Qi Gong for Long-COVID Fatigue: A Breath-Led Reset

If you’re living with long-COVID fatigue, you need movement that’s kind, rhythmic and adjustable day-to-day. Qi Gong offers exactly that: small shapes, longer exhales, and attention without strain. In this guide you’ll learn why breath-led practice can help with post-COVID symptoms, how to keep it safe (especially with post-exertional malaise and dysautonomia/POTS), two short routines (seated and standing), and a gentle four-week plan you can trust.

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Why Qi Gong helps (plain English)

• Longer exhale → calmer system. Slow, quiet out-breaths nudge your body towards rest-and-digest, easing arousal and helping sleep settle. That’s a core aim in many long-COVID rehab pathways. (UCL Hospitals NHS Trust)

• Gentle rhythm reduces guarding. Repetitive, low-effort movement tells muscles and fascia to soften. The brain senses “safe enough” and the “threat volume” can drop.

• Low impact, highly adaptable. Stand on steadier days, sit on tougher ones. Keep ranges tiny and still gain benefit.

• Evidence is emerging. Reviews and early trials suggest Tai Chi/Qi Gong and breathing-centric rehab can support fatigue, mood, breathlessness and function post-COVID—especially when progressed slowly. (PMC)

Takeaway: tiny, regular practice is the lever. Comfort first. Consistency over intensity.

UK care context (where this fits)

NICE’s guidance on the long-term effects of COVID-19 supports assessment, self-management and rehab tailored to symptoms, not rigid protocols. Activity should be symptom-titrated—in small steps—rather than fixed increases. (NICE)

Where post-exertional malaise (PEM) is present (similar to ME/CFS), NICE explicitly cautions against fixed-increment graded exercise programmes. Pace within your “energy envelope” and build gradually only if symptoms stay stable. (NICE)

Across the NHS, post-COVID services encourage pacing and symptom-titrated activity (for example, ≤10% increments, then monitor 24–48 hours). (UCL Hospitals NHS Trust)

Safety first (please read once)

• Move inside comfort. No forcing range.

• Keep a micro-bend in knees/elbows; never lock joints.

• Breathe lightly through the nose with a longer exhale.

• PEM/“crash” risk: end while you still feel OK; leave 20–30% “in the tank.” If symptoms spike later, cut time next session. (NICE)

• Dysautonomia/POTS: favour seated/recumbent practice, short blocks, slow transitions, hydration/salt per your clinician, and compression if advised. Practise near support. (nhs.uk)

• Red flags: chest pain, severe breathlessness, new/worsening neuro or bone pain → stop and seek medical advice. Follow your clinic’s plan. (NHS England)

Pacing for long-COVID (no boom–bust)

1. Start tiny. 5–8 minutes counts.

2. One movement = one quiet breath. Longer exhale, softer shoulders.

3. Symptom-titrate. Change just one variable at a time (time or intensity).

4. 48-hour check. If symptoms rise, roll back. If steady, keep the same dose for a few sessions before nudging up. (UCL Hospitals NHS Trust)

5. Flare plan. On tough days, switch to the 3–4 minute calm set (below), then stop.

8-minute Seated Calm (treatment-friendly)

Set-up: Stable chair. Sit near the front edge. Feet flat. Soft gaze.

1. Arrive (60s) — Inhale 3, exhale 6–7. Soften jaw, brow and shoulders.

2. Neck ease (45s) — Tiny yes/no nods; slow half-circles within comfort.

3. Seated spinal wave (90s) — Inhale tip pelvis forward, heart softens open. Exhale tip back, belly relaxes. Small, smooth waves.

4. Cloud Hands (90s) — Hands float side-to-side at chest height. Weight shifts gently between sit-bones. One breath per sweep.

5. Open–Close the Chest (90s) — Inhale open a touch. Exhale round as if hugging a tree. Elbows heavy.

6. Belly breathing close (90s) — One hand below the navel; three long exhales. Small bow.

If symptoms or emotions spike, stop. Sit tall, sip water, rest your eyes.

10-minute Standing Ease (good-day option, near support)

Posture: Feet hip-width. Knees soft. Crown tall. Stand beside a counter/chair.

1. Shake & settle (60s) — Loosen ankles, knees, wrists.

2. Lift the Sky (2 mins) — Inhale float hands up. Exhale glide down. Shoulders soft.

3. Gather to Centre (2 mins) — Scoop from the sides to the lower belly. Longer exhale.

4. Separate Heaven & Earth (2 mins) — One palm up, one down. Long sides, tiny range.

5. Hug-the-Tree Stillness (2 mins) — Arms rounded, elbows heavy, breath quiet.

6. Close (60s) — Hands rest below the navel. Notice warmth, mood, breath.

Swap any block for the seated version on sensitive days. For POTS, stay seated throughout. (nhs.uk)

Breath pacing that helps (and why)

• Calm baseline: 3 in, 6–8 out.

• Very sensitive days: 3 in, 5–6 out.

• HRV-style practice (optional): ~5–6 breaths/min can support autonomic balance; early long-COVID studies are promising but still preliminary—comfort first. (SAGE Journals)

If breath gets choppy, shrink the movement and shorten the out-breath until it’s smooth again.

Troubleshooting (fast fixes)

• “I crash after ‘good’ sessions.” You likely overdid it. Reduce total time by 30–50% for a week and end earlier.

• “Neck/shoulders tense.” Make ranges smaller. Keep elbows heavy and jaw soft.

• “Breath gets stuck.” Slow down. Use 3 in, 6 out until smooth; consider brief seated stillness. (UCL Hospitals NHS Trust)

• “Dizzy on standing.” Sit down, elevate legs if needed, sip water. Next time stay seated and move smaller. (nhs.uk)

• “I feel nothing.” Look for quiet wins: warmer hands, softer jaw, steadier sleep. Change often whispers first.

A four-week plan (gentle and realistic)

Week 1 — Learn the shapes
Seated Calm 5–8 mins, 5–6 days. Eyes softly open. Stop before fatigue.

Week 2 — Add variety
Alternate Seated Calm and Standing Ease (8–10 mins). Keep a rest day. Note sleep and mood.

Week 3 — Consolidate
Keep 10–12 mins on steadier days; 6–8 mins on tougher days. Repeat your two favourite blocks (e.g., Cloud Hands + Gather).

Week 4 — Personalise
Build your best-feel 10–12 min mix. Aim for 4–6 days/week. Pair with short walks, water, and low-screen evenings.

Rule of thumb: stop while you still feel OK. Tomorrow matters more than today’s “big push.”

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Want gentle structure, kind coaching, and live encouragement during recovery? Join Bright Beings Academy and follow our long-COVID-friendly sequences with chair options, soft progressions, and weekly live classes you can replay anytime. Membership options below.

Evidence snapshot (what the research suggests)

• Guidelines: NICE covers identification and management of long-term COVID effects; emphasis is on tailored, symptom-titrated rehab rather than fixed increments. (NICE)

• PEM caution: In conditions with post-exertional malaise (ME/CFS and overlapping long-COVID presentations), avoid fixed-increment graded exercise; pace within an energy envelope. (NICE)

• Pacing in practice: NHS post-COVID services recommend small activity increases (often ≤10%) with 24–48-hour symptom checks. (UCL Hospitals NHS Trust)

• Breathing pattern disorder: NHS clinics and physio resources endorse breathing retraining for breathlessness after COVID. (UCL Hospitals NHS Trust)

• Mind–body movement: Systematic reviews suggest Tai Chi/Qi Gong may reduce fatigue and improve mood/sleep in post-viral/PCS cohorts; more high-quality trials are needed. (PMC)

• Respiratory muscle training: IMT has shown improvements in dyspnoea and function in post-COVID populations; programmes are typically home-based and gradual. (ERS Publications)

• Orthostatic intolerance/POTS: Long-COVID is linked with orthostatic intolerance; adjust practice (seated/recumbent, slow transitions), and follow lifestyle measures as advised. (NIHR Evidence)

• Prevalence (UK): ONS reported ~3.3% self-reported long COVID in England & Scotland (Feb–Mar 2024), ~2 million people affected. (Office for National Statistics)

Bottom line: Treat Qi Gong as a low-risk, high-kindness habit. Keep it small, regular, and exhale-led. The baseline shifts over weeks, not days.

FAQs — Qi Gong for Long-COVID Fatigue: A Breath-Led Reset

Is Qi Gong safe while I’m still symptomatic?
Often yes—gently. Keep sessions short, ranges small, and practise at home on low-energy days. Check with your clinic, especially if you experience PEM or dysautonomia. (NICE)

Will this cure my fatigue?
There’s no single cure. Qi Gong is a supportive tool that pairs movement and breath to reduce arousal and improve function—best alongside your clinical plan. (NICE)

How often should I practise?
Aim for 5–10 minutes, 4–6 days a week. If you crash after sessions, shorten time and stop before fatigue arrives. Consistency beats intensity. (UCL Hospitals NHS Trust)

What if I have POTS symptoms (racing pulse on standing)?
Practise seated, keep transitions slow, and follow your team’s hydration/salt and compression advice. Build in tiny steps only when stable. (nhs.uk)

Can breathwork alone help?
Yes—breathing retraining and HRV-style slow breathing are used in clinics; early long-COVID studies look promising. Keep it comfortable and stop if symptoms rise. (UCL Hospitals NHS Trust)

When will I notice change?
Many people feel calmer and warmer right away. Sleep and energy often shift within 3–8 weeks of short, regular practice.

Further reading on Bright Beings Academy

• Seated Qi Gong: The Complete Chair-Based Guide — https://brightbeingsacademy.com/post/seated-qi-gong-complete-guide

• Design Your 10-Minute Daily Qi Gong: Plug-and-Play Templates — https://brightbeingsacademy.com/post/10-minute-daily-qi-gong-templates

• Morning vs Evening Qi Gong: Choose by Your State — https://brightbeingsacademy.com/post/morning-vs-evening-qi-gong

• Standing Meditation (Zhan Zhuang): 5-Minute Foundations — https://brightbeingsacademy.com/post/standing-meditation-zhan-zhuang-foundations

• Eight Brocades (Ba Duan Jin): A Gentle Starter Guide — https://brightbeingsacademy.com/post/eight-brocades-ba-duan-jin-guide

• Qi Gong Evidence (2025): What Studies Actually Say — https://brightbeingsacademy.com/post/qi-gong-evidence-2025

Join Bright Beings Academy

Ready to move softly and reset your energy—at your pace? Join Bright Beings Academy below and choose the membership that suits you. I’ll place the membership options block here so you can get started right away.

I look forward to connecting with you in my next post.
Until then, be well and keep shining.
Peter. :)