Asthma – Pilates as a Therapy

by Pamela McAvinue

When I was asked to write this article I was concerned that it may come out sounding like an article that is about me and how I coped with my fitness restrictions with Asthma. I feel strongly that by sharing my experience, I hope I can encourage other asthmatics that they too can benefit from a daily exercise regimen of Pilates.

In a day where sedentary lifestyle seems to be a new epidemic of inactivity and obesity, it’s important now more than ever to get asthma and allergy sufferers to add a safe and effective exercise program. To those individuals who have breathing issues, Pilates is a program that can improve your health without subjecting you to your allergy and asthma triggers that are generally associated with outdoor activities.

Currently, there is very little anecdotal evidence that Pilates will mitigate asthma symptoms. However, in my case, as I will describe for you below, Pilates has improved my coordination, flexibility, breathing, and strength. Concentrating on our core muscles and using the breath to facilitate movement enabled me to focus on endurance as well as concentration and centering as it has also decreased frequency of asthmatic episodes. I feel that I have an increased my lung capacity and mobility of the upper thoracic back and shoulders.

As far back as I can remember I’ve had to deal with asthma, just as my mother did for all of her life. Unfortunately, in my mother’s case it ultimately contributed to her death at fairly early age. Although doctors today can help a patient manage their asthma, they don’t know how to heal the disease. Once you have it, it’s for life. In addition, there is still very little known about what triggers asthma, so most of the focus has been on treating the symptoms.

I painfully recall times while growing up, doctors telling me or my mom that it was in our heads. Actually, asthma is a chronic disease in the airways of your lungs. The airways, which are tubes that carry air into and out of the lungs, are inflamed. This makes the airways swollen and very sensitive. They tend to react
strongly to airborne substances that are breathed in. When the airways react, the muscles around them tighten. This causes the airways to narrow and less air flows into and out of the lungs.

Those individuals blessed without asthma will never know what it’s like to have an asthma attack and struggle for every breath. As most people know, many of the triggers for asthmatics are allergens. In my case, I do remember at the age of 9 being diagnosed with allergic Rhinitis. I later found that this too was a contributing factor to my laryngitis episodes. This condition would last 2-3 weeks at a time and would
occur up to 3 times a year. Doctors would say to me to “relax” and tell me to rest my voice, and it would come back. This went on intermittently for years, as I tried various allergy immune-suppressant programs to control my asthma.

When I reached my 20’s, the frequency of laryngitis appeared to be slowing down and some of my more severe asthma and allergic tendencies were being better controlled. For a while there I thought that I was managing the symptoms and learned to live with them. Occasionally, I would experience a few side symptoms that didn’t appear to be a major problem. These included; a persistent sinus drip, allergic coughing and sneezing along with my asthmatic cough and tension in the lungs. My thinking was that they were relatively minor compared to the bigger picture. In actuality, it was these very symptoms in 2002 that caused me to lose the use of my vocal cords for nearly two years as well as disrupting my normal breathing rhythms and increasing my asthmatic episodes.

The continual inflammation from the former symptoms and the percussive effects of coughing, sneezing and tension on the vocal cords essentially caused them to move into a state of paralysis. There they stayed, shut down for a better part of two years. The volume level of my voice remained at just a whisper. It was very frustrating for me personally, unable to communicate effectively at times. In fact, I recall occasions at
home when I answered the telephone only to have the caller hang-up because they couldn’t hear me. Later, these problems seemed to cause further issues. Not only physical but also subtler emotional issues developed which started to take a toll on me. Because the vocal cords were not functioning at all they were in an open state in the esophagus. So when I tried to communicate with people in whispered tones, you could not control the airflow into and out of the body causing dizzy spells and light headedness.

After seeing 6 specialists and a Physical Therapist specializing in vocalization, we finally found the root cause and effect and started a Physical Therapy program immediately. My doctor informed me that our vocal cords function very differently in the body and that often times they have a mind of their own. Furthermore, I was also told that they will start to function when they were ready. After eight months of vocal therapy, which consisted of many exercises to stimulate the vocal chords, I saw no results. On
one occasion a physical therapist recommended that I take up Pilates to help supplement the vocal physical therapy program. At first, I wasn’t completely convinced it would help. But, I thought if it might help my breathing and strengthen my core it might have some benefit.

I joined the local YMCA and started take the Pilates mat class there 3 days a week. Three months went by and I could see some increased improvement in my lung capacity and endurance. I continued my Pilates
classes along with the physical therapy program and progressively, my doctors and therapist and I could see incremental improvements were developing.

Twelve days shy of two years my voice started to come back in crackled tones similar to that of an adolescent boys voice change. This went on for another couple of months, and finally my voice, weaker in quality, had returned.

The exercises that were most frequently emphasized were the following. We combined some of the physical therapy vocalization with the Pilates exercises posted below.

Imagine, humming in as low a range as possible while keeping it heavy not only into the chest, but try to carry it upward into the head.
Examples: Humming Meeeeeeeeeeeee, Maaaawhhhhs, awwwwwwhhhhs, ahhhhah’s as you worked to
sustain or suspend the exhalations while moving through-out the various core exercises.

1) Breathing Exercises – focused on back breathing in a seated flexed position, supine and or prone positions with soft 9” ball.
2) Head Float – (Nose Circles and Nods while performing raspberries through pierced lips). Lengthening and relaxing face, neck and jaw muscles releasing any tension.
3) The 100 – To strengthen the abdominal muscles.
4) Band Stretching – Worked to improve shoulder movement and rotation and open up the chest.
5) Single leg Stretches, Double Leg Stretch – Strengthening the abdominals while challenging the body’s center of gravity through movement. Mobilizing the shoulder joints and to coordinate the breathing with movement of arms and legs with abdominal control.
6) Lateral Flexion – to open and stretch ancillary muscles of the side ribs.
7) Seated Twist – providing mobility in the spine in rotation and to expand the ribs on the inhalation.
Swan - Swan opens the front-body, expands the chest and stretches the abdominals, hip flexors and quadriceps.
9) Scissors – to increase abdominal control.
10) Alternating Arm Swings – to mobilize the shoulder joints, open up the chest muscles.
11) Leg Lowers – used to strengthen the abdominal and increase body extension.

It’s important to note: Asthma and allergy sufferers should seek out treatment from your doctors and collaborate together to develop a treatment program to control future asthmatic episodes before adding any new exercise programs. Avoid triggers and allergens and use preventative medications to manage you symptoms while adding a safe and effective exercise program such as Pilates. In my case, I ignored these symptoms; I thought I had most of my symptoms covered and under control. But, in hindsight I’ve learned that by ignoring those minor symptoms, it contributed to the loss of my voice and breathing irregularities.

Pilates instructors working with asthmatic clients should use slow controlled nasal breathing methods. This type of breathing through the nose helps to warm and humidify the air intake into the body. I would encourage instructors to emphasize posterior and lateral breathing to increase lung expansion and flexibility of the rib cage.

In the final analysis, I don’t want to imply that Pilates will cure someone’s asthma and it’s certainly not a substitute for your asthma medication. However, I do feel it can go a long way to help support and enhance your current treatment program. Pilates helps by calming the mind and lowering the stress hormone activation, enhancing proprioception and kinesthetic awareness. I also feel that it improves muscular
strength, posture, balance, breathing and confidence in one self. I feel lucky that I had the benefit of two strong and encouraging role models that supported and guided me to wellness through Pilates. I would like to acknowledge Sheri Cognetti and Joan Lachiewicz.

About the Author: Pamela McAvinue, 47, is a Certified Pilates Teacher from the PhysicalMind Institute.  She is also a Personal Trainer and Group Fitness Instructor. Pamela has taught at the YMCA in Fanwood-Scotch Plains, New Jersey for the past 5 years.  Other certifications include: Reebok Cycle, Fit ball, Punk Rope, Yoga Fit and WillPower and Grace.

Tags: Pamela McAvinue, PhysicalMind Institute