The effects of COVID-19 have been felt across all areas of life, but for some Australians, the impact continues well beyond the initial illness. A growing number of people are living with long COVID, a condition that can cause fatigue, breathlessness, brain fog and pain for months after infection. Others are dealing with post-viral fatigue from different illnesses. Physiotherapists are playing an important role in helping these people rebuild their strength, regain confidence and find a safe path back to normal life.

Long COVID is still being studied, but it is now recognised as a genuine health condition. It affects people differently. Some experience lingering chest tightness or trouble breathing. Others struggle with exhaustion after only mild activity. In some cases, memory and concentration are affected, making work and daily life difficult. What most patients share is a sense of frustration. They want to feel better, but pushing too hard too soon can lead to setbacks.

This is where physiotherapists can help. Using their knowledge of movement, recovery and chronic illness, they support patients in managing symptoms and improving function at a steady, manageable pace. Unlike recovery from a broken bone or joint injury, the approach for long COVID must be more gentle and flexible. The focus is on pacing, energy conservation and slow, guided rehabilitation.

Physiotherapists begin by understanding each person’s experience. They assess breathing patterns, posture, mobility and daily activity levels. Many people with long COVID develop unusual breathing habits without realising it, such as shallow upper-chest breathing. Physios teach breathing control techniques to restore a more natural pattern, which can reduce fatigue and anxiety.

Energy management is another key area. Patients are often guided to track their activity and symptoms, looking for patterns that might be causing crashes or flare-ups. Physiotherapists introduce pacing techniques that allow people to spread tasks throughout the day and avoid overexertion. This approach is often called the "energy envelope" and helps patients stay active without making symptoms worse.

Strength and conditioning exercises are added gradually. These might include seated stretches, light resistance work or walking plans, depending on the individual. The goal is not fast progress but safe progress. Some patients can return to regular activity within weeks, while others may take months. Physiotherapists monitor and adapt the plan as needed, ensuring that setbacks are addressed and not ignored.

Post-viral fatigue is not new. People recovering from illnesses like glandular fever or influenza have long reported similar symptoms. What is new is the scale of the issue. With COVID-19 having affected millions of Australians, long COVID has put a spotlight on post-viral conditions that were once overlooked. Physiotherapists are now drawing on past experience while adapting to the new challenges of this widespread condition.

Support is particularly valuable for people whose daily life has been turned upside down. Some cannot return to full-time work or care for their families as they once did. Physiotherapy can help them set short-term goals and measure small wins. This might mean being able to walk to the letterbox, cook dinner without needing to lie down, or return to work for a few hours a week. These may seem like minor steps, but for someone with long COVID, they represent major progress.

In some parts of Australia, dedicated long COVID clinics have been set up within hospitals or health networks. These often include physiotherapists as part of a wider team, along with occupational therapists, psychologists and doctors. For those without access to such clinics, community physiotherapists are providing one-on-one care, either in person or via telehealth.

Access to care can still be uneven. Long COVID is not always well understood by employers, health insurers or even some healthcare providers. Physiotherapists are helping to raise awareness of the condition and its impact. They also support patients in navigating medical systems, applying for workplace adjustments or accessing financial support when needed.

Mental health is a major part of recovery. Living with long-term fatigue and uncertainty can take a toll on a person’s confidence and mood. Physiotherapists are not mental health professionals, but their encouragement and regular contact often help reduce feelings of isolation. Some work closely with psychologists or refer patients when extra support is needed.

There is still much to learn about long COVID, but physiotherapy is already proving to be a valuable part of the response. It offers practical, evidence-informed support that focuses on the whole person, not just the symptoms. For people trying to rebuild their strength after months of illness, this kind of care can make all the difference.

As understanding of post-viral conditions continues to grow, physiotherapists will remain a key part of helping Australians manage fatigue, restore function and return to the activities they value most.