Asthma, Allergy and Physical Therapy

Spring is upon us again and with it comes rebirth, renewal, warmer weather, flip flops and open toed shoes, flowers abloom...and allergies!

If your like most of allergy sufferers, You'll just take a 24 hour Anti-histamine medication, get some nasal sprays as you stack up on facial tissues and pray to the heavens that Spring passes you by quickly.

Here are some tips to better cope with the allergy season.

1. Avoid allergens.
   Avoid the outdoors as much as possible and close your windows during sunny days. Air and vent out your windows when it rains or after a rain ( the pollen would have all fallen down).
2. Take a shower and use a nasal wash.
   Take a shower before going to bed to wash away all the pollen that have accumulated in your hair and body during the day. use a saline nasal spray/wash to wash away pollen from your nasal passages. Its non medicated and safe to use!
3. Replace clothing and bedsheets as well as pillowcases and blankets that have been exposed to allergens. Wash them with hot water.

For Chronic asthma and shortness of breath Physical Therapy may help. Relaxation exercises and breathing exercises are an excellent accompaniment to your treatment regimen. Here are some breathing exercises you can use.

A. Pursed Lip Breathing

The technique prolongs exhalation and helps empty the lungs completely. This allows the following breath to be deeper.

Difficulty: Moderately Easy

Instructions

1. Step 1
   Understand when to do pursed lip breathing. People with COPD may experience shortness of breath during exertion. Pursed lip breathing can be used when doing activities which you find challenging such as climbing stairs.
2. Step 2
   Inhale slowly through your nose. Count to two as you inhale. Keep your mouth closed. Breathe normally. It is not necessary to take a deep breath.
3. Step 3
   Pucker your lips. Your mouth should be slightly opened as if you were going to whistle. Your head should be in a neutral position and your shoulders relaxed.
4. Step 4
   Exhale slowly through pursed lips. Count to four or five while exhaling. Keep in mind the exhalation should always be twice as long as your inhalation. The purpose is to slow breathing down and exhale the trapped air out of the lungs.
5. Step 5
   Repeat the process. After you have finished exhaling, then repeat Steps 2 through 4. Continue to do pursed lip breathing until your shortness of breath has decreased.
6. Step 6
   Practice the technique daily. Because it is not your natural pattern of breathing it may take some time to make pursed lip breathing a habit when you are short of breath.

B. Diaphragmatic Breathing for Anxiety

When overcoming high levels of anxiety, it is important to learn the techniques of natural breathing. Many people who live with high levels of anxiety are known to breathe through their chest. Shallow breathing through the chest means you are disrupting the balance of oxygen and carbon dioxide necessary to be in a relaxed state. This type of breathing will perpetuate the symptoms of anxiety.

The natural breathing technique is called Diaphragmatic Breathing (stomach breathing). We automatically breath this way when we are born. Diaphragmatic breathing uses the diaphragm muscle ( a strong dome shaped muscle) located under our ribs and above our stomach. When we breath in, we push the muscle down, and our stomach moves forward. When we breath out, the diaphragmatic muscle moves back to resting position and our tummy moves back in. There is little or no upper chest movement.

As we grow older many of us change our pattern of breathing and start breathing through our chest. This can be the result of a number of factors such as the pressure on women to have a flat stomach, certain fashions, poor posture, and of course anxiety.

Diaphragmatic breathing is intended to help you use the diaphragm correctly while breathing to:

• Strengthen the diaphragm
• Decrease the work of breathing by slowing your breathing rate
• Decrease oxygen demand
• Use less effort and energy to breathe

Diaphragmatic Breathing Technique

1. Lie on your back on a flat surface or in bed, with your knees bent and your head supported. You can use a pillow under your knees to support your legs. Place one hand on your upper chest and the other just below your rib cage. This will allow you to feel your diaphragm move as you breathe.
2. Breathe in slowly through your nose so that your stomach moves out against your hand. The hand on your chest should remain as still as possible.
3. Tighten your stomach muscles, letting them fall inward as you exhale through pursed lips (see "Pursed Lip Breathing Technique"). The hand on your upper chest must remain as still as possible.

When you first learn the diaphragmatic breathing technique, it may be easier for you to follow the instructions lying down, as shown on the first page. As you gain more practice, you can try the diaphragmatic breathing technique while sitting in a chair, as shown below.

To perform this exercise while sitting in a chair:

1. Sit comfortably, with your knees bent and your shoulders, head and neck relaxed.
2. Place one hand on your upper chest and the other just below your rib cage. This will allow you to feel your diaphragm move as you breathe.
3. Tighten your stomach muscles, letting them fall inward as you exhale through pursed lips (see "Pursed Lip Breathing Technique"). The hand on your upper chest must remain as still as possible.

Note: You may notice an increased effort will be needed to use the diaphragm correctly. At first, you'll probably get tired while doing this exercise. But keep at it, because with continued practice, diaphragmatic breathing will become easy and automatic.

How often should I practice this exercise?
At first, practice this exercise 5-10 minutes about 3-4 times per day. Gradually increase the amount of time you spend doing this exercise, and perhaps even increase the effort of the exercise by placing a book on your abdomen.

C. Complete Natural Breathing

1. Sit or stand with good posture.
2. Breathe through your nose.
3. Inhale, filling first the lower part of your lungs then the middle part, then the upper part.
4. Hold your breath for a few seconds.
5. Exhale slowly. Relax your abdomen and chest.

For acute and/or moderate-severe asthma attack, always call your doctor and use your medications and inhalers as prescribed. Happy Spring!