Long COVID Service Breathless Management

The purpose of this leaflet is to provide different exercises that you can complete to help manage your breathing, reduce anxiety and relax.

Relaxing your shoulders

Relaxing your shoulders will help you to relax those accessory muscles when out of breath. This will help optimise your breathing and reduce oxygen demand.

Breathing control (diaphragmatic breathing)

This is a more efficient way of breathing which will help you to relax and gain control of your breathing. It will help you to implement a correct breathing pattern into your daily routine.

1. Sit in a well supported position where your back is rested, that is, sat upright in bed, sat in an armchair, or lying flat with your knees bent
2. Start by making sure your head, neck, shoulders and upper chest are relaxed
3. Place one hand on your upper chest and one hand on your stomach just above your belly button
4. Breath in through your nose and out through your nose or mouth – counting as you breath (in 2, 3 and out 2, 3, 4).

You should feel little movement from your upper chest, your stomach should rise as you breathe in and fall as you breath out, your breathing should be quiet and effortless. Practice this multiple times per day to make it more automatic.

Rectangular breathing

This strategy can help you to recover from anxiety, panic attacks and breathlessness. This technique can be incorporated with thumb squeeze or pursed lip breathing.

1. Focus on an item in the room that is rectangular, for example, TV, picture frame etc.
2. Follow the sides of the rectangle with your eyes clockwise
3. Breath in through your nose on the shorter sides
4. Breath out through pursed lips on the longer sides.

Focus on making the breath out longer, to help regulate and slow down your breathing. Continue following the rectangle around until you feel relaxed and in control of your breathing.

Fan therapy

Using a handheld fan can help you relax and feel that you’re getting more air by stimulating nerves around your mouth and nose. When these nerves are stimulated, signals are sent to the brain to calm your breathing down.

1. Make yourself comfortable and place the fan approximately six inches from the face
2. Aim the fan towards the centre of your face so you can feel the breeze around your nose.

Pursed lip breathing

This technique can be used any time to help you gain control of your breathing.

1. Slowly breath in through your nose and purse your lips as if you were to blow out a candle
2. Breathe out through your mouth in the pursed lip position as much as you feel comfortable - not forcing air out till your lungs feel empty.

Blow as you go

This is for when you are completing a task that you know makes you breathless. It can be used in conjunction with pursed lip breathing.

1. Breathe in before you do the action - breathe in before the step
2. Breathe out through pursed lips whilst doing the action - breathe out whilst stepping/standing up.

Thumb squeeze

Acupuncture points can help our nervous system to relax and reduce anxiety.

1. Using two fingers, squeeze the webbing between the thumb and index finger for four to five seconds and then release
2. Repeat as needed throughout the day.

Positions of ease

Position 1: Lean against a wall. Your shoulders should be relaxed and arms hanging loosely by your side.

Position 2: Sit forward resting your arms or elbows on your knees. Let your head and shoulders relax.

Position 3: Lean forward on a windowsill or wall that is a suitable height. Relax the shoulders and head.

Position 4: Lie on your side with your knees bent and a slope of pillows to raise your shoulders with another pillow to rest your uppermost arm on. The top pillow should be above the shoulder supporting your head and neck and another pillow between your knees. 

Contact us

If you have any questions relating to the content within this leaflet, please contact your physiotherapist for further guidance. Or contact the team at Netherton Health Centre, Magdalen Square, Bootle, L30 5SP or call 0151 247 6417.

Our patients matter

Mersey Care NHS Foundation Trust listens and responds to patients and their carers to help improve the services we deliver. If you have any comments, compliments or concerns you can speak with a member of staff or contact our Patient Advice and Liaison Service (PALS) and Complaints Team.

Phone: 0151 471 2377 or 0800 328 2941 Email: palsandcomplaints@merseycare.nhs.uk

To request this leaflet in an alternative format or language, please speak to a member of staff.

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