Asthma is one of the most common chronic respiratory diseases in Canada, affecting more than 3.8 million Canadians, and is the third most common chronic disease. Symptoms include difficulty in breathing, wheezing and cough at night, trouble in expiration, and tightness of the chest/discomfort in the chest. Chronic respiratory diseases are becoming more prevalent in Canada, and increasing so as Canada’s population ages. This places quite a demand on our healthcare system. Tobacco use and reduced air quality are two major risk factors of many and Canada’s government admits that respiratory diseases are a major health problem, requiring a collaborative approach. Could Yoga be a possible solution to address this looming concern?
Yoga Therapy, as defined by the International Association for Yoga Therapists, is the process of empowering individuals to progress toward improved health and well-being through the application of the teachings and practices of Yoga. As spoken by the well known Yoga Instructors TKV Desikachar & Kausthub Desikachar, “Yoga therapy can not only be preventative or curative, but also serve a means to manage the illness, or facilitate healing in the person at all levels.” If Yoga Therapy has this potential, especially with the application of breath work and physical postures affecting the respiratory system- two known applications of the traditional Yoga practice- one can only imagine the likely benefit it will bring to those effected by chronic respiratory conditions such as Asthma.
Yoga Therapy stands apart from “traditional” Yoga lineages in that it incorporates modern medical and scientific knowledge to address health holistically and comprehensively. Yoga has accumulated a huge store of experiential data and medical research is growing in support of its effectiveness for conditions such as back pain, multiple sclerosis, insomnia, cancer, heart disease, and even tuberculosis. Through the application of Asana (stable postures), Diet, Breathing Exercises, Meditation, and Mobility Exercises, Yoga has been shown to reduce stress, increase strength, flexibility and balance, enhance immune function, lower blood sugar and cholesterol levels, and improve emotional and mental well-being.
Yoga promotes “mastery over the mind”, based on the premise that “the root of all psychosocial illnesses is in the mind; which causes an internal imbalance due to long standing stressful and demanding situations of life.” Awareness of our thoughts and discipline of the mind has tremendous potential to bring clarity of mind, inner peace, and emotional stability. And when the mind is calm, the body is calm. Anxiety makes us want to pace, whereas stimulating the vagus nerve can alleviate depression. Those who exercise report a more positive outlook on life. Breathwork calms the body, and in turn calms the mind. The influence is bidirectional and calming one should influence the other.
This is the mind-body connection, and it is not just a theory anymore. The effect of stress and negative emotions on our immune system is well documented. Chronic stress has been associated with suppression of immune function, whereas Meditation benefits the immune system (by decreasing cytokine) and promotes health aging (telomere shortening). Likewise, the positive emotion brought about by meditation helps with mental conditions such as social anxiety disorder, post-traumatic stress disorder (PTSD), anxiety, and depression.
The practice of Yoga aims to cultivate awareness of one’s mental and behavioural patterns and has great potential to being mental, emotional, and physical well-being. Its potential to alleviate Asthmatic symptoms is also well-documented by medical literature. A 90 day practice can positively impact pulmonary function in those with mild to moderate severity of bronchial asthma. The Yoga practice, assuming it is properly introduced, ideally by a well-trained Yoga Therapist, might be worth considering as an adjuvant therapy to standard asthma treatment. Breathing exercises, in particular, may have positive effects on quality of life, hyperventilation symptoms, and lung function.
Breathing exercises are commonly used by physiotherapists and other professionals to control asthma symptoms. Dysfunctional breathing is commonly observed in 29% to 64% of asthmatic patients, with a higher incidence in patients with difficult-to-treat asthma and poor asthma control. Dysfunctional breathing is characterized by an unusual breathing patterns with disproportionate breathlessness. Such breathing patterns contribute to dyspnoea (shortness of breath) in those with asthma.
There is debate about how to promote proper breathing in those affected by asthma, so as to not worsen their condition and exacerbate the asthma symptoms. The Buteyko breathing technique, for instance, teaches patients to voluntarily reduce the volume of breathing by relaxing and tolerating slight “lack of air” sensations. This technique can improve the length and force generating capacity of the diaphragm and alleviate asthma symptoms within months with regular practice. Hypertonicity and weakness of respiratory muscles can contribute to dysfunctional breathing patterns. For this reason, controlling the breathing volume and consciously relaxing the tensed respiratory muscles are likely to be of benefit to those experiencing asthma. By contrast, diaphragmatic breathing (The Papworth Method) has been demonstrated to potentially increase dyspnoea and decrease functional strength due to excessive relaxation of the abdominal muscles.
Asthma patients would also benefit from practicing nasal breathing as opposed to mouth breathing. Chronic mouth breathing can negatively affect respiratory system and overall health, contributing to a greater incidence of snoring and sleep apnoea and inducing negative changes in the bone structure and overall facial appearance. Nasal breathing, by contrast, is important for eliminating bronchoconstriction, leading to better prevention and treatment of asthma. Breathing training protocols for asthma might also include the application of relaxation techniques to self-regulate when faced with stressful circumstances that induce anxiety.
The application of the wisdom of Yoga through improvement of breathing patterns and the incorporation of relaxation techniques can improve asthmatic symptoms (wheezing, shortness of breath, chest tightness, and coughing) and reduce or eliminate the use of steroids. Those affected by asthma with a regular and well-guided Yoga practice can benefit from healthier lungs muscles and improved breathing patterns. The yoga practice also helps in controlling asthmatics attacks through Minimum Breathing, Asanas, Relaxation, and Meditation.
Yoga students with asthma who are not accompanied by an experienced Yoga Teacher or Yoga Therapist might consider some of the following approaches:
Seated posture for breathing exercises: Sit comfortably on a chair or in a cross-legged position. The hips should be higher than the hips. You can sit on a cushion to elevate your hips. There should be a natural curve in your lower back and ensure that the lower ribs are not sticking out. If it is, bring the ribs in so that the spine is long. The ears should be in line with the shoulders and the chin slightly tucked such that you are elongating from the crown of the head. Relax the shoulders.
Lengthen the exhalation: As you breathe, gradually lengthen the exhalation such that it is longer than the inhalation. In the beginning, the exhalation may be only twice as long as the inhalation. Progress until the exhalation is 4 times as long as the inhalation and observe the effect of this on your body and mind. Try to breath through the nose for this exercise. If this is difficult, inhale through the nose and exhale through pursed lips. You can try to do this whenever you feel an asthma attack coming on. And if this is not the solution for you during the onset of an asthma attack, it may help you to find calm within yourself after the attack has passed.
Buteyko breathing technique (instructional video in link): This technique refers to slow, regular breathing through the nasal passages. Slow down your breathing to the point that you feel that you need to take a bigger breath. Deliberately soften your breath and so that the breath is calm, light and soft. It is recommend to practice this technique daily. If it is uncomfortable, you may want to consult a Yoga Therapist for assistance. There seems to be a wide consensus that this technique has great potential to relieve asthma symptoms, and such as session may be worth the investment in light of this.
Full body relaxation exercise: Lie down comfortably for this exercise. You might prefer to practice this right before bed. Tighten all parts of the body one at a time (for 3–5 seconds), then relax them. Repeat this 2 more times. You might also opt to tighten body parts separately, such as the legs and feet, then the hips and glutes, then the abdomen, torso and back, then the arms and hands, then the shoulders and neck, then the head and face. The body should feel very relaxed after this exercise. You might also consider consciously relaxing each body part with intention. For example, repeat to yourself in your mind “I am relaxing my feet, my feet are relaxed.” Do this for each body part.
Visualization: After you have relaxed the body, perhaps with the method mentioned above, visualize in your mind’s eye a beautiful place, what you consider to be the most beautiful place in the world where there are no worries and no problems. Many like to visualize the beach, a meadow or a forest, whatever you consider to be beautiful and peaceful. Notice your surroundings and incorporate the various senses: listen for sounds and notice the textures. Put a lot of detail into this visualization. Spend some time in this place and profit from the deep relaxation that it brings.
Self-massage: Massage easy to reach areas such as the neck, head, shoulders, face and feet. If you have a foam roller, you might also consider massaging the calves, hamstrings, thighs, glutes, lower back, and iliotibial (IT) band. Self-massage can reduce anxiety and depression, muscle strain and tension, pain, digestive problems, and headaches.
Meditation: There are many ways to go about this. You can repeat a mantra out loud or in your head, such as the mantra OM (pronounced AUM). Another mantra is SO-HAM. You can recite “SO” on the inhale and “HAM” on the exhalation. SO-HAM is the sound of the breath. You can also focus on your breath, observing the inhalation and exhalation, as well as the pauses between the inhale and exhale. Many prefer guided meditations, which are recordings of different people guiding you to relax and concentrate on different things, such as the breath, body sensations, the sounds around you, and more. This is a great way to start your meditation practice. Another option is Trataka, or prolonged concentration on the flame of a candle. With this method be sure to blink when your eyes start to water. Any of these approaches are just fine. Chose a meditation technique that appeals to you so that you are more likely to practice it. Regularity is key and it is best to practice at the same time each day, if possible. Be patient with yourself as you strive to develop consistency and patience.
As you can see, there are many resources available within the realm of Yoga for those who struggle with Asthma. There are many possibilities, many of which can be found in Yoga journals and in informational videos, such as those on Youtube. If you have asthma or know someone affected by this condition, try to be mindful of the sources you are taking your information from and ensure that they are reliable and reputable. A consultation with an experienced Yoga Teacher or a Yoga Therapist would be useful to get some feedback on your breathing habits and implement some strategies that could bring long term results and eventually improve asthmatic symptoms. Self-care rituals, such as visualization, journaling, and meditation are also highly recommended and the regular implementation of such rituals can make a big difference alone. For the best outcome, however, modification of breathing patterns is the best course of action.
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