Yoga v Long Covid

Can yoga help relieve the symptoms of Long Covid? Part Two: the nervous system. By Imogen North

In this three-part series we are diving into Long Covid and how yoga can help to relieve its symptoms. In the first article (Yoga and Long Covid - Part 1) we looked at the respiratory system and how to increase our breath capacity through specific breath practices. In this article I wanted to take a closer look at the nervous system. Two of the top three Long Covid symptoms reported (out of 203 identified by the Lancet’s journal EClinicalMedicine recently) were fatigue and post-exertional malaise. Both these symptoms are directly connected to the function of the nervous system.

In Traditional Chinese Medicine (TCM) ‘Deficiency’ or ‘Xu’ is one of the eight principles that defines TCM. Deficiency shows up in the body as fatigue, weakness or chronic pain and we can normally notice the symptoms to be worse after something (e.g. exercise / when we exert ourselves in a big way). Deficiency implies a lack of something.

Both fatigue and post-exertional malaise are deficiency symptoms. Anytime energy is expended you feel worse after. You can look at it like an equation. One plus one always equals two. But if you are already fatigued it works as a negative so, one minus one brings you back to zero and if you keep expending, or ‘taking away’, you will go deeper and deeper into the negative. The more energy you expend the worse those symptoms are going to get.

So how do we manage deficiency symptoms like fatigue and post-exertional malaise?

Well, we need to add something into the equation so there is no longer a lack. What are ways we can add into the equation from a yoga perspective? What kind of practices can we use? The easiest place to start is with practices that support and nourish the parasympathetic nervous system. The part of our nervous system that helps us rest and digest. We want to use practices that nourish our system and fill us up. I suggest introspective, reflective practices, particularly restorative practices and meditation. Any practices that will calm your central and sympathetic nervous systems and increase vagal tone. Remember we touched on vagal tone in the first article in this series. Vagal tone is a measure of the resiliency of our system and has a parasympathetic influence on the heart (therefore will also help ease Long Covid symptoms like increased heart rate and heart palpitations).

Another way to look at it from a TCM perspective is to nourish the kidneys. The kidneys are located on the back side of the body just behind the lower ribs. They filter the blood and regulate the body’s fluids (and are linked to the water element). Energetically, the kidneys are the root of yin and all other precious substances in the body. They are responsible for birth, growth and development. They house the essential essence (Jing) that we lose easily when the body’s systems are stressed. In TCM the kidney’s health is directly linked to our deep energy reserves, stamina and nervous system; when the kidneys are depleted or deficient, symptoms like fatigue and post-exertional malaise are common.

So what poses are useful to nourish the kidneys and support the parasympathetic nervous system?

Here are my top three:

1. Setu Bandha Sarvangasana: Restorative Bridge Pose

To set up for this pose you will need a couple of bolsters or firm cushions and a blanket or two that you can roll. You want to set the two bolsters into a T shape and roll the blankets and place them at the bottom of the T to support your ankles. Sit on the T and lie back so your shoulders are on the floor and arms laid out in a T position parallel to the top bolsters also on the floor. Your neck and head should be relaxed and the whole back of your body should be supported by the bolsters. Ankles resting on the rolled blanket.

If you have an eye pillow you may also want to place that over the eyes. Settle in and focus on your breath. Stay in this pose for at least 5 minutes. If you can, see if you can hold for 10-15 minutes.

Restorative bridge pose is a supported lunar inversion. This family of poses can be really cooling for the body, calming the nervous system and activating parasympathetic tone. The head position here is below the heart, which activates one of the body’s homeostatic mechanisms, the baroreflex. This reflex helps to maintain a steady blood pressure level that surpasses the sympathetic ‘fight-or-flight’ response of the nervous system and stimulating that all important parasympathetic state.

2. Upavistha Konasana: Supported Seated Wide Leg Forward Bend

To set up this pose you will need a bolster or two and some bricks or pillows, enough to create a little tower to lean into. If you have tight hamstrings you might also want to sit on the edge of a rolled blanket. Spread your legs wide, but not too wide, you want to be able to relax them. You want to avoid too much rounding in the lower back, so make sure you build your tower high enough, and then relax your head onto the bolster. Relax and focus on your breath. Stay in this pose for at least 5 minutes. Again, you can hold for up to 15 minutes.

This is a great pose for stimulating the kidneys and the kidney meridian. The kidney meridian begins in the little toe of each foot. It travels through the sole, the arch, and up the inside of the knees and thighs and enters our torso near the tailbone. It continues up along either side of our spine, connecting internally with our bladder and kidneys, to our throat ending at the root of our tongue.

The introspective nature of this forward fold and the stimulation of the third eye on the bolster also encourage our nervous system to drop into its rest state. It is in this rest state that our deepest energy reserves can fill up.

3. Viparita Karani: Legs Up the Wall

To come into this pose you will need a wall and a bolster or rolled blanket. Sit against the side of the wall and then swing your legs around so they slide up the wall. The bolster or blanket should sit under the back of your sacrum bone, avoiding the lower back. Arms, shoulders, head all rest comfortably on the floor. You can stay in this pose for up to 15 minutes, again using an eye pillow if you have one.

In this pose, as well as the head being lower than the heart, and baroreflex being stimulated (as in our supported bridge pose), this is also great to encourage the flow of lymph and other body fluids down the body supporting the immune system and the circulatory system. It is also a really great place to learn to stop. Remember we can only run on overdrive so long. When we start to slow down and we tell our body it’s okay to stop, when we tell our body that we are going to take care of it, that is when the body begins to learn to relax. We are built to switch between both worlds — the doing and creating, and the resting and nourishing; we need to do both, but do we give ourselves the time to learn how to?

I mentioned in the first article in this series that the respiratory system is like a muscle, it needs regular repetitive inputs to make change. So too does the nervous system. These three poses practiced regularly will shift your nervous system, and retrain it, giving your body time to refill the deep energy reserves that are deficient when we suffer with fatigue and post-exertional malaise. These poses work like a stress management practice for our whole being, not only nourishing the nervous system but keeping stress at bay; this will, in turn, also support the immune system. More on the immune system in the final article in this series.