Yoga asana and breathing exercises can help people with COPD (Chronic Obstructive Lung Disease) and related lung diseases. In fact, COPD patients who follow a routine woven around yoga, manage life with minimal or no medicine.
What is COPD (Chronic obstructive lung disease)?
COPD (Chronic obstructive lung disease) is the fifth leading cause of disability and is touted to be the third leading cause of death in the world by 2030, according to WHO – Global Burden of Disease.
COPD is characterised by persistent cough, irreversible airflow obstruction, dyspnea, increased work of breathing, gradual decline in lung function and a high rate of morbidity and mortality. The three lung disorders i.e. bronchitis, bronchial asthma and emphysema can lead to COPD.
How yoga and breath retraining/ pranayama helps a person with COPD?
Recent research indicates that various programs like yoga, pulmonary rehabilitation, tai chi and breath ‘pranayama’ training can help…
1. Improves lung volumes
2. Helps to improve energy level
3. Helps to reduce respiratory rate
4. Improves breath holding capacity
5. Reduce dyspnea and breathlessness
6. Helps to improve overall lung function
7. Helps prevent decline of lung function
8. Helps to strengthen respiratory muscles
9. Improves maximum voluntary ventilation
10. Improves exercise tolerance and exercise capacity
11. Helps relieve COPD associated Stress and anxiety
Yoga and breath retraining exercises/ pranayama improves lung function – possible physiology
COPD patients should start a yoga and breath retraining exercises program to help strengthen the respiratory muscles and gives some control over dyspnea and also overall body movement control.
1. Helps to de-stress
Ideally, during pranayama and yoga asana, practitioner not only tries to breathe but also concentrates on breath quality. This act of this single minded concentration helps to relives all worries and eventually de-stress by activating parasympathetic “rest-relax” nervous system.
2. Improves oxygenation
Recent research suggests that pranayama increases oxygen intake for up to five times as it involves vertical breathing; which allows alveoli of both lungs to open up and provides a vast expanse of alveolar membrane for exchange of gases.
3. Increases lung compliance
Pranayama and yoga postures helps to reduce elastic and viscous resistance present in lungs at the time of inhalation. It acts as a physiological stimulator to release lung surfactant and prostaglandins, which increases lung compliance.
4. Improves respiratory muscle efficiency
Breathing exercises and stretching postures strengthen principal respiratory muscles at the same time relaxes accessory muscles of respiration.
5. Helps efficient emptying and filling of lungs
Increase in respiratory muscle strength, cleansing of airways secretions and efficient use of diaphragmatic and abdominal muscles as a consequence of yoga, contributes to efficient lung functioning.
6. Causes rise in thoracic pulmonary compliances and Bronchodilation
Inflation of lung and alteration of breathing pattern can cause stimulation of pulmonary stretch receptors, which reflexively relaxes muscles of larynx and tracheobronchial tree. This ultimately reduces airway resistance.
Breath retraining and Dyspnea control strategies
First step in breath retraining is identification of present breathing patterns that includes respiratory rate and length of inhalation and exhalation this will help you to identify any irregularities in breathing patterns.
Breath retraining involves continuous breath awareness, monitoring and auto correction of irregular breathing pattern with the help of breathing strategies.
Some of the dyspnea episodes occurs as a result of incorrect or reverse breathing i.e. abdomen going in and not out during inspiration. So learning the correct pattern helps in following complications…
1. Shortness of Breath: Pursed lip breathing helps in relaxation and alleviation of shortness of breath. Counting along with pursed lip while breathing helps to calm down the breath-flow rhythm.
2. Hyperventilation: Conscious slow breathing as done in various techniques of pranayama helps to ease over breathing.
3. Accessory Muscles Breathing: The moment you notice recruitment of neck and shoulder muscles during inhalation, start relaxing your body and at the same time start doing pursed lip breathing slowly, steadily and consistently. Restore diaphragmatic breathing to ensure efficient breathing.
4. Dynamic Hyperinflation of lungs: Due to Obstructive condition all the air does not come out and gets trapped in the air sacs and affects the exchange of gases along the alveolar membrane. Again pursed lip breathing helps to get the excess air out of the alveoli.
5. Hypoventilation: Breathing less than your normal occurs when diaphragm does move efficiently and lungs doesn’t breathe normally. After recognising hypoventilation gently stretch your spine, engage breathing muscles and work up to a normal pattern of breathing.
Optimise your breathing pattern
Consult an expert to establish the best breathing patterns and apply them consistently until it became automatic.
Perform relaxed breathing as much as you can. Gradually learn to exhale longer than inhalation. Perform these exercises daily for toning of respiratory muscles…
1. Abdominal Breathing: It is the most beneficial practice for COPD patients. During inhalation focus should be on descending of diaphragm and expanding of lower ribs and abdomen, which causes more satisfactory inhalation. While during exhalation focus should be on diaphragmatic ascend with lower ribs squeezing and abdominals contraction assisting in emptying of lungs.
2. Pursed-lip Breathing: Inhale through nose, if possible and exhale through pursed lip to control breathlessness. Pursed lip encourages abdominal contraction, which forces diaphragm upwards assisting in complete emptying of lungs. It helps to slow exhalation down and may also help to strengthen respiratory muscles.
3. Diaphragmatic Breathing: In some COPD patients breathing problem aggravates in lying position so perform diaphragmatic breathing exercise in reclined position. It can be performed with a sandbag kept on abdomen for strengthening of the muscle. Gradually weight of the sandbag can be increased. One should practice both abdominal as well as intercostal breathing techniques.
The ultimate aim of all the breath retraining program is get the breath vibration into a diaphragmatic sine wave breathing rhythm.
Yoga asana practice for COPD
In general, there is no drug, which can hinder the progression of COPD, but practice of yoga asana with breath control has been shown to reduce disability in many of the patients with respiratory diseases.
As we know if not checked timely COPD can cause further impairment, resulting in inactivity, which in turn can deteriorate lung functioning. So the comprehensive training including breathing exercises and yoga postures can increase strength and endurance of entire musculature.
Yoga postures that actively involve neck, thorax, shoulder and pelvis can strengthen respiratory musculature. Yoga postures involving forward bends, backbends, spinal side bends and twists can help the person with COPD. If lying is uncomfortable you can modify the posture by keeping bolster under the head or can perform it in sitting or standing position.
Guidelines for practice of yoga asana…
While practicing yoga asana, try to maintain exhalation little longer than inhalation. You can practice pursed lip breathing while performing postures to avoid dyspnea attack.
It is important to coordinate breathing with movement. For e.g. in standing forward bend exhale while bending forward and inhale while coming up. The coordinated Breathing allows efficient exhalation along with strengthening of respiratory muscles.
1. Backbends as in beginning of sun salutation is helpful in opening the chest and allows maximum space for lungs to expand.
2. Mountain pose performed with stretched arms helps to increase spinal extension as well as improves chest mobility.
3. Warrior 1 Pose is helpful in strengthening both inspiratory and expiratory musculature.
4. Standing side bends as done in triangle pose is beneficial to improve flexibility and strength of intercostal muscles. One can incorporate breathing with this posture to gain maximum benefits. Look down if you experience breathing difficulty in looking up at the extended hand while performing the posture. If standing side bends is difficult for someone, sitting side bends are good alternative.
5. Cat pose is highly restorative as it improves spinal mobility along with assisting in inhalation and exhalation.
6. Combining cat pose with Vajra asana in a flowing manner as done in vinyasa yoga i.e. coming to vajrasana from cat pose while exhaling and going back to cat pose while inhaling can help strengthen breathing muscles and allows maximum exhalation.
7. Bhujang asana (Cobra pose) is helpful in strengthening breathing muscles. Try to maintain the posture for a minute or two to get added benefits.
8. Avoid Poses like Bal asana (child pose) as it can cause pressure against diaphragm. Stop immediately if you feel breathless while performing any posture. Immediately sit with leaning forward and arms supported on the back of chair and perform deep-pursed lip breathing.
With increase in strength and stamina a person with COPD can increase repetitions of the postures and can create an aerobic effect, improving cardiac efficiency as well. Respiratory system and circulatory system work in coordination to supply oxygenated blood to the body in a more efficient way.
With increase in conditioning of respiratory muscles oxygenation improves and it can halt the progression of the disease. It is important to end the session with pursed lip breathing and progressive muscle relaxation techniques.
These specific yoga and breath retraining exercises can help manage and reverse, to an extent, the progression of respiratory diseases like COPD. It can also provide a great way to manage stress, which can aggravate respiratory ailments and helps to achieve a positive outlook towards life.
Most of the Doctors, nowadays, are recommending yoga and yogic breathing exercises for copd rehabilitation. Please consult a related professional for your needs… Attend copd rehabilitation classes, lectures, workshops, courses and retreats, whenever possible.
A writers note: I have kept this specific articles very generic and basic. COPD being a complexed issue, it needs specific attention. I request you to meet a related expert to understand your needs, limits and what can work for you. All the Best!