Best Breathing Exercises for Asthma

This article is based on reporting that features expert sources.

For most of us, breathing is an automatic action we don’t often think about – it just happens without any conscious effort. But for some people with lung conditions, the simple act of breathing can be a much more difficult proposition.

If you're one of the estimated 25 million Americans who have asthma, catching your breath can sometimes be a challenging endeavor. But in addition to managing your asthma with medications, your doctor may encourage you to increase how much you exercise you get and even offer specific breathing exercises to improve your lung function.

What Is Asthma?
“Asthma is a chronic lung condition that affects the airways,” says Dr. Sumita Khatri, co-director of the asthma center at the Cleveland Clinic in Ohio. “Asthma stems from inflammation that causes airways to narrow, producing symptoms such as cough, tightness in the chest, wheezing and shortness of breath. Asthma also causes the cells that line the airways to produce more mucus.” All of these changes in the lungs can add up to difficulty breathing.

But asthma is actually a very heterogeneous condition, meaning that it can take many forms. Dr. Brian Modena, an allergist and assistant professor in the division of allergy and clinical immunology at National Jewish Health in Denver, says that “asthma is an umbrella term,” that describes a diverse array of symptoms and types.

A few of the more common types of asthma include:

Exercise-induced asthma, or sports asthma, in which symptoms are triggered or exacerbated by physical activity.
Allergic asthma, in which an allergen such as pet dander or pollen cause or exacerbate symptoms.
Nonallergic asthma, which is triggered by external factors that are not allergens, such as infections, medications, stress, food additives and weather.
Occupational asthma, which is caused or worsened by workplace exposure to triggers, such as chemical fumes or dust.
Best Asthma Exercises
For all types of asthma, even exercise-induced asthma, “exercise is important overall for good health,” says Dr. Jack Stewart, a pulmonologist with St. Joseph Hospital in Orange California. “Exercise improves the efficiency of skeletal muscles and improves cardiovascular fitness.” These improvements can help support your body as it tries to clear the lungs of secretions. Generally speaking, you should always seek to be as active as possible, but especially when you have a chronic lung condition such as asthma.

But when it comes time to exercise, which is the best one for asthma? Most any kind of exercise can support overall health and wellness. The key is to pick something you enjoy doing that you’ll be able to keep up long term. Experts suggest that certain exercises may be better than others for people with asthma, including:

Swimming.
Running, walking or biking.
Respiratory therapy or pulmonary rehabilitation.
Yoga and breathing exercises.
Breathing retraining.
If you have asthma but want to start exercising more, talk with your doctor before you get going. Dr. Purvi S. Parikh, an adult and pediatric allergist and immunologist with NYU Langone Health, says it’s important to “get on appropriate medication and get your asthma under control before you try vigorous exercise.” Stewart adds that “exercise-induced asthma is usually able to be well controlled by using two puffs of albuterol (a rescue inhaler) prior to exercise if the underlying asthma is well controlled.”

Swimming

Stewart says “swimming may be the best exercise for asthma,” because in addition to the full-body, low-impact cardiovascular workout that it provides, swimming often occurs inside a warm, humid pool area. “Breathing warm, moist air is less likely to trigger asthma,” Stewart says, but notes that if the chemicals in the pool aren’t properly regulated, that could actually make symptoms worse. “Very heavily chlorinated pools might trigger asthma,” because when chlorine comes into contact with organic compounds, such as sweat or urine, that creates compounds called chloramines that can irritate the skin, eyes and respiratory tract, the Centers for Disease Control and Prevention reports. In pools that aren’t well maintained or properly ventilated, a build-up of chloramines can cause breathing problems in sensitive individuals.

Running, Walking or Biking

In addition, “running, walking and biking are all good options, but you should avoid doing so on days with bad air quality,” Stewart says. The Office of Air Quality Planning and Standards, a division of the Environmental Protection Agency, publishes a zip-code searchable air quality index online, and this information is often included in your local weather report. The air quality index measures how much pollution is in the air. The more pollutants, such as ozone, carbon monoxide and sulfur dioxide are in the air, the more difficult it becomes for anyone to breathe. People with severe asthma are likely to be a lot more sensitive to fluctuations in air quality levels.

Similarly, breathing in cold air can trigger asthma symptoms in some people. This is because cold air is drier than warm air, and that dryness can pull fluid out of your lungs faster, resulting in coughing. In some people, cold air can also trigger the body to produce histamine, the same compound the body makes in response to an allergen. Increased levels of histamine can lead to wheezing, coughing and other allergy responses. This all means that activities like cross-country skiing may be a less ideal option than cycling indoors on a cold day.

Respiratory Therapy and Pulmonary Rehabilitation

Although asthma is sometimes thought of as a children’s disease, it also affects adults. It’s incurable, and most people with asthma have symptoms their entire life. The CDC reports that 1 in 12 people have asthma, a total of some 25 million people. The statistics further show that 7.7% of adults and 8.4% of children have the disease. If you have asthma but struggle with mobility, Stewart recommends seeking out a “supervised exercise program run by a physical therapist or respiratory therapy.” In severe cases of asthma at any age, a pulmonary rehabilitation program might be a right approach. Pulmonary rehabilitation is a combination of education and gentle exercises usually led by a respiratory therapist and designed to help you breathe easier. Your doctor can help connect you with a good program.

Yoga and Breathing Exercises

Not all exercise has to be super strenuous to be effective. Carol Krucoff, a yoga therapist with Duke Integrative Medicine and co-author of “Relax into Yoga for Seniors: A Six-Week Program for Strength, Balance, Flexibility, and Pain Relief,” says yoga can be a great option for people with breathing difficulties because much of a yoga practice centers on learning to breathe in a more efficient way. “Everyone alive knows how to breathe. That’s a given. But the reality is that many people in Western culture don’t breathe correctly; they don’t breathe efficiently.”

She’s talking about our tendency to breathe shallowly, out of the chest, instead of breathing deeply from the belly. Diaphragmatic or belly breathing uses the diaphragm, which is the large muscle under the rib cage, to help push more air into and out of the lungs. In her book, Krucoff writes that diaphragmatic breathing “can be a powerful way to help people with lung disease to strengthen and learn to properly use the diaphragm, which is the main muscle of breathing.” In some patients with severe asthma, air can get trapped in the lungs. Focusing on belly breathing and practicing it regularly until it becomes a habit can help you remove every last bit of spent air from your lungs.

Another breathing exercise that can help improve how air flows into and out of your body is a technique called pursed lip breathing. This type of breathing, in which you position your lips as though you were trying to blow out candles on a birthday cake, keeps your airways open longer to help flush out any spent air caught in the lungs. In addition to yoga, you can also choose to use a breathing trainer like OPUMP to perform the above breathing exercises anytime, anywhere.

Breathing Retraining

Studies have shown that a strategy called breathing retraining that focuses better breath control can be helpful for many asthma patients. There are a variety of approaches out there, and some formal programs, such as the Papworth method or Buteyko breathing. The basic idea of breathing retraining is to relax and relearn how to breathe. Breathing retraining may include:

Focusing on breathing through the nose instead of the mouth, as this gives your body time to warm up the air and add moisture to it as it passes through the respiratory tract.
Slowing down your rate of breathing by adding pauses and breath holds as much as possible to prevent hyperventilation and to allow the lungs to completely empty between breaths.
Relaxing and trying to not feel anxious or tense about breathing.
Encouraging good posture, which can improve how air flows into and out of your lungs.
As with other forms of exercise, talk to your doctor before you embark on any specific training regimen and get some pointers from a qualified provider for the best ways to apply different breathing techniques and exercises.

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