So, let’s clear this up once and for all: long COVID is not simply a case of deconditioning “being out of shape .” It’s not like the time you quit the gym for a few months, realized your biceps weren’t quite as “ripped” as they used to be, and you thought, Right, time to get back on the treadmill. Long COVID is a multi-system condition with some pretty unique symptoms that no amount of lunges or cardio can fix—and, in fact, pushing through with “reconditioning” exercises could for some make things worse. Let’s dig into the difference and why that “just exercise more” advice is about as useful as telling someone with a sunburn to “just go out and get more sun.
1. Long COVID Symptoms: Way More Than Just Feeling Tired
First off, If long COVID were simply deconditioning, you’d expect things like weaker muscles or a bit of breathlessness when climbing stairs. But long COVID serves up a much more colourful array of issues: brain fog, nerve pain, dizziness, random spikes in heart rate, and post-exertional malaise (PEM)—the experience of feeling utterly wrecked after even minor exertion.
This isn’t your typical ‘I skipped the gym’ kind of fatigue. Feeling out of shape might leave you breathless after climbing stairs, but long COVID can make you need a two-day rest after just walking around the block.
2. The Post-Exertional Malaise (PEM) Paradox
Here’s the catch: with long COVID, trying to exercise through symptoms can actually trigger PEM. This is when even light activity—like a gentle walk—leaves you feeling as though you’ve been hit by a truck, but the effects don’t show up straight away.
You might feel fine after a brief stretch or a short yoga session, only to crash the next day, barely able to lift your head. Such delayed and disproportionate exhaustion is a hallmark of PEM, and it’s a big sign that long COVID isn’t just about being out of shape.
3. The Heart Rate (and Heat) Rollercoaster
In long COVID, autonomic dysfunction—where your body struggles to regulate automatic processes like heart rate or blood pressure—is a common issue. With deconditioning, your heart rate might rise during exertion because you’re out of practice. With long COVID, your heart can race for no reason—even when you’re lying down.
For some, standing up feels like preparing for an Olympic sprint. Conditions like POTS (postural orthostatic tachycardia syndrome) make simple activities feel like monumental tasks. Explaining to friends that standing leaves you dizzy or exhausted can result in baffled looks, but this isn’t deconditioning—it’s your body’s systems going haywire.
4. Pacing and the Energy Envelope: Learning Your Limits
Living with long COVID means mastering the “energy envelope.” Think of it as a limited supply of energy that you have to ration carefully. Unlike regular fatigue, which you can often push through with determination, long COVID fatigue punishes you for overdoing it.
Imagine attending a party where everyone else has an endless supply of snacks, but you’re only allowed three crisps. Eat a fourth, and you’ll be wiped out for days. That’s the reality of pacing: staying within your limits to avoid PEM and managing your body’s unpredictable demands.
5. Research Confirms: Long COVID Isn’t About Being “Lazy” or “Unfit”
There’s growing evidence that long COVID isn’t about laziness or being out of shape. Research points to immune system dysregulation, chronic inflammation, and damage to blood vessels as underlying causes. These findings confirm that long COVID is a complex, multi-system condition—far removed from simple deconditioning.
If it were merely about getting fitter, we’d be handed gym memberships, not complex management plans. But researchers are uncovering neurological, immune, and vascular impacts that explain why long COVID doesn’t respond to typical recovery methods.
Final Thoughts: Why We Need to Move Past the “Deconditioning” Myth
In a world where fitness culture encourages us to push harder, it’s easy to think that long COVID is just a matter of “toughening up” and getting back to exercise. But here’s the reality: long COVID is not your average post-illness recovery. It’s a condition where exertion can lead to PEM, heart rate can go rogue, and your immune system might decide to throw a party you didn’t ask for.
So, if someone suggests long COVID is just about being “out of shape,” feel free to hand them this article—and then rest as much as you need to. Recovery is about respecting your body’s limits and understanding that this isn’t your average post-illness fatigue.
Remember: your body is doing its best, even if that means moving at a slower pace than you’d like.
This article is based on personal experiences living with long COVID. Everyone’s journey with this condition is unique, and what works for one person might not work for another. For medical questions, advice, or treatment options, always consult a healthcare professional.
Long Covid Journey 