The Role of Physiotherapy in “Long-Covid” and how to advocate.

Stairs - showing oakville RMT

We are learning every day about how Covid-19 affects our bodies. So much has been identified with regards to the common symptoms, whether mild or severe.

We go through a list of Covid-19 symptoms with every patient, at every appointment in our North Oakville clinic. We see the lists upon entering our local grocery stores.

There has been a little confusion with regards to mild symptoms. Many people have assumed because the symptoms they have been experiencing have been like their colds, that it couldn’t be COVID-19. This is not necessarily the case. This is also why our Physio’s, RMT’s, Acupuncturist and Chiropodists will not see you in person with any of these symptoms whether mild or severe. This is also why our PPE (personal protective equipment) standards are so high and why we ask you to wear masks to your appointments and wash / clean your hands upon entering the building and clinic.

But, that’s not the purpose of this blog.

The purpose of this post is to explore the role of community based Physiotherapists in treating patients who are recovering from COVID-19 or who have “long lasting COVID”.

In hospitals, Physio’s work to mobilize / move patients, they may provide breathing exercises, and as a person recovers they get them moving to prepare them for home or a rehabilitation facility.

Physiotherapists in the community such as us, work with patients to increase their quality of life, help with balance, increase strength and endurance, progress activities of daily living, help with various neurological symptoms.

Part of learning how Physiotherapists can help with COVID -19 recovery comes with learning more about what the long-term effects are.

Slacklining picture to show oakville and burlington physio and yoga clinic

Some people’s experience of the effects of COVID-19:

General Functional Limitations

Intensive care acquired weakness.

Weakness from immobility / bed rest at home / hospital.

Joint and body pain.

Chronic Fatigue Syndrome

If symptoms post-covid of fatigue, don’t resolve in 4-5 months of the infection, it may be diagnosed as Chronic Fatigue Syndrome. This is also known as Myalgic Encephalomyelitis.

Disturbance of Sleep

Cognition Deficits

Mood Changes / PTSD

Surprisingly, 86% of people with Long Covid report relapses over 7 months. Physical activity, stress, exercise and mental activity being the most common reported triggers of relapses.

Having decreased function and decreased ability to participate in activities of daily living are risk factors in hospital admission or readmission. Physiotherapist in the community have a role in helping keep people at home.

Physiotherapists in the community also will help optimize the recovery of patients who have experienced COVID-19.

There has been recent light shed on the fact that in general out-patient physiotherapy is not covered under OHIP in Ontario. It has been many years since it has been delisted and the people who qualify is quiet narrow. The amount of clinics who are able to take OHIP patients for physiotherapy treatment has been limited to a small number per capita. These clinics are “grandfathered in” and most of them are owned by large corporations, including hospitals.

As there are more people with a variety of symptoms as COVID long-haulers that could benefit from physiotherapy treatment that do not have access to them as noted in a recent CBC Marketplace article.

In the UK the NHS has invested in specialty clinics to focus on the health and recovery of COVID-19 long-haulers.

There are many Physiotherapists and other health care practitioners who are willing and able to assist these patients but there is a gap in many people’s ability to access care.

When we opened 6 years ago in North Oakville, we tried to apply to be able to accept OHIP and were told they were not giving out any more licences.

The good news is that we are able to assess and treat anyone because we are direct access. This means that we can assess and treat a person without a Doctor’s referral. We accept payment from private payers (yourself) as well as insurance companies other than OHIP.

The bad news is that there are many people who are not able to afford to pay out of pocket for care, especially right now.

What you can do:

It is easy to feel helpless these days. Your voice does matter.

shows woman receiving Telehealth / tele rehabilitation in Milton, Oakville, Burlington Ontario for pain.
  1. Davis HE, Assaf GS, McCorkell L, Wei H, Low RJ, Re’em Y, Redfield S, Austin JP, Akrami A. Characterizing Long COVID in an International Cohort: 7 Months of Symptoms and Their Impact. medRxiv. 2020 Jan 1.