What is Asthma?

Asthma is a condition where the airways of the lungs narrow and swell due to inflammation. Often those who suffer from Asthma have shortness of breath, wheezing, coughing, and chest tightness. For some, it is particular situations that will worsen their symptoms, such as air pollution, exercise, allergies, etc. 

Breathing Pattern and Breathlessness 

Whether it’s Asthma, or any other condition that is causing a change in our breathing, our body adapts. The feeling of being breathless can be dramatic, and unnerving, and can trigger our sympathetic nervous system (our flight/fight/freeze system). When this side of our nervous system is overactive, we tend to use our secondary breathing muscles (some of our neck muscles, and front chest muscles). Due to the overuse of these areas, tightness can develop. This tightness, along with biochemical changes due to the stress response, our body adapts by breathing more shallowly from the chest. If we start to use this maladapted breathing pattern for a prolonged period of time, we can start to rely on this habit even if the Asthma symptoms are not an issue. By utilizing this shallow, chest breathing pattern, our nervous system is getting cues that suggest we should still be in the flight/flight/freeze mode. This can trigger our body to try and take in more air than we require, and eventually contribute to chronic hyperventilation. This cascade of effects can mimic Asthma, when really, it’s the way in which we are breathing rather than airway inflammation.

How can Physiotherapy Help Asthma? 

Physiotherapy, and breathing retraining, can be a great adjunct therapy to assist with breathlessness. There is a great deal of evidence supporting breath retraining as a way to improve, and control Asthma symptoms. Physiotherapists can analyze your breathing pattern, do some objective measurements, as well as evaluate your movements. We take this information, along with factoring in your sleeping habits, stress levels, etc. and work with you to create a plan that will move you towards your goals. 

References: 

Eirini Grammatopoulou et al.  The Effect of Physiotherapy-Based Breathing Retraining on Asthma Control.  Journal of Asthma, 48:593–601, 2011

Elizabeth A Holloway, Robert J West.  Integrated breathing and relaxation training (the Papworth method) for adults with asthma in primary care: a randomised controlled trial.  Thorax 2007;62:1039–1042. doi: 10.1136/thx.2006.076430

Mike Thomas, R K McKinley, Elaine Freeman, Chris Foy.  Prevalence of dysfunctional breathing in patients treated for asthma in primary care: cross sectional survey.  BMJ VOLUME 322 5 MAY 2001 bmj.com

Thomas M, Bruton A. Breathing exercises for asthma. Breathe 2014;10(4):312-322

Turner S, Eastwood P, Cook A, Jenkins S. Improvements in symptoms and quality of life following exercise training in older adults with moderate/severe persistent asthma. Respiration 2011;81(4):302-310

Ren-Jay Shei, Hunter L. R. Paris, Daniel P. Wilhite, Robert F. Chapman & Timothy D. Mickleborough. The role of inspiratory muscle training in the management of asthma and exercise-induced bronchoconstriction. The Physician and Sportsmedicine (2016)