Section 2 Breathlessness Management
Breathlessness Management Breathing techniques There are various techniques for coping with breathlessness. If you practice these every day when sitting, as you become more familiar they will help you when you are active and getting breathless. They will also help you manage if you get short of breath suddenly. Try all of these gently - don't force yourself. You can combine these techniques - they're all helpful for when you're short of breath. And remember, never hold your breath - you need the oxygen! Breathing control This is helpful if you are generally short of breath. Breathing control means breathing gently, using the least effort, with your shoulders relaxed and supported. Use one of the positions below. In a comfortable, supported position, relax your shoulders, arms and hands. Breathe in gently through your nose and breathe out through your nose or mouth. Try to feel more relaxed and calmer each time you breathe out. Relaxed breathing techniques When doing an activity like walking, gently slow down your breathing and breathe more deeply. Breathe in through your nose and breathe out through your mouth. When breathing out try not to force the air out. Place your hands on your tummy, feel your tummy rise when you breathe in and fall when you breathe out. This can be used at rest or on exertion and can be combined with pursed lip breathing.
Pursed lip breathing Breathe out with your lips pursed, as if you're whistling. This slows your breathing down and helps to make your breathing more efficient. Blow as you Go Breathe out when you're making a big effort, for example: stretching your arms above your head reaching for something on a shelf bending down going up a step or stair standing up or during the hardest part of any action BLOW as you GO! Positions of ease The best positions are the ones which need the least energy or effort. If you tense your shoulders and grip onto things when you are breathless, you're wasting energy (and oxygen). Try the following positions to assist your breathing:
Standing or walking Using a walking aid (walking stick, or a frame with wheels at the back and front) can help you find one of these comfortable postures when you are out and about. Most people feel better pushing a supermarket trolley - it works the same way. Paced breathing This is useful when climbing the stairs (or walking). Breathe in, in time with the steps you take. Do this in a rhythm that suits you and how breathless you are. For example: breathe in when on the stair, and breathe out as you go up a stair (blow as you go!), or breathe in for one stair and out for one stair, or breathe in for one stair and out for two, or breathe in for two stairs and out for three Boom and Bust Activity Cycle On a day when you are feeling better, it is very tempting to increase your activity. You try to catch up and do jobs or exercise you have neglected on bad days. It is easy to do more than your body is used to handling. This is known as the boom phase. What happens next? You crash the bust phase. Your body is forced into recuperation, and can t do anything. This can become a vicious cycle, where you take one step forward and two back. Pacing your activities Pacing is the opposite of the boom and bust cycle. You learn to recognise how much activity you can manage. Instead of continuing an activity to the point of exhaustion, you stop and rest. It may be that you first need to find out by trial and error what you can comfortably do. Once you know this, you can achieve a balance between your activity and rest.
Arranging things around the house Put items that you use most frequently in easily accessible places. This may take some organisation, but will help to make life easier for you. Things to avoid People find that lifting heavy items such as wet laundry or shopping bags can cause them to become tired or short of breath quickly. Try to only carry small amounts at once. Rushing to answer the telephone, try to make sure that your family and friends know that it can take you some time to answer the phone. It is important to practice the breathing, positioning and pacing techniques when you are not breathless to help you perform them well when you need to use them. Burnley General Hospital Telephone: 01282 804110 Accrington Victoria Hospital 01254 359061 Pendle Community Hospital 01282 804983 Accrington PALS Telephone: 01254 282390 Royal Blackburn Hospital Telephone: 01254 735091 Rossendale Primary Health Care Centre Telephone: 01706 253607 Clitheroe Physiotherapy Centre 01200 423805 St Peters Centre Telephone: 01282 644086 Author: Physiotherapy Date of issue: September 2015 Revision date: August 2017 Version: 3 Document ID No: PHYSIO 003 Breathlessnessmanagement September 2015