Until lately, operating was a serious a part of Emma Zimmerman’s life. The 26-year-old freelance journalist and graduate pupil was a aggressive distance runner in school and, even after she graduated, logged about 50 miles per week. So she tentatively tried to return to her operating routine roughly per week after a possible case of COVID-19 in March, doing her finest to beat the malaise that adopted her preliminary allergy-like signs. Every time, although, “I’d be caught in mattress for days with a extreme stage of crippling fatigue,” Zimmerman says.

Months later, Zimmerman nonetheless experiences well being points together with exhaustion, migraines, mind fog, nausea, numbness, and sensitivity to screens—a constellation of signs that led docs to diagnose her with Long COVID. Although she will’t know for positive, she fears these exercises early in her restoration course of could have worsened her situation.

“I had no concept that I ought to attempt to relaxation as exhausting as I wanted to relaxation,” she says.

Tales like Zimmernan’s—sickness, enchancment, train, crash—are frequent in the Long COVID world. They usually spotlight what many researchers, sufferers, and advocates say is among the strongest instruments for managing, and probably even stopping, Lengthy COVID: relaxation.

The one assured solution to keep away from Lengthy COVID is to not get contaminated by SARS-CoV-2. But when somebody does get sick, “Relaxation is extremely necessary to provide your physique and your immune system an opportunity to battle off the acute an infection,” says Dr. Janna Friedly, a post-COVID rehabilitation specialist on the College of Washington who recovered from Long COVID herself. “Persons are kind of preventing by means of it and pondering it’ll go away in a couple of days and so they’ll get higher, and that doesn’t actually work with COVID.”

Researchers are still learning a lot about Long COVID, so it’s unimaginable to say for positive whether or not relaxation can really stop its improvement—or, conversely, whether or not untimely exercise causes problems. However anecdotally, Friedly says most of the Lengthy COVID sufferers she sees are working girls with households who rushed to get again to regular as quickly as attainable. It’s exhausting to provide one-size-fits-all steerage about how a lot relaxation is sufficient, however Friedly recommends anybody recovering from COVID-19 steer clear of high-intensity train for a minimum of a pair weeks and keep away from pushing by means of fatigue.

For individuals who have already developed Lengthy COVID, relaxation may also be helpful for managing signs together with fatigue and post-exertional malaise (PEM), or crashes following bodily, psychological, or emotional exertion. The U.S. Facilities for Illness Management and Prevention recommendspacing,” an activity-management technique that includes rationing out exercise and interspersing it with relaxation to keep away from overexertion and worsening signs.

In an international study revealed final 12 months, researchers requested greater than 3,700 long-haulers about their signs. Nearly half stated they discovered pacing a minimum of considerably useful for symptom administration. In the meantime, when different researchers surveyed about 500 long-haulers for a study published in April, the overwhelming majority stated bodily exercise worsened their signs, had no impact, or introduced on combined outcomes. Which may be as a result of long-haulers have impairments of their mitochondria, which generate power cells can use, recent research suggests.

Earlier than Lengthy COVID existed, researchers and sufferers inspired relaxation and pacing for the management of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). The situation’s hallmark signs embrace PEM and severe, long-lasting fatigue—diagnostic standards that many individuals with Lengthy COVID now meet. A study of greater than 200 individuals with Lengthy COVID revealed in January discovered that 71% had power fatigue and nearly 60% skilled PEM.

For years, clinicians tried to deal with ME/CFS sufferers by regularly growing their bodily exercise ranges. However that follow has since been proven to be not only ineffective, but often harmful, as a result of individuals with ME/CFS “have a singular and pathogenic response to overexertion” as a consequence of mobile dysfunction, explains Jaime Seltzer, director of scientific and medical outreach on the advocacy group MEAction. Most individuals with ME/CFS choose pacing over exercise-based remedy, one 2019 study found.

To tempo successfully, individuals should be taught to select up on cues that they’re overdoing it and unlearn ingrained concepts about productiveness, Seltzer says. “For those who’re doing laundry, for instance, there’s nothing that claims it’s a must to fold each single merchandise in a single sitting,” she says. Breaking apart duties could really feel odd, however it may be essential for preserving power.

Individuals with new Lengthy COVID signs ought to maintain a log of their weight loss program, exercise, sleep, and signs for a pair weeks to be taught their triggers, Friedly says. For individuals who can afford one, a health tracker or different wearable may also be useful for assessing how a lot exertion is an excessive amount of, Seltzer says. As soon as somebody has an thought of behaviors that enhance or worsen signs, they’ll use that data to plan their days and divide actions into manageable chunks.

For many individuals who take a look at optimistic for COVID-19, nevertheless, even taking a couple of days off from work to isolate is a monetary and logistical problem. Many individuals haven’t any selection however to return to bodily taxing work or obligations like youngster care as quickly as attainable. “Relaxation is completely recommendation that’s weighted socioeconomically and politically,” Seltzer says.

Individuals with Lengthy COVID or ME/CFS could possibly safe workplace accommodations, equivalent to working from residence, taking up a job that may be achieved sitting as an alternative of standing, or applying for disability if necessary. Seltzer additionally suggests leaning on buddies, religion teams, or mutual support networks for assist with some duties. Past that, Friedly recommends searching for artistic methods to make use of much less power all through the day. When she was residing with Lengthy COVID signs, she purchased many pairs of similar socks so she’d by no means need to waste effort and time looking for a match.

Issues like that “could seem small,” she says, “however when you add these up all through the day, they make an enormous distinction when it comes to how a lot power you’re expending.”

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Write to Jamie Ducharme at jamie.ducharme@time.com.