How to exercise with shortness of breath

Shortness of breath is common in people with heart and circulatory conditions. It can be caused by low activity levels after a heart attack or surgery, but it can also be caused by heart problems such as the weakening of a heart that’s not pumping as well as it should.

If you struggle to breathe, you may feel frightened or have panic attacks, which can make catching your breath even harder. You can also experience ‘good’ days when you may feel tempted to do so much that you end up exhausted for days.

In general, regular exercise can help many people with breathlessness find daily tasks easier, including shopping and gardening, or even getting up from the sofa.

“When people come for cardiac rehab, we focus on educating, setting realistic goals and pacing,” says Laura Cartwright, an exercise physiologist and cardiac rehab specialist at Wrexham Maelor Hospital.

Understanding what’s normal

People often want to know if it’s okay to get breathless during exercise. “Most of the time,” says Ms Cartwright, “breathlessness isn’t harmful, but it’s distressing and tiring.”

So how can you tell the difference between normal breathlessness with activity and breathlessness that might indicate a problem? Doing any activity increases the amount of oxygen that the body needs, so breathing automatically becomes faster. But breathing that’s fast and erratic can be a sign of a heart condition. Other signs may include needing to breathe through the mouth rather than the nose, and struggling to calm the breath at rest.

If you can comfortably talk while moving, you’re not overdoing it

You may also feel very tired very easily. “Watch how your breathing changes,” Ms Cartwright says. “In general, as long as you can move and comfortably talk, you’re not overdoing it.”

And how to tell when it’s too much? Stop if you get any chest pain or discomfort, or any palpitations. Take any breathlessness medication that your specialist has recommended. If you have angina and get no relief from your medication within 10 minutes, call 999.

Call 999 immediately if your breathing difficulties are severe. See your doctor or specialist nurse after any episode of severe breathlessness.

The benefits of exercise and setting goals

“At the start of cardiac rehab, we ask people to set a realistic goal,” says Ms Cartwright. These could include feeling like oneself again, regaining independence, walking the dog without needing to sit on a bench, or playing with children or grandchildren, to name a few.

We often caution people that their specific goal may be possible, but the timelines involved may be longer than they’re prepared for,” says Ms Cartwright. “Regular exercise at a suitable level is a goal in itself,” she says. “The recommended 150 minutes of moderate intensity activity a week may be difficult to achieve for many people. But some exercise is always better than no exercise.”

For some people, the goal is just to keep their strength and ability to stay active for as long as possible, as their condition progresses.

Exercise to help with shortness of breath

Exercises that build strength, such as balancing on one leg when brushing your teeth, are a good place to start if you have severe breathlessness. They can give you the benefits of exercise, but your lungs and heart don’t have to work as hard as they do with cardio workouts.

“Strength exercises also build confidence, helping people progress to the next level,” says Ms Cartwright. This could be a slow walking programme, where you go at your own pace and rest when you need to, increasing the distance over time.

Chair-based exercises to improve your posture can also help you breathe better. Sitting in a hunched-up position can make muscles tight, which makes breathing harder.

“With good posture, the muscles support the body and free up the lungs,” says Ms Cartwright. Having better posture and relaxed shoulders can help you breathe using the diaphragm (a big muscle under the lungs that helps you breathe).

“Letting your tummy expand when you breathe in gets the diaphragm to help bring more oxygen to your body. It can also help control the panic that breathlessness can cause.”

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