Cough Variant Asthma: Lifelong Suffering Relieved with Yoga

by Bonnie J. Golden M.Ed, e-RYT 

Wind Blowing Clouds by Marie Lossky
(@Marie.Lossky on Instagram)

The year is 1984, a time when many yuppies were operating in full career mode. Waiting at the dais, I am poised to lead an important and politically loaded presentation to my employers, a college board. Of course I’m “dressed for success,” as defined in the 1980s. 

Along with my notes, I clutch a plastic bag of cough drops as I approach the podium. I know that the only way I will be able to complete a sentence is if there is a trusty lozenge in my mouth. I sucked these cough drops the entire talk; when one dissolved, I popped in the next. It’s a wonder that the presentation went well—even though I bloopered “excuse me while I DRINK another cough drop.” Tacky, to say the least! 

My presentation cough drop-crutch was one in a long series of frustrating adaptations for a regularly occurring, undiagnosed, dry hacking cough. I needed to create these workarounds in order to function for the first three decades of my life. And my bag-o-menthol was my special partner for this particularly high profile speech. 

I grew up in Chicago. Winters are gray, snowy, and dark. Winter also brings the cold season. Then, spring finally arrives. And along with the change of seasons comes: hay fever. My dreaded cough manifested itself like clockwork. Following those inevitable winter common colds, or a bout of spring hay fever, the hacking would begin. No, my colds didn’t simply subside. Instead, they would “gift” me with a cough that would last 6-8 weeks, long after the cold was gone. 

The symptoms began in junior high school. I tunneled under the covers of my bed so as to not to wake my family. Still, I would be coughing, and sometimes weeping with frustration. A visit to the family physician resulted in the foulest tasting prescription grade “cough syrup” one could imagine. And it did nothing for the cough. 

Fast forward to undergraduate school at the University of Illinois in Champaign. I rode my bicycle everywhere. And of course Champaign in central Illinois was VERY cold in the winter. A particularly awful coughing episode sticks in my mind: I recall sore abdominal muscles as I pedaled to classes on my bike. Nowadays we might deem this a great deep core workout! But it was pain—soreness induced by the unrelenting muscular contractions of the cough, and the effort of attempting to suppress it. On an icy morning, completely bundled up with a knitted muffler on my face, I pedaled several miles to the student health center. This time, my lungs were x-rayed. Nothing was found and another prescription was provided for foul cough syrup. Symptom relief: none. 

Sleep deprivation—along with pain, anxiety, fear and depression—came with this cough. After a particularly horrible night, I consulted the yellow pages (yes, the actual book) and called ear, nose, and throat specialists until someone answered. I had the brainstorm in the middle of the night that I should try another kind of physician. This physician diagnosed a secondary ear infection and a deviated septum. 

Did I have my answer? Well, antibiotics for the ear infection certainly helped me sleep better. But, the cough did not abate. Once morning had broken (to quote one of my favorite singer/songwriters of all time, Cat Stevens) the cough reared its ugly little head again. 

Cough drops, hot tea, urgent care clinics—episode upon pitiful episode of no relief—for decades. Finally, I consulted with an allergist and received a full work-up, patch tests and all. I was      
definitively diagnosed with cough variant asthma, and directed to administer an inhaler at the first sign of a cold. As you can imagine, I would become hyped up from the expensive medication. (Don’t get me started on the American way of health care!) Inhalers did eventually help the cough episodes, however, and I am deeply and utterly grateful for the diagnosis and 
treatment. 

Then about 12 years ago, my yoga practice shifted from sporadic to genuinely committed. I began participating in an online group of like-minded yoginis literally from around the U.S and the world, discussing our practices and our readings, and checking-in with one another about our deepening insights and discoveries. We also often met “real life.” taking immersions with Felicity Green, Erich Schiffmann, Manuso Manos, and others. At the same time, I began attending Iyengar and Iyengar-inspired classes in Tucson. Of course like any good yogini, I built my yoga library. 

During this period I acquired Yoga: The Path to Holistic Health by BKS Iyengar. During one of my asthma episodes, I referenced this volume and decided to try the sequence provided in this beautiful book. The series, which began with an introduction that stated, “asthma is usually caused by allergies or stress” (yes that’s me!) gave me a path to a new approach. So I gave it a go! 

With the book open in front of me in my living room, I began with the seated poses such as Staff pose, Cobbler’s pose, Wide Angle Seated pose, and Hero pose, pose, and then progressed to reclined propped versions of those same asanas, as well as Supported Bridge pose. From there I moved to Downward-Facing Dog pose, Mountain pose with arm variations , and Half Moon pose. I substituted heavily propped (I just did not have all of the supports depicted in the book) Staff and Camel poses, with Supported Bridge and a chest opening Savasana. 

After this first practice, I IMMEDIATELY felt better! My stress was relieved and my coughing abated noticeably. This instant relief was motivation to continue with Mr. Iyengar’s specific sequence (and my own adaptations) during this and subsequent acute episodes. Furthermore, my committed well-rounded practice always included focus on my posture, particularly side-body and chest openers, such as Bridge pose on a block Sphinx pose, Warrior 2, and shoulder openers with a strap. I noticed that when I would suffer from the cough variant asthma symptoms, the episodes eventually became much shorter. 

I firmly attest that my asana practice helped to slowly and incrementally open the tissues around the lungs and chest so I could breathe better. Also, the apprehensive anxiety that would come from the anticipation of another asthma episode became managed with my practice. I learned to calm myself with basic pranayama and relaxation, along with asana. Additionally, about 5 years ago when symptoms would arise, I started using a neti pot, which I know that helps immensely.

Now, even though the coughing is an issue, it is minor. I discern exactly what to do for myself, and the duration of the cough and the concomitant stress is completely manageable and short. In essence, my quality of life has improved in a myriad of ways. In my case, yoga has reduced the frequency and severity of cough variant asthma, a condition that caused me a great deal of suffering throughout my life. Yoga has been a magnificent gift to relieve this suffering. I feel deep gratitude for the practice of yoga and to all of my teachers! 

Bonnie Golden, M.Ed e-RYT  is a long-time yoga and stress management teacher and the owner of Yoga with Bonnie/Yoga in Balance LLC in Tucson, AZ  (see www.yogawithbonnie.com).  She specializes in gentle and strong, “boomer,” and prenatal/postpartum yoga. Bonnie received her yoga teacher certification through international yoga master Tias Little's Prajna Yoga. She has completed more than 1,000 hours of yoga instruction, earning her a Yoga Alliance 200-e (expert) designation. Her additional yoga studies include specialized training in prenatal yoga with Linda Spackman of Prajna yoga, doula training, and female pelvic-floor health with Leslie Howard. She is certified in Relax and Renew with Judith Lasater and Roger Cole, and is trained in several Yoga Tune Up specialties with Jill Miller. She recently completed the Yoga for Healthy Aging immersion with Baxter and Nina, and will be offering workshops and specialized sessions based on the terrific learning from that experience. Bonnie also served on the counseling faculty of Pima Community College for over twenty years, is the author of two books, and a recipient of the Outstanding Faculty Award from the Pima Community College Foundation. 

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How Yoga Fosters Respiratory System Health

by Nina

Big Sur Clouds by Melina Meza

In our post 6 Strategies for Using Yoga to Help with Medical Problems, Baxter and I identified six basic strategies that you can use on their own or in combination to address a wide variety of medical conditions. Today I’m going to conclude my recent series about these individual strategies with this overview how you can use yoga to foster respiratory system health. (See Friday Practical Pointers: Your Respiratory System is more than Just a Pair of Lungs for information about what your respiratory system is and the individual components that comprise it.)

First of all, you can use both asanas and breath practices to maintain the health of your respiratory system overall. In general, asanas that move your spine in all directions of movement, and that stretch and strengthen the muscles all around your upper torso, will help support your respiratory system by keeping respiratory muscles strong and flexible. And breath practices that lengthen your inhalation and exhalation, such as gradual lengthening of equal breath, or that include rapid inhalations and exhalations, like Skull Shining breath, can exercise your breathing muscles even more. 

Yoga asanas, breath awareness, and pranayama can help with mild asthma and COPD by improving breathing efficiency and decreasing inflammation. Baxter’s, students report that their regular yoga practice has been helpful for exercise-induced asthma, which can affect younger adults, but can also arise in older adults.  

CAUTION: Yoga has mixed reviews on its benefits for moderate to severe asthma. For this specific condition, we recommend working with a very experienced teacher.  

Exercise 

In addition to keeping your respiratory muscles strong and flexible, you can use your asana practice to reverse changes to your body due to aging, physical habits, injuries, and scoliosis, that negatively impact your ability to breath. These include structural changes to both muscles and fascia of your chest as well as the chest wall bones and thoracic spine. 

In general, you can reverse changes by: 

1. Improving your posture by strengthening back spinal muscles.

2. Increasing movement in your chest and spine by regularly stretching your chest muscles all directions.

3. Improving the flexibility and strength of your respiratory muscles and fascia by regularly practicing a combination of well-balanced asana sequences and breath practices. 

You can also use asanas to target specific problem areas. For example, if you are developing more rounding of the thoracic spine, adding more dynamic and static back bending postures into your practice can help reduce the rounding. You can also use asanas to strengthen weak chest muscles around your lungs. For example, you can use Plank, Side Plank, and Upward Plank poses to strengthen the muscles around your chest wall and active back bending poses, such as Cobra or Upward-Facing Dog pose, to strengthen your back and front chest muscles.

Breath Awareness 

Your ability to breathe in a healthy way can be compromised by unhealthy breathing patterns, such holding excessive tension in your abdominal muscles. However, by practicing breath awareness with special attention to the movements of your chest and belly, you can learn about your particular breathing patterns and potentially identify any problems. 

In normal, healthy breathing, as you inhale, your chest and ribs will expand slightly and your belly will rise up or bulge forward, and as you exhale, your belly will relax back and your chest and ribs will relax back toward center. Although not common, there are two different breathing patterns that occur in some people that can be problematic:  

Chest Breathing. Instead of your belly expanding on your inhalation and relaxing back on your exhalation, there is no movement in your belly at all. All the movement during respiration is in your chest alone.  

Reverse Breathing. Instead of your belly expanding on your inhalation, it actually sucks in during the inhalation and your chest expands dramatically. And on your exhalation, your belly rises as your chest relaxes.

To observe your own breathing patterns:

1. Start by setting yourself up in a comfortable reclined pose, such as Savasana or Reclined Cobbler’s pose, or a comfortable supported seated pose, such as Easy Sitting pose with your back against the wall.
2. Take a moment to relax completely and breathe naturally, with an easy, relaxed breath.
3. Keeping your breath easy and relaxed, turn your awareness to your chest and belly as you inhale and exhale. Just watch. Is your belly rising/expanding/bulging with your inhalation and relaxing back with your exhalation? Or is something else going on?

If you do identify a problematic breathing pattern—or think that you have—unless you are a very experienced practitioner of pranayama, it’s best for you to work with your yoga teacher or yoga therapist to change your breathing habits. Your present pattern of breathing is likely to be a well-established one. And an expert will not only be able to observe your breathing with a trained eye but will also have techniques available to effectively coach you to change your ingrained habits.

Breath Practices 

A well-rounded breath practice, that includes calming, balancing, and simulating practices, can promote the health of your respiratory system by improving the strength and flexibility or your chest muscles and fascia as well as improving the alignment of your ribs and spine. In general, you’ll benefit from actively challenging your diaphragm with practices that extend the length of the inhalations and exhalations, and that include inhalation and exhalation pausing. 

In addition, recent studies have shown that pranayama is effective in improving lung function in those with chronic obstructive pulmonary disease (COPD. For this condition, equal lengthening of the inhalation and exhalation is recommended. 

Finally, breathing practices that calm your nervous system, such as extending the exhalation or pausing at the end of it, add the benefit of lowering overall stress, which can be particularly helpful to people who are challenged by a respiratory condition.

See Calming Breath Practices We Recommend, Stimulating Breath Practices We Recommend, and Breath Practices for Balance.

Stress Management 

Like the rest of your body, your lungs and the rest of your respiratory system need downtime to rest and repair. In the Rest and Digest state, your respiratory system will get a good rest because you don’t need as much oxygen in this state, so lungs and respiratory system won’t need to work as hard! And, of course, spending time in the Rest and Digest state provides the optimal setting for the system to heal from problems and repair itself. 

So spending time in the Rest and Digest state provides an important break that will foster the health of the entire system. In addition, reducing stress also has positive effect on your immune system, which could lower your chances of getting infections of the respiratory tract, from your nose and mouth all the way into the deep part of your lungs. 

Because many people with chronic respiratory conditions experience ongoing anxiety or other negative emotions related their condition, those who have breathing problems can improve the quality of their lives by practicing stress management. This will help quiet your mind and calm your emotions as well as resting your respiratory system. However, if you have respiratory system problems, meditating on your breath can actually cause stress if you worry about breathing. So if this is the case for you and you want to meditate, we recommend either choosing a different type of focus, such as a mantra, or using a simple guided meditation. 

See Techniques for Supportiing Your Respiratory System for specific recommendations on how to practice.

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The Respiratory System, Aging, and Yoga

by Baxter and Nina

Grasses in the Mist by Marie Lossky

It’s very easy to take your breath for granted—after all, it is the first action that states to the world you have arrived, with the cry you make as you take your very first breath. And once your breath gets going, you usually don’t have to give it any conscious thought for most of your life. Yet, as with all systems of the body, the respiratory system undergoes age-related changes to its various components, such as tissues, tubes, muscles and joints, affecting how efficiently they do their jobs. These changes can decrease your capacity both to take in oxygen and exhale carbon dioxide. And a decreased capacity to breathe gradually reduces your ability to physically exert yourself—whether that is on the tennis court or climbing a long flight of stairs—causing shortness of breath and decreasing your overall endurance.

You can use both asanas and breath practices to maintain the health of your respiratory system overall. In general, asanas that move your spine in all directions of movement, and that stretch and strengthen the muscles all around your upper torso, will help support your respiratory system. And practice breath practices that lengthen your inhalation and exhalation, such as gradual lengthening of equal breath, or that include rapid inhalations and exhalations, like Skull Shining breath, can also help.

Airways. With age, the elastic quality of your airways gradually declines, reducing the exchange of oxygen and carbon dioxide in and out of your lungs. This will eventually lower the amounts of oxygen in your blood needed for fuel. In the larger airways, the small hairs that move mucus and small particles up towards your mouth so you can cough or spit them out start to work less effectively. Plus, the nerves in the airways that trigger the cough reflex become less sensitive to smoke, bacteria, and viruses. The combination of these two changes in your larger airways increases your risk of developing respiratory infections or damage to your lungs.

By practicing poses that move your neck and upper spine in all their directions of movement, you can use your asana practice to maintain flexibility and movement in your airways. And the breath practices that foster health of your respiratory system will all have a beneficial effect on your airways.

Lungs. After the age of 25 or so, the ability of your lungs to function gradually declines. In general, exchange of gases between the air and blood stream happens less efficiently and provides reduced immune functioning. As the elastic tissue deteriorates, this reduces the ability of your lungs to fill and empty, reducing the size of your largest breath, and moves the air in and out more slowly. To support the functioning of your lungs, focus on breath practices that lengthen your exhalations and inhalations.

Respiratory Muscles and Diaphragm. Age-related changes in the muscles that enable you to breathe, including the muscles that support your ribs (intercostal muscles) and your respiratory diaphragm, can make the muscles weaker and smaller. This reduces your capacity to take full inhalations and exhalations, as well as your ability to breathe quickly. These changes can also contribute to poor coughing, which, along with changes in your large airways, increases your risk of respiratory infections. By practicing yoga poses that address your respiratory muscles, including forward bends, backbends, sidebends, and spinal twists, you can help maintain their strength. Breath practices that lengthen your inhalations and exhalations can also help strengthen your diaphragm and intercostal muscles.

Chest Cavity. Age-related changes to bones, fascia and ligaments of your chest wall, such as arthritis in joints of chest and osteoporosis of ribs and vertebrae, and thoracic spine deformities, such as kyphosis, and scoliosis, can lead to stiffness of the chest wall, leading to increased work of breathing. Combined with age-related changes to lung tissue and the muscles of breathing, this reduces the amount of air you can inhale and exhale. You can improve mobility and strength in your chest cavity by practicing yoga poses that stretch and strengthen the muscles all around the upper torso. To keep the bones of your spine strong and prevent fractures that could limit chest movement, focus on doing static holds of poses that take your spine in all directions of movement (see Strength Building: How Long to Hold Poses). To increase the amount of air you can inhale and exhale, try practicing gradual lengthening of equal breath.

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Friday Practical Pointers: Your Respiratory System is More Than Just a Pair of Lungs

by Baxter

Cloudscape by Melina Meza

When we inhale, our breath delivers air to our lungs, which extract oxygen for use as fuel. And when we exhale, we release carbon dioxide, a waste product delivered to our lungs from our blood stream for removal. To make this all happen, many different organs and systems in your body work together to enable us to do what we simply call “breathing.” 

Airways. The openings of the nose and nasal passageways, the mouth, the pharynx (back of throat), larynx (the passageway by the vocal cords), trachea and bronchial tree that leads to the air sacks inside your lungs make up the airways that allow oxygen to come into your lungs and carbon dioxide to be released from them. Breath practices will help you learn whether the upper and lower passages are open and relaxed. If not, you can use calming breath practices or stress management tools to try to reopen them. You can also use stress management tools to support your immune system, lowering the chances of infections, such as sinusitis, bronchitis and pneumonia, and for those with asthma and allergies, to relax the bronchial tree so air can flow more easily through it.

Lungs. Although our lungs are essential to breathing, they actually depend on the contractions of our respiratory diaphragm and other helping muscle groups to draw air in for the inhalation and push it out for the exhalation. So to maintain the health of our lungs, we can use our asana and breathing practices to support the health of the muscles, connective tissue, and bones that surround the lungs, and work on maintaining healthy breathing patterns. 

Respiratory Diaphragm. Positioned just below the lungs, the diaphragm is the main muscle of breathing, which allows the lungs to expand on the inhalation and deflate on the exhalation. If you are relatively active and healthy, the diaphragm does not need any special “exercising.” However, if you have been sedentary, suddenly gained weight, suffered from periods of inactivity or developed poor posture, your diaphragm may not be working optimally. In these cases, you can use your asana practice to stretch areas of restriction and re-establish healthy posture. And you can use breath practices, such as gradually lengthening your inhalation and exhalation, to improve your lung capacity over time. 

Chest Cavity. Made up of your ribs, breastbone and spine, your chest cavity provides the housing for your lungs and respiratory diaphragm (as well as your heart and its arteries and veins, and your esophagus). The muscles and fascia that connect the bones in and around your rib cage assist in your breathing by expanding your chest cavity on your inhalation and compressing your chest cavity on your exhalation. For a healthy person, a well-balanced yoga practice will help you maintain optimum functioning of your chest cavity. For a person who has gained weight, being sedentary or inactive, or has poor posture, you can use your asana practices to improve the strength and flexibility of your chest cavity and restore your posture to a healthier state. 

Circulatory System. To carry out its functions, your respiratory system depends on your circulatory system. The circulatory system circulates blood that has passed through your lungs to the trillions of cells in your body to provide them with oxygen for fuel. And it returns blood containing waste carbon dioxide from the cells back to your lungs for removal. Therefore, yoga practices that support a healthy cardiovascular system also support your respiratory system (see Techniques for Improving Cardiovascular and Heart Health).

Brain and Nervous System. Both your lungs and the muscles that stimulate your inhalations and exhalations are in continual communication with your brain through your nervous system. Your brain monitors your levels of oxygen and carbon dioxide moment by moment to modify the rate and depth of your breathing to match the energy demands of the activities you engage in. Your brain then sends messages to the your breathing muscles to either speed up or slow you’re your breathing. So without good communication between our brains and respiratory systems, we simply could not breathe. 

In addition, chronic stress can disrupt the normal balance between your brain and your respiratory system by causing unhealthy breathing patterns. That’s because when you are stressed and triggering your Fight or Flight response, your brain reacts by stimulating your respiratory system to take in more oxygen to prepare you for action. But if you’re chronically just “feeling” stressed, you don’t actually need to take action, though you’ll still be breathing as if you do. By using yoga stress management techniques and spending more time in a state of relaxation, you can rebalance your brains input to your respiratory system and re-establish healthier, more appropriate breathing patterns.

On a very simple and urgent level, we all need to breathe well to live. So using yoga practices to support the optimal functioning of your respiratory system and the systems with which it is connected will provide benefits for your overall health. For information on techniques for using yoga to support your respiratory system, see Techniques for Supporting Your Respiratory System.

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Observing Unhealthy Breathing Patterns

by Nina

Trees are the Lungs of the Earth by Melina Meza

Your ability to breathe in a healthy way can be compromised unhealthy breathing patterns, such holding excessive tension in your abdominal muscles. However, by practicing breath awareness with special attention to the movements of your chest and belly, you can learn about your particular breathing patterns and potentially identify any problems. 

In normal, healthy breathing, as you inhale, your chest and ribs will expand slightly and your belly will rise up or bulge forward, and as you exhale, your belly will relax back and your chest and ribs will relax back toward center. 

Although not common, there are two different breathing patterns that occur in some people that can be problematic:

Chest Breathing. Instead of your belly expanding on your inhalation and relaxing back on your exhalation, there is no movement in your belly at all. All the movement during respiration is in your chest alone. 

Reverse Breathing. Instead of your belly expanding on your inhalation, it actually sucks in during the inhalation and your chest expands dramatically. And on your exhalation, your belly rises as your chest relaxes. 

To observe your own breathing patterns: 

1. Start by setting yourself up in a comfortable reclined pose, such as Savasana or Reclined Cobbler’s pose, or a comfortable supported seated pose, such as Easy Sitting pose with your back against the wall. 
2. Take a moment to relax completely and breathe naturally, with an easy, relaxed breath. 
3. Keeping your breath easy and relaxed, turn your awareness to your chest and belly as you inhale and exhale. Just watch. Is your belly rising/expanding/bulging with your inhalation and relaxing back with your exhalation? Or is something else going on? 

If you do identify a problematic breathing pattern—or think that you have—unless you are a very experienced practitioner of pranayama, it’s best for you to work with your yoga teacher or yoga therapist to change your breathing habits. Your present pattern of breathing is likely to be a well-established one. And an expert will not only be able to observe your breathing with a trained eye but will also have techniques available to effectively coach you to change your ingrained habits. 

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Techniques for Supporting Your Respiratory System

by Baxter and Nina

Joy Sassoon, Age 60, photographed by Tanya Constantine

Your respiratory system is essential to life, and a completely healthy chest and lungs make a full life more likely. Today, we are recommending techniques for supporting the health of your respiratory system, whether you are healthy and want to stay that way, or whether you have a respiratory disorder or medical condition that directly affects or may eventually affect your respiratory system. These recommendations apply to people who: 

• Are currently healthy
• Are sedentary but wanting to improve your respiratory system
• Are ex-smokers 
• Have lung diseases, such as asthma, exercise-induced asthma, and chronic obstructive pulmonary disease (emphysema)
• Have been exposed to lung toxins, such as asbestos
• Have heart conditions such as congestive heart failure that directly affect the lungs or heart valve problems that may eventually affect the respiratory system

Start by considering your current condition. If you are currently healthy, you can use a combination of any of our recommended active and relaxing practices. 

For those who have a compromised respiratory system, increased activity could cause unwanted stress on your system. So start with more passive, gentle practices, such as restorative poses, beginning level breath practices (for example, 1:2 ratio breathing) and slow, gentle dynamic poses such as Cat/Cow pose. When you observe gradual improvement in your respiratory system, you can advance your practice. 

If you are currently having trouble breathing, such as from a sudden flare of asthma, we recommend that you focus on stress management practices, such as restorative and supported poses, such as Cobbler’s pose (Baddha Konasana) at the wall, version 4 of Supported Backbend, and version 2 of Reclined Cobbler’s pose, and guided relaxation. (Of course, you should also continue using the protocols prescribed by your doctor for an acute situation.) 

If you have a severe lung disease, such chronic obstructive pulmonary disease (emphysema), unless your doctor says it is safe to advance your practice, you should focus on supported poses and gentle breath work. When you are ready to advance your practice, try a gentle, active practice, as this may provide you with important benefits, including less shortness of breath, better exercise tolerance, and improved sleep. 

Cautions: In general, if you become suddenly short of breath, stop whatever yoga practice you are doing, sit down with some support, in a chair or against a wall, and see if reducing activity quickly resolves your symptoms. If not, seek prompt medical attention. Shortness of breath can be the sign of more serious underlying problems, such as a dropped lung (pneumothorax) or a heart attack. On a less urgent level, be mindful that Savasana or other reclined poses (supine or prone) could make breathing more difficult for a person with lung disease. Adapt supine poses by raising the torso with a support, such as using a bolster under your back in Reclined Cobbler’s pose (Supta Baddha Konasana). Adapt prone poses by finding more space for the belly to move, for example, by widening your knees in Child’s pose. If these adaptations do not improve your breathing, skip these poses for now and practice meditation or breath practices in a seated position. 

How Often to Practice. If you are healthy, practice up to six days a week, alternating days of active practice with days of gentle and restorative practice. If you are currently experiencing respiratory problems, try practicing four days a week, also alternating between active days with restorative days. If you see positive changes, slowly add more days of practice. 

Breath Awareness. Practicing simple breath awareness can reveal breathing habits that you are not currently aware of. You can practice breath awareness in both active poses and relaxation poses to reveal breathing patterns you might want to change, such as chronic shallow, rapid breathing that might not be so healthy during Sun Salutations or physically demanding postures. You may decide to skip this technique However, if you are experiencing shortness of breath, such as an acute asthma episode, you may wish to skip this technique, as focusing on your breath may make you more anxious. 

Balanced Practice. Because one of the primary benefits of yoga asana for your respiratory system function is releasing any tension in the muscles and fascia around the chest region, we recommend practicing a balances sequence that includes: forward bends to open your back, backbends to open your chest, side bends to open the sides of your torso, and twists to release tension from the diagonal muscles and fascia around your chest. Include a mix of both dynamic and static poses. If you have been sedentary for a period, an asana practice that includes these elements can help you regain strength in all the muscles that assist in breathing and improve your overall lung capacity. Round out your practice by including breath practices, restorative poses, and stress management practices.

Breath Practices. Since there are times in your everyday life when you need to breath fast and deep and other times when you should be resting and breathing comfortably, your breath practices can help support whatever context you find yourself. So you should do both stimulating as well as relaxing breath practices. For relaxing your respiratory system a good way to start is by using a 1:2 ratio breath or by slowing and slightly deepening both your inhalation and exhalation equally. To improve your total lung capacity, start with an even breath of 2 seconds in/out,. Then, gradually over time work up to 6 seconds or more in/out, up to your tolerance. 

Dynamic Poses. Focus on dynamic poses that stretch and strengthen the muscles and tissues around your chest area. For example, moving with your breath between Mountain pose, Arms Overhead pose, and Standing Forward Bend and back stretches and strengthens both the front and back of your chest. Moving between Arms Overhead pose to Crescent Moon pose (the side bending version of Arms Overhead pose) stretches and strengthens the sides of your chest. And a dynamic seated twist stretches and strengthens the diagonal muscles of your torso. 

Start with 6 rounds in and out, and work up to 10 rounds. Initially move at a comfortable breath pace. Experiment with slowing down your breath and movement pace or speeding both up gradually to train the body for different situations. 

Static Poses. Focus on poses either stretch or strengthen your torso, including forward bends, backbends, and twists, or standing poses that include or combine those movements. Some examples are Standing Forward Bend (Uttanasana), Triangle pose, Extended Side Angle pose, Warrior 1, Cobra pose variations, Marichyasana 3 or Easy Sitting Twist. While passive stretches such as a Supported Backbend will only improve flexibility, many active poses can improve both flexibility and strength. For example, Triangle pose strengthens some muscles along the slides of the torso while also stretching others. So for improvements in flexibility, combine those active poses with passive, supported stretches, such as a Supported Backbend or Reclined Twist. 

If you are new to practice or have a respiratory condition, start off with short holds 10 seconds. Then gradually work up to 30 seconds. From there, to maximize improvements in strength in flexibility and strength, aim for eventual holds of 90 seconds or more. 

Restorative Poses. In general, restful poses are beneficial to the overall functioning of your respiratory system, as they rest your overall respiratory system and lower stress levels. We recommend practicing restorative poses that gently stretch and open your torso area but do not trigger shortness of breath, such as Supported Backbend, Childs’s pose with or without a bolster, and Legs up the Wall pose with arms to your sides or overhead. If focusing on your breath in these poses causes anxiety, try any focusing instead on a different physical sensation, an image, or a mantra. 

Stress Management. Reducing stress has positive effect on your immune system, which could lower your chances of getting infections of the respiratory tract, from the nose and mouth all the way into the deep lungs. In addition, your lungs need downtime to rest and repair, so spending time in Rest and Digest mode provides a beneficial break for them. And for those with chronic respiratory system conditions, practicing regular stress management can improve the quality of your life by reducing anxiety and fear. Use any of the stress management practices we have described elsewhere (see The Relaxation Response and Yoga) that you can tolerate and that also lead to improvements in your breathing.

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Friday Practical Pointers: Your Posture Affects Your Breathing!

by Nina

Supported Backbend is
Excellent for Improving Posture

Did you know that your ability to take a deep, full breath is influenced by your posture? Because when you inhale, your rib cage expands to its maximum to make room for your lungs to expand. And if the muscles that allow your rib cage to expand are tight—due to habitual slouching or other postural problems—your lungs won’t be able to expand to their maximum because there just won’t be as much room within your chest cavity for them. If you have long-time poor posture, you might not notice this problem when you’re sitting at your desk. However, in physically demanding situations, you will likely notice that your breath is restricted. 

And if some of your chest or back muscles are weak, your endurance will be affected. That’s because if the muscles that allow the rib cage to expand are weak and therefore tire easily, you’ll run out of steam when you are in a physically demanding situation that requires rapid or deep breathing. 

To maintain good posture for optimum respiration, cultivating both the flexibility and strength of your torso muscles is vital. In general, a well-rounded asana practice that includes standing poses, backbends, twists, forward bends, and side bends, will help you maintain the flexibility and strength you need. 

However, you can also use asanas to target specific problem areas. For example, if you are developing more rounding of your thoracic spine, adding more back bending poses to your practice will help reverse this trend. If the sides of your chest are tight, you can lengthen them with full side stretches, such as Crescent Moon pose, and partial side stretches, such as Triangle pose. And if your back muscles are tight, forward bends, such as Standing Forward Bend and Child’s Pose, will help release them those muscles.

You can also use asanas to strengthen weak muscles around your lungs. To strengthen chest muscles, practices poses where you lift your chest away from gravity, such as Plank pose and Downward-Facing Dog. To strengthen the sides of torso, practice poses where you keep one side lifted away from gravity, such as Side Plank pose variations and Triangle pose. And to strengthen back muscles, practice active backbends, such as Warrior 1, Cobra pose, or Upward-Facing Dog.

Medical conditions that influence posture, including kyphosis and scoliosis, also restrict your breathing capacity by limiting space in the chest wall . So for these conditions, it is especially important to maintain both the flexibility and strength of your torso by doing poses appropriate for your condition. For scoliosis, there is even early evidence that certain yoga poses can help reduce the curve of your spine (see Side Plank Pose (Vastithasana) Could Reduce Spinal Curves in People with Scoliosis!). Work with a yoga therapist or teacher who is an expert in your condition to find the poses that are right for you.

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