If you have experienced symptoms of COVID-19, you likely felt the effects it has on your ability to breathe easily. You may have been short of breath, coughed a lot, and in more severe cases required oxygen supplementation or mechanical ventilation. After recovering from the actual virus, you may be noticing that you are still short of breath. Many people report experiencing this breathlessness long after fighting off the virus.
How does COVID-19 affect your breathing?
Medically / Physiologically
As the virus spreads through the respiratory tract (nose, throat, lungs), it infects cells. In response, the body’s immune system fights back, and this process involves airways becoming inflamed, resulting in sore throat, cough and breathlessness. If the infection progresses into the lower airways of the lungs, it may cause pneumonia and/or Acute Respiratory Distress Syndrome, meaning that the little air sacs (alveoli) deep in the lungs become inflamed, filled with fluid. The air sacs are where oxygen that we breathe is supposed to move into our bloodstream in order to be sent all over the body. However when the air sacs are inflamed and filled with fluid, oxygen cannot properly move between the lungs and bloodstream, causing further breathlessness.
Typically, we breathe by using a large dome-shaped muscle below our lungs and rib cage that is called the diaphragm. To inhale, the diaphragm descends, creating a vacuum effect above it, which pulls air into our lungs. “Diaphragmatic breathing” is a relaxed form of breathing and allows the belly to rise and fall as we breathe. In contrast, when we are short of breath and/or we feel distressed, our body responds by activating all muscles that can possibly help us take a breath. These muscles are called the accessory muscles of breathing. They are smaller muscles that typically are involved in movement of our head, neck and shoulders, but are now recruited as breathing muscles to pull the chest open to allow air in. This breathing pattern, known as “apical breathing”, is a distressed form of breathing that involves the chest and shoulders rising as we take a deep breath. This is how many people breathe during and after recovering from COVID-19. Despite the body no longer being infected with the virus, the body gets used to breathing this way, and we continue to breathe in an apical, distressed manner.
Why is apical breathing not healthy in the long term?
Breathing in an apical manner can lead to neck and shoulder problems, and does not allow the deep parts of our lungs (air sacs/alveoli) to fill properly with air. It also makes the body feel as though it is still in a dangerous situation, keeping the sympathetic / fight or flight mode activated, during which our heart rate and blood pressure are increased.
How can we help you with your breathing pattern?
During the ReCOVery program, we will help you breathe in a healthy manner again. Through specialized exercises and cues from your physiotherapist, you will relearn to breathe using the diaphragm instead of the accessory muscles of breathing.
While challenging at first, it will in time help you feel less short of breath. Diaphragmatic breathing will allow you to fill the deep parts of your lungs with air, will improve oxygenation of the entire body, put less strain on the heart and it may also reduce stress and anxiety.
We look forward to helping you in your recovery!