Training your body is about more than doing arm curls to work “the guns” or crunches for six-pack abs. Your lungs need training too. It doesn’t matter if you’re an elite athlete or managing a chronic respiratory condition. Some simple exercises can increase your breathing capacity. This means you won’t just feel better working out. You’ll feel better, period.
Laboring Lungs
Lungs are always active. Whether you’re on the final leg of a triathlon or wandering through an endless parking lot trying to find your car, your lungs are engaged. They are constantly working to bring oxygen into your body and expel carbon dioxide. Meanwhile, your equally hard working heart is pumping oxygen to your muscles. The difference between what our lungs do when we’re lying in bed binge-watching, versus when we exercise is striking. Most people breathe around 12 breaths per minute at rest with a resting tidal volume of 500mL. This produces a minute ventilation of 6 Liters per minute at rest. With vigorous exercise, average people can increase their respiratory rate to 50 breaths per minute with a tidal volume of 2.5L and maybe even 3 L. This produces a minute ventilation of over 100 LPM.
In addition to lung function, a patient’s conditioning also helps determine their functional capacity. Think of it this way, an average 30-year-old without any lung disease but doesn’t exercise regularly will most definitely struggle to complete a marathon run if asked to do so. On the other hand, a well-conditioned athlete would be able to complete the marathon as they are in peak physical conditioning to do so. It’s especially important for patients with lung disease to understand this concept. If you have a chronic lung disease, yes you will have more difficulty with exertional activities than the average person without lung disease. However your conditioning will spiral downwards if you do not incorporate regular exercise into your lifestyle. This will make it more difficult to complete even simple activities you are currently capable of completing. Incorporating these breathing exercises into your lifestyle will prevent this downward spiral and improve your quality of life.
Patients with chronic lung diseases such as COPD, asthma, and pulmonary fibrosis have different reasons why their lungs may limit their physical function. However, no one escapes father time. Everyone’s lung function declines gradually over time starting around age 25-30 when people hit peak lung function. This is one reason why by the time you hit age 40 you may notice certain exercises being more difficult than when you were in your 20s. Regular aerobic exercise can also benefit people without lung disease by helping to maintain optimal cardiopulmonary conditioning. As always, consult with your primary care provider before engaging in any new exercise programs.
Belly breathing
Yoga practitioners are familiar with this. So are martial artists. Most of us breathe from the chest. This makes sense, as it’s where our lungs are. However, the diaphragm is the most important respiratory muscle. Emphasizing the diaphragm will help us all breathe better–especially people with COPD.
The exercise can be done lying down or sitting. If you are lying down, it can help to bend your knees or put a pillow under them. Put one hand on your tummy, the other on your chest. Breathe in through your nose for two seconds. Focus on your belly –– it should be moving more than your chest. Hold it for two seconds, then purse your lips like you’re pouting and breathe out for two seconds. Be aware of your stomach muscles –– they should be doing the work of exhaling.
This is also an excellent meditation technique. The trick is to close your eyes and extend the lengths of your breaths –– until you are inhaling, exhaling, and holding your breath for a count of five or six. Your inhales and exhales should be of equal length.
Pursed lips breathing
A variation of the above technique, the goal with pursed-lips breathing is to slow down your breathing. It will keep your airways open longer and reduce the work of breathing. The carbon dioxide/oxygen exchange will be improved. Considered easier to do than belly breathing, it can be done anywhere. Simply inhale slowly through the nose. Then breathe out through pursed lips. This should take twice as long as your inhale. Repeat. This is a great way to manage anxiety; try doing it on the way to a store, work, or any other environment you find stressful.
Rib Stretch
Exhale all of the air from your lungs while in a standing position. Breathe in slowly until your lungs are full. Put your hands on your hips –– make sure that your thumbs are pointed forward. Your pinkies should touch the small of your back. Exhale the air very slowly. Relax. Repeat. Try to do this exercise at least four times.
The Push Out
Everyone has heard of the push up. Well, this breathing exercise, the “push out,” is a bit more involved than the others. Stand up. Keep your knees relaxed as you bend at the waist. Push out the air from your lungs. Return to standing upright. Inhale slowly, filling your lungs to capacity. Lift your arms while holding your breath –– try for at least 20 seconds. Relax, lowering your arms as you exhale. Take a deep breath, then bend over once again. You should do this exercise four times.
The importance of consistent activity
Breathing exercises and aerobic exercises are not enough. Even if you are training three hours a day, it’s a small fraction of the time your lungs are working. After all, these organs are on the job 24/7. Foods rich in antioxidants like blueberries, pecans and spinach can help your lungs. Antioxidant supplements appear to be less effective. The Centers for Disease Control and Prevention’s Physical Activity Guidelines recommends that adults get at least 150 minutes of moderate-intensity aerobic physical activity or 75 minutes of vigorous-intensity physical activity, or an equivalent combination each week. If you’re not already exercising regularly, walking is a great way to meet this mark. Start with short strolls and go from them. In colder weather, many prefer mall walking to outdoor activity. Quitting smoking also has immediate benefits.
The truth is, most of us don’t pay much attention to our lungs until we have a hard time catching our breath. Give your lungs some quality time now, and you will be rewarded with excess capacity and reduced anxiety later.
Written by John Bankston
Kelly Fan, MD