This is a common misconception with long COVID. Many people believe that the fatigue and disability experienced by those with Long COVID is simply a result of deconditioning or inactivity.

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However, the fatigue that comes with long COVID is a result of physiological changes to the body. Long COVID is characterized by Post-Exertional Malaise, or PEM, which is a condition where over-exertion results in worsening fatigue and symptoms (you can learn more about PEM here).

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For those with long COVID, traditional graded exercise programs should be avoided. Graded exercise programs involve progressively increasing exercise time or difficulty week after week and pushing oneselves to achieve this. These programs are typically prescribed to help people recover from deconditioning. However, graded exercise programs will typically trigger long COVID symptoms and make fatigue worse. Therefore, this approach should be avoided.

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Instead, an approach called symptom-titrated activity progression is typically recommended. This will be reviewed in more detail later in this section.