Exercise Your Lungs

Michael Asarch, 47, spent 20 years building swimming pools for a living. Now, instead of building pools, he swims in one three times a week to exercise his lungs and improve his breathing.

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A longtime smoker who was diagnosed with chronic obstructive pulmonary disease (COPD) in 2000, Asarch breathes with the assistance of an oxygen canister 24 hours a day, seven days a week. His lung disease prevents him from breathing well enough on his own to get the oxygen his body needs. “When I swim, there is a metal tank on the side of the pool with 50-foot nose cannula to deliver the oxygen,” says the Denver father of two.

Despite his breathing difficulty, exercise is an important part of Asarch’s treatment. On the days he doesn’t swim, he takes 20-minute walks. “If you just sit in a chair all day and feel sorry for yourself, your lung function is only going to get worse,” he says.

COPD, which is estimated to affect 30 million Americans and is the fourth-leading cause of death in the United States, is a term referring to chronic diseases in which the tubes that carry air into and out of the lungs are partly blocked. Chronic bronchitis, the inflammation and eventual scarring of the lungs’ air passages, and emphysema, the enlargement and destruction of air sacs in the lungs, are the most common forms of COPD.

Most cases are caused by cigarette smoking. Other risk factors include long-term exposure to lung irritants, including certain chemicals, dust, fumes or secondhand smoke, as well as genetic factors.

How exercise helps
During its early stages, the disorder causes minimal shortness of breath. Some people, like Asarch, eventually require supplemental oxygen to help them breathe. While there is no cure, the disease typically is managed with medications and lifestyle changes, including quitting smoking and increasing physical activity.

“Exercise is an integral part of the treatment of COPD,” says Dr. Barry Make, co-director of the COPD program at the National Jewish Medical and Research Center in Denver.

Regular physical activity has numerous benefits for people with the lung disease. “For starters, it reduces shortness of breath, which means patients can do more and go further without getting short of breath,” Make says. “This really improves their quality of life.”

Exercise also helps lessen the depression and anxiety that often go hand-in-hand with COPD. It also helps with weight control, which lowers the risk for other health problems, such as heart disease and diabetes—diseases that claim the lives of many people who have smoking-related lung disease.

Asarch says exercise has been tremendously beneficial for him. “I’m feeling better than I have in a long time,” he says. “Exercise keeps your airways open and when you have COPD, everything starts closing up, so it’s vitally important that you get out and move.”

Exercise regime
A typical exercise program for a person with COPD consists of a warm-up stretch, some strength training to help with the muscle weakness that can accompany the disorder, and aerobic activity. Those who have any breathing problems should talk to their doctor before beginning an exercise program.

“I advise patients to build up to exercising three or four days a week for at least 20 minutes at a time,” Make says. “If they also need to lose weight, I recommend exercising for longer periods of time.”

Following a brief warm-up, aerobic activity such as walking, swimming or riding a stationary bicycle can be very effective, he says. A physical therapist can plan an appropriate strength training routine.

Exercise is an essential part of pulmonary rehabilitation programs, comprehensive programs that also include education about lung disease as well as psychological and nutritional counseling. Asarch participated in pulmonary rehabilitation before adopting his own exercise regimen.

“The whole key is to exert yourself a little bit,” says Asarch, whose breathing has improved enough that he can take his daughters on weekend camping trips. “I may not be able to do a lot of the physical stuff that I used to,” he says, “but we still go places and there is a lot I can do.”

Breathing Better with COPD

Certain breathing exercises can help people with chronic obstructive pulmonary disease (COPD) breathe better and more deeply.

“People with COPD have lungs that are hyperinflated,” explains Dr. Samuel A. Allen, a pulmonologist at William Beaumont Hospital in Troy, Mich. “There is no more room for their lungs to expand,” he adds. “The only way they get air in and out is to breathe fast and shallow.”

One breathing technique that can help people with COPD control shortness of breath when exercising, climbing stairs, bending or lifting is called “pursed-lip breathing.” To practice this exercise, inhale through the nose until the abdominal muscles expand. Then, purse your lips as if you were about to whistle or give a kiss, and exhale gently through the mouth while making a hissing sound. The exhalation should be twice as long as the inhalation. This technique slows the breathing rate and helps to keep airways open.

Yoga, a series of stretching exercises that link breath with movement, can help, too. “Yoga can help people with COPD concentrate on their breathing and breathing patterns and learn to control the respiratory muscles and decrease the anxiety surrounding being short of breath,” Allen says. Poor posture can compromise breathing by squeezing the lungs, but yoga poses in which you keep the neck, head and spine straight and relaxed can help with breathing by encouraging lung expansion. If you have COPD or any breathing problems, talk to your doctor about which breathing exercises will be most helpful for you.

Story by Denise Mann of New York City.

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