SARS-CoV-2, the coronavirus that causes COVID-19, attacks the lungs and other organs of the respiratory system. While symptoms can be mild, severe cases often lead to pneumonia and acute respiratory distress syndrome (ARDS). Lung damage can persist long after the acute illness has passed. While lung function recovery is certainly possible, it may require breathing exercises and other therapies for several weeks or months. 

“Deep breathing can help restore diaphragm function and increase lung capacity,” says Johns Hopkins physical therapist Peiting Lien. “The goal is to build up the ability to breathe deeply during any activity, not just while at rest.” In a recent article, Lien provides several breathing exercises to help COVID-19 and Long COVID sufferers expand their lung capacity and restore breathing function. 

A Word of Caution 

Lein warns that you should not start these exercises and should call your doctor if you have:

• A fever
• Shortness of breath or difficulty breathing while at rest
• Chest pain or palpitations (the sensation of “fluttering” in your chest)
• New swelling in your legs

If you’ve already started doing the exercises, you should stop immediately if you experience:

• Dizziness
• Unusual shortness of breath 
• Chest pain
• Cold, clammy skin
• Excessive fatigue
• Irregular heartbeat

Call 911 if these symptoms don’t stop after resting for a few minutes.

Recommended Breathing Exercises

Lien’s recommended regimen includes deep breathing (while on your back, on your stomach, sitting upright, and standing) and exercises that incorporate deep breathing and motion.

Deep Breathing

Deep breathing through your nose strengthens your diaphragm and relaxes your nervous system. There are three phases, or positions, to this exercise: 

• On your back, with knees bent
• On your stomach, with your head resting on your hands
• Sitting upright at the edge of a bed or on a sturdy chair
• Standing

In each position, deep breathing involves inhaling slowly through your nose, with your mouth closed. Imagine that you are drawing your breath all the way down to your stomach. Exhale slowly through your nose. Repeat for one minute.

Only move from one phase to the next when you can complete the previous phase without struggling to breathe. 

Yawn to Smile

This exercise helps to:

• Increase your coordination 
• Build strength in your arms and shoulders  
• Open up the muscles in your chest, giving your diaphragm space to expand

Sitting upright on the edge of a bed or in a chair, reach your arms up over your head and stretch your mouth as though you are yawning. Lower your arms and smile for three seconds. Repeat for one minute. 

Humming While Exhaling

Humming while exhaling increases nitric oxide production in the body. Nitric oxide:

• Builds neural plasticity 
• Dilates blood vessels 
• Reduces stress by calming the nervous system

Sitting upright on the edge of a bed or in a chair, inhale through your nose, drawing the breath down into your stomach. When your lungs are full, slowly exhale while making a “hmmmmmmmm” sound through closed lips. Repeat for one minute.

These exercises can also be used to help patients with other illnesses besides COVID-19, says Lien. “Working toward recovery starts simple: with a focus on breathing.”

*Lien, P. (2021). Coronavirus Recovery: Breathing Exercises. Johns Hopkins Medicine. https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/coronavirus-recovery-breathing-exercises 

Much about the novel coronavirus, i.e., COVID-19, is still not fully understood. As research progresses and our knowledge of the virus increases, information can change rapidly. We strive to update all of our articles as quickly as possible, but there may occasionally be some lag between scientific developments and our revisions.