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Tuesday, October 22, 2013

Yoga and Mild Asthma

by Baxter
Ball and Wire, by Melina Meza
I got this inquiry recently, and again was surprised to find that I have not written about asthma in any detail, as it is a very common condition and one that many of my students present to class with. Here’s what one of our readers asked:

“What advice do you have for those with mild asthma that does not interfere with daily activities? Do you have any suggestions on what to do to strengthen the lungs/ bronchial/breath? Any warnings?”

As always, it’s good to start off with defining what asthma is, so we are all on the same page. According to the folks at the Mayo Clinic website, asthma is “a condition in which your airways narrow and swell and produce extra mucus. This can make breathing difficult and trigger coughing, wheezing and shortness of breath.” There are different degrees to which people will experience bouts of asthma flares or “attacks”, from very mild asthma, which our reader is interested in, to those with frequent bouts of asthma-induced shortness of breath. And there are those more rare instances where the condition can be so severe as to run the risk of death. This is a condition that requires some support from your lung specialist doctor, either an allergist or a pulmonologist, even if you don’t require much in the way of medication to help with flares. Even my students with mild asthma usually keep an inhaled medication handy that can be used in the event of unexpected asthma attack.

As far as someone with mild asthma that does not interfere with daily activities participating in yoga, for the most part there should be no problem. In fact, certain benefits gained from a regular yoga practice could positively influence the student’s asthma course. In general, both the physical asana practices and pranayama breathing practices can lead to an overall improvement in strength of the muscles of the body that assist in moving the air in and out of the lungs, including the main muscle of breathing, the respiratory diaphragm. And the stretching of the muscles of the chest region, along with breath practices that lengthen the inhale and exhale can improve your “vital capacity” or the volume of air breathed out after the deepest inhalation. You may only need to use this amount of air movement during truly demanding physical activity.

In addition, two of the triggers of asthma attacks are strong emotions and stress.  As we have highlighted in numerous posts in the past, yoga can be an excellent tool to combat stress and to temper strong emotional swings. Applying those tools that support improved control over stress and emotional lability, especially relaxation techniques and guided meditations, should have positive benefits for those with even mild asthma. 

There are a lot of the other triggers for asthma attacks, according to the Mayo Clinic:
  • Airborne allergens, such as pollen, animal dander, mold, cockroaches and dust mites
  • Allergic reactions to some foods, such as peanuts or shellfish
  • Respiratory infections, such as the common cold
  • Physical activity (exercise-induced asthma)
  • Cold air
  • Air pollutants and irritants, such as smoke
  • Certain medications, including beta blockers, aspirin, ibuprofen (Advil, Motrin, etc) and naproxen (Aleve)
  • Strong emotions and stress
  • Sulfites and preservatives added to some types of foods and beverages
  • Gastroesophageal reflux disease (GERD), a condition in which stomach acids back up into your throat
  • Menstrual cycle in some women
If any of these triggers are something you’ve experienced, you‘d want to take this into account as it relates to your yoga practice. I’d highlight a few of the above as examples. Exercise-induced asthma is fairly common form of asthma, and I have students who only complain of shortness of breath with physical practices - this might lead to increased work for the heart or lungs. That could include more physically demanding forms of yoga and may mean that you would want to work with an experienced teacher to design a practice that would benefit your overall health without triggering your asthma symptoms.

Another common trigger for my students is the wool blankets that some of the studios where I teach have available as props.  You may have to bring your own cotton blanket or request the studio have a few available for you to use. If reflux or GERD is one of your triggers, you’d need to avoid any kind of inversion and maybe even lying flat on the ground if it causes GERD symptoms, which can lead to asthma attacks. I have students in this camp do things like half Dog at the Wall instead of regular down dog. And if we are doing supine warm ups, you can create a ramp-like lift for the chest and head with blankets. If any of the triggers above are bothering your breathing, default to a quieter, gentler practice for a few days until your breathing returns to normal and then gradually re-introduce all of your normal activities, not just yoga. 

And not all breathing practices are great for asthma suffers. My colleague and friend Barbara Benagh developed a more serious form of asthma as an adult and found that pranayama practices that emphasized lengthening the inhalation or holding the breath after inhaling actually triggered or worsened her asthma.  She went on a personal search to look for better ways to breathe and her findings are quite interesting. I highly recommend you check out her web site to learn more about her recommendations.

I suspect we will return to this topic again down the road, but hopefully the information here will allow you to breathe easy as you work with yoga for asthma!

Studies on Yoga and Asthma: Most have been done in India or other countries, but do point out the benefits of yoga for asthma. On my quick search for recent studies, this study was the first listing, cataloged on the NIH website. Check out the references at the end of the study for more places to look for scientific studies on the subject.

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