Simple breathing exercises for COPD – help for shortness of breath, coughing & hyperinflation

Physiotherapist Marlies Ziegler explains how respiratory physiotherapy for COPD works. In addition, she presents three simple breathing exercises. The exercises increase the ribcage’s flexibility and they can reduce shortness of breath, coughing and hyperinflation, as well make it easier to dislodge mucus from the bronchial tubes. This time she shows the exercise “Standing Crescent Moon”.

PARI blog: Ms Ziegler, what is COPD?

Marlies Ziegler: COPD stands for chronic obstructive lung disease. COPD patients commonly experience shortness of breath and sometimes have a great deal of mucus in the bronchial tubes. In most cases the lungs hyperinflate and lose elasticity.

Emphysema can develop as the disease progresses. Chronic inflammation in the lungs often makes them highly susceptible. Coughing is a major problem and in the later stages of the disease there is the additional problem that mucus is not as easy to get out of the lungs. Not every patient experiences all of the symptoms to the same degree. This depends on the stage of the disease, but is also due to every person being different.

Breathing exercises are appropriate for all COPD patients regardless of the stage of the disease. Because the disease can alter the muscular situation. Subsequently, the ribcage can become more rigid and stiffer, which negatively impacts breathing, fitness levels and capacity to perform routine activities.

Marlies Ziegler: Breathing exercises and exercises which improve ribcage flexibility help ease the symptoms of COPD. The exercises help the system referred to as the respiratory pump work better. The respiratory pump includes the respiratory centre and the peripheral nerves, the bony ribcage, the muscles of breathing, and the accessory muscles of breathing. The exercises make the respiratory pump more flexible, which helps patients better manage their symptoms.

Marlies Ziegler: I chose these exercises because they are easy to incorporate into one’s daily routine and can also be done by patients who are no longer as flexible as they once were.

This exercise stretches your sides and mobilises your ribs, relaxing your muscles. A stretched ribcage can more assist with the movements of breathing, making it easier to breathe. How to do this exercise:

1. Starting position: Stand approximately an arm’s length from a wall with your side to the wall. Your right shoulder is closest to the wall.
2. Lean against the wall supported by your right arm and bend your upper body toward the wall. Move your hip to the left, away from the wall.
3. Put your left leg behind your right leg.
4. To increase the intensity of the exercises, bring your left arm up over your head in the direction of the wall.
5. Hold this position and breathe in deeply through your nose and out through your nose or using pursed lip breathing (‘slowed breathing’).
6. You will feel the stretch in your side. When this subsides, your muscles will also relax.
7. 4 to 8 breaths per side.
8. Do the exercises on the other side.

The focus of this exercise is on the spine’s rotational movement. You also will stretch the pectoral muscles, which also act as accessory muscles of breathing. How to do this exercise:

This exercise mobilises the cervical spine and the ribs and stretches the pectoral muscles. This exercise is performed using a fluid movement and in sync with one’s breathing. How to do this exercise:

1. Starting position: Sit up on a stool next to a wall. Feet together. The right side of your body should lightly touch the wall.
2. Put your palms together, raise both arms up (a bit over shoulder height) and rest your right arm against the wall.
3. Inhale and slide your left hand a bit past your right hand.
4. Exhale and rotate your torso to the back. You can breathe out through your nose or using pursed lip breathing. While exhaling, move your left arm at chest level to your left costal arch and pull your elbow back and down. Imagine you are drawing a bow. Your right arm and your bottom should stay where they are while you perform this movement and not move. Make sure you do not shrug your shoulders and that they remain relaxed.
5. Inhale again. While inhaling move your left hand starting at the costal arch back to where it started and extend it past your right hand, which is against the wall.
6. 4 to 8 breaths per side.
7. Repeat the exercise on the other side.

This article was written in cooperation with Marlies Zieger. She works as a physiotherapist in private practice in Munich. She specialises in respiratory therapy. She has been treating patients with chronic obstructive and restrictive airway diseases such as asthma, COPD, cystic fibrosis (CF) and primary ciliary dyskinesia (PCD), for more than 20 years.

• Main page COPD with information on symptoms and treatment
• These 3 tips can help: Shortness of breath
• Clearing mucus: 7 tips on how to gently clear mucus from your lungs
• How to use inhalation chambers properly: Spacer for asthma & COPD sprays
• You should know these: Helpful breathing techniques

Note: The information in this blog post is not a treatment recommendation. The needs of patients vary greatly from person to person. The treatment approaches presented should be viewed only as examples. PARI recommends that patients always coordinate with their doctor and physiotherapist.