 seconds
Cat-Cow: Small Range
Gentle spinal mobility in a small, safe range helps maintain fluid movement in the spine and reduce stiffness without placing excessive load on sensitive structures.
Breath · 60 to 75 seconds
Arriving with the Breath
A gentle, guided arrival that simply invites you to notice your breath without changing it: the calmest possible way to begin.
Restorative · 120 to 180 seconds
Banana Pose
A deeply restorative supine side-body stretch that releases tension along your entire lateral line, from your outer hip through your side ribs and waist.
Breath · 180 to 300 seconds
Bhramari: Humming Bee Breath
The gentle vibration of humming during exhale stimulates your vagus nerve, creating a powerful calming effect that reduces stress and soothes your nervous system.
Restorative · 120 to 180 seconds
Broken Wing
A prone shoulder stretch that passively opens your posterior shoulder capsule, releasing the tightness that restricts internal rotation and contributes to rounded posture.
Restorative · 120 to 240 seconds
Butterfly
A gentle, grounding pose that opens your inner thighs and deep hip rotators with minimal joint loading, allowing long passive holds that gradually release fascial tension.
Restorative · 60 to 300 seconds
Child's Pose: Chair Facing Back
A fully seated rest: sit facing the back of a chair, fold forward, and rest your arms and forehead on the backrest. No floor needed; all the calming benefits of Child's Pose from a chair.
Restorative · 120 to 180 seconds
Deer Pose
An asymmetrical seated pose that simultaneously works internal and external hip rotation, improving the balanced rotational mobility your pelvis needs for comfortable movement.
Breath · 180 to 300 seconds
Diaphragmatic Breathing: Dirga Pranayama
Slow belly breathing activates your parasympathetic nervous system, helping to reduce pain sensitivity and calm your body before or after movement.
Breath · 70 to 90 seconds
Following the Movement of the Breath
A slightly more detailed breath-awareness opening that helps you notice exactly where and how your breath moves: good preparation right before breath-led movement.
Sessions for this lean on the breath and restorative families in the library. These are the ones most likely to appear, not a prescription: your own session is built from your answers on the day.
Common questions
Should I be building fitness back up?
It depends on whether exertion is followed by a delayed crash. Where PESE is present, guidance points away from fixed increases in activity. Where it is not, and after medical screening, gradual rebuilding by your dominant limitation is more appropriate.
How do I know which type I have?
The practical test is what happens one to two days after activity, and it is a conversation to have with your clinician rather than something to settle alone. Screening for exertional desaturation and cardiac impairment comes first either way.
Can I do anything on a bad day?
Breath-led sessions are available and require very little, and doing nothing at all is also a complete choice. That is often the honest answer on a bad day.
This is the version everyone gets. Yours is different.
Start your first sessionAlso called post-COVID syndrome, post-acute sequelae of COVID-19, PASC, long haul COVID. Movements are drawn from the clinically authored Vinys library, and the guidance above is sourced to the publications listed. This page is general movement information, not medical advice, and it is not a diagnosis. How the method works.