Long Covid Symptom: Solar Plexus/Diaphragm Tightness

Dr. Brian Lum


I am a doctor and certified practitioner of functional medicine who has specialized in helping people heal from complex illnesses for over a decade.


This experience has made me no stranger to complex symptoms that can result from infection, and I was unsurprised when thousands of people started to experience what is now referred to as ‘Long Covid’ soon after the pandemic started.


My wife and I contracted Covid in March of 2020, and while I recovered quickly, my wife developed Long Covid. Using my experience treating complex illnesses and her feedback, we have developed techniques and treatment plans to help resolve Long Covid symptoms.


One symptom, in particular, is remarkably consistent among my Long Covid patients: a persistent feeling of tightness in the solar plexus/diaphragm region that makes taking a natural, deep breath difficult.




Many patients report a feeling of muscle tightness in the solar plexus/diaphragm area of their chest. This spot is located in the soft hollow in the center of the chest beneath the sternum.

a 3d anatomical image with the diaphragm highlighted

Sometimes patients can feel a very tight ‘knot’ in this area with their fingers; others only notice the tightness when a deep breath is attempted.


Many patients find themselves compensating for this by taking deep breaths outside of their natural breathing rhythm and by raising their shoulders to try to take in more air.


This symptom is usually accompanied by a sense that the patient is never getting enough oxygen even when their oxygen levels have been checked by their doctor.


Solar plexus/Diaphragm tightness is also a symptom that is highly responsive to stress. Increased physical activity, work stress, trying to push yourself in any way, or having a fight with a spouse can all worsen this symptom. This is due to oxidative stress, which we will discuss more below.


Tightness is usually accompanied by anxiety, depression, fatigue, breathlessness, sleep problems, muscle cramps, and muscle twitches.




Recent medical research is putting forth various potential causes for this feeling of tightness in the solar plexus/diaphragm area.


Everything in functional medicine is about tailored treatments and good diagnostics.

Remember that the same symptom can have different causes for different patients, and different treatments could be employed for the same symptom depending on the patient’s needs!


Another note is that I have not yet had a patient with ONLY solar plexus/diaphragm tightness; they always have secondary symptoms, which points to a more systemic problem like the ones below.




There is evidence that a Covid infection can cause pathological changes in the muscle tissue in the diaphragm resulting in scar tissue. [1]


The presence of scar tissue can impede the normal range of motion of a muscle.


Depending on the location and quantity of scar tissue, as well as the presence of any underlying conditions – there are various ways to reduce and remove scar tissue, and scar tissue can also heal on its own. [2]




Your mitochondria are responsible for energy production; unfortunately, this process can be impaired due to a Covid infection.


Researchers theorize that Covid can trigger a redox imbalance, where the balance between antioxidants and oxidative stress is disturbed. [3]


A Covid infection essentially hijacks the mitochondria so that they start producing inflammatory compounds and molecules that disrupt the natural function of your immune system.


These compounds are intended to shut down your immune system enough so that the virus can survive. In the process, mitochondria can become impaired in their ability to produce energy for the body in the long term. There is also a resulting impairment in oxygen utilization which creates chronic states of low energy and disrupted oxygen distribution (which is why patients can feel like they are not getting enough oxygen).


Another knock-on effect of a Covid infection is that it affects microglia (immune cells for the nervous system), resulting in the nervous system becoming inflamed.


These inflamed microglia explain why exercise and exertion can make your fatigue and feelings of breathlessness so much worse. Metabolic fitness and overall oxygen capacity are affected.


Fortunately, there is a range of effective lifestyle interventions that, when paired with treatment from a functional medicine practitioner, can result in improved mitochondrial function. [4] [5] [6]




Not all forms of inflammation are bad; in fact, inflammation is one of the methods our body uses to heal itself.


If you cut your finger and it gets red and hot, that inflammation is speeding white blood cells to the site and carrying away and killing pathogens; even the heat helps the body stave off infection.


Often, the reason why symptoms last far beyond the initial infection (not just for covid but for other viral and bacterial infections, too) is that there is oxidative stress in the mitochondria, which perpetuates chronic inflammation.


That inflammation is the body’s attempt at clearing the virus. When the infection is over, excess inflammation should go back to normal, but in some people, the inflammatory cycle continues.


This causes the body to be in a chronically inflamed state where it has trouble cleaning up viral debris from the initial infection and is compromised on a cellular level.

  • TAKE IT SLOW Particularly early in your recovery, do not try to go back to your normal routine right away. Rest more than you think you need to. Take baby steps when getting back into your exercise routine. If you have a day when all your symptoms have returned, then it is a sign that you are moving too fast and you need to rest.

  • MONITOR FOOD REACTIONS It is very common for Long Covid patients to have developed new food allergies or sensitivities as a result of their initial infection. These allergies and sensitivities can produce severe symptoms. Dairy and gluten are the most common; monitor any adverse reactions and cut them out of your diet if you are symptomatic.

  • (CAREFULLY) ENGAGE IN SELF MASSAGE Gently massaging the solar plexus area with your index and middle finger in a circular motion (with the abdominal muscles relaxed and you leaning slightly forward in a seated position) can provide temporary relief.

  • ​Another area to massage is the spot in the abdomen halfway between the end of the chest bone (sternum) and your belly button. Often this area is tight and tender to the touch as well. When massaged, it can stimulate the restoration of lymphatic flow in the torso.

  • SEE A FUNCTIONAL MEDICINE PRACTITIONER Frequently, Long Covid symptoms result from fixable, diagnosable imbalances that are quickly resolved. Even with complex cases, functional medicine, with its specialized testing, superior diagnostics, and lengthened appointment visits, is ideal for getting to the bottom of persistent symptoms.



I cannot stress enough the importance of working with a functional medicine practitioner to pinpoint exactly what is causing this and any of your other Long Covid symptoms.


Advanced testing and accurate diagnostics can speed up your healing significantly and get you out of discomfort and back to your life. Too many patients have been told that there is nothing they can do but wait or endure painful symptoms. There is always something that can be done.


I offer functional medicine consultations for patients around the world.




Disclaimer: If you think that you may have a medical emergency, call your doctor or 911 immediately. No action or inaction should be taken based solely on the contents of this information. Nor should you ever delay seeking medical advice or treatment due to the information contained on this Website. The information on this Website is not intended to diagnose, treat, cure, or prevent any disease or medical condition. The information discussed is not intended to replace the advice of your healthcare provider. Reliance on the information provided by this Website, Dr. Brian Lum, or Functional Healthcare Institute is solely at your own risk.




[1] Shi Z, Bogaards SJP, Conijn S, Onderwater Y, Espinosa P, Bink DI, van den Berg M, van de Locht M, Bugiani M, van der Hoeven H, Boon RA, Heunks L, Ottenheijm CAC. COVID-19 is associated with distinct myopathic features in the diaphragm of critically ill patients. BMJ Open Respir Res. 2021 Sep;8(1):e001052. doi: 10.1136/bmjresp-2021-001052. PMID: 34544735; PMCID: PMC8453595.


[2] Martin CA, Gajendragadkar PR. Scar Tissue: Never Too Old to Remodel. JACC Clin Electrophysiol. 2020 Feb;6(2):219-220. doi: 10.1016/j.jacep.2019.11.003. PMID: 32081226.


[3] The Institute for Functional Medicine. Mitochondrial Impairment in Long Covid-19. https://www.ifm.org/news-insights/mitochondrial-impairment-in-long-covid-19/.


[4] The Institute for Functional Medicine. Mitochondrial Impairment in Long Covid-19. https://www.ifm.org/news-insights/mitochondrial-impairment-in-long-covid-19/.


[5] Burtscher J, Burtscher M, Millet GP. The central role of mitochondrial fitness on antiviral defenses: An advocacy for physical activity during the COVID-19 pandemic. Redox Biol. 2021 Jul;43:101976. doi: 10.1016/j.redox.2021.101976. Epub 2021 Apr 23. PMID: 33932869; PMCID: PMC8062414.


[6] Leung B. Role of Nutrients for COVID-19 recovery: an integrative approach. Eur J Integr Med. 2021 Dec;48:101978. doi: 10.1016/j.eujim.2021.101978. Epub 2021 Dec 17. PMCID: PMC8696099.