What does breathing have to do with asthma?

 One of my most frequent referrals from respiratory professionals is for helping people get better control of their asthma.  These people are often well controlled medically - meaning the medication they are on significantly improves their lung function - but they still struggle with symptoms of shortness of breath.  Often this occurs when they are exerting themselves - either during exercise or during normal activities of daily living (stairs!).  At first, it doesn't seem to make sense to them - if the asthma medication is working, why do I feel so bad?  The answer is that we have to "think outside the lung," and consider what else might be going on to contribute to symptoms.  Both scientific research and clinical evidence indicate that the WAY you breathe when you have asthma, impacts HOW you feel.

What the research says:

• Thomas et al (2001) found that nearly one third of women and one fifth of men with asthma have symptoms suggestive of dysfunctional breathing
• Agache et al (2012) found that of those with asthma and symptoms of dysfunctional breathing, 17% exhibited dysfunctional breathing during exercise testing
• Grammatopoulou et al (2011) found that physiotherapy-based breathing retraining improved asthma control 

Clinical Evidence:

• In my practice, many kids and adolescents are being referred for symptoms that are not in line with their lung function.  These individuals frequently exhibit mouth breathing, accessory (neck and chest) muscle use and increased breathing rates
• Many people that come in are simply breathing inappropriately for their body's needs, resulting in troubling symptoms that includes shortness of breath
• Typically a few weeks of working on breathing awareness, breathing pattern retraining and integration of core stability and breathing strategies will produce a significant change in symptoms

To the point...

• It is important for asthma to be medically managed so talk to your doctor or respiratory educator to make sure you have an accurate diagnosis and are on the right medication for you
• While medications are critically important in managing airway inflammation and constriction, they aren't able to change the impact of poor breathing patterns
• If you have asthma, and continue to struggle with shortness of breath, despite good medical management, consider getting a breathing assessment to determine if your breathing pattern is limiting your quality of life

Check back in a few weeks for Part 2, where I will discuss some tips for breathing better with asthma.

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