Exercise and relaxation techniques for managing breathlessness Written by Charlotte on Tuesday the 21st of November 2017. In a special blog for PH Awareness Week, Carol Keen, a clinical specialist physiotherapist in pulmonary hypertension at the Royal Hallamshire Hospital, shares her tips for managing breathlessness with exercise and relaxation techniques. Breathlessness is the most common symptom of PH and patients often fear that taking part in any kind of exercise will worsen their symptoms. However, there are particular forms of gentle exercise and breathing techniques that can help improve breathlessness. Just as you would train the muscles in your legs to walk or run, it is important to train the muscles in your diaphragm to be able to control your breathing. Yoga and Pilates are two exercises that focus on breathing control and strengthening the muscles. Practice yogic breathing Practicing yogic breathing at home or attending a yoga class can help manage symptoms. Yoga is an ancient form of exercise that focuses on strength, flexibility, and breathing to boost physical and mental wellbeing. The main components of yoga are postures (a series of movements designed to increase strength and flexibility) and breathing. Most yoga classes begin and end with a relaxation and breathing component. Typically, Hatha yoga classes are a basic and classical approach to yogic breathing exercises and postures and may be a good place to start. Alternatively, ask your yoga teacher if they are offering any beginner sessions. Strengthen the muscles with Pilates As one of the six original Pilates principles, the breath is also the foundation of Pilates movement. A technique called lateral breathing is used to coordinate the exercises with inhaling and exhaling patterns, and the breath is used to initiate and support movement. Adding lateral breath to your diaphragmatic breathing will increase your overall breathing capacity. Please consult your physiotherapist or doctor before trying yoga or Pilates, and remember to let your teacher know about your PH. I would advise patients to avoid head down postures, where the head is below the heart. Join a choir If yoga and Pilates don’t sound right for you, you might be surprised to find that joining a choir can not only boost your wellbeing but can improve your lung function too. This is because the vocal exercises that take place during a choir practice help control your breathing. Rock Choir offers an alternative experience to the traditional classical or community choir, pioneering a new approach to vocal training and entertainment. Search for your nearest choir. Alternatively, download a useful ‘Singing for Breathing’ audio CD. Try mindfulness Concentrating on techniques to manage your breathing is important because it gives you opportunities to relax, rather than experiencing shallow, anxious breathing. Coping with anxious thoughts and breathing could be improved through a technique called mindfulness. Mindfulness is the practice of paying more attention to the present moment – to your own thoughts and feelings, and to the world around you. Mindfulness meditation involves sitting silently and paying attention to thoughts, sounds and the sensations of breathing or parts of the body, bringing your attention back whenever the mind starts to wander. Photo by Lesly Juarez on Unsplash Many people have found the headspace app useful for practicing mindfulness and relaxation techniques. The app teaches you how to meditate and can help people feel less stressed, improve sleep and feel more focused. These are just a few of the techniques I would recommend trying out to help control your breathing and to start on a journey to improving your symptoms of breathlessness. PHA UK also offers a CD guide to managing breathlessness. Please call the PHA UK office on 01709 761450 or email firstname.lastname@example.org to obtain your copy. It’s all about finding what works for you and what feels right for your body. Please always consult your physiotherapist or doctor before carrying out a new exercise practice, as they will be able to advise and support you.