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The Official Guide to Exercising with COPD

Jun 1, 2018 3:14:54 PM / by Cory Luckner


Did you know that pushing yourself to exercise within reasonable limits can actually help to manage and improve the quality of your chronic obstructive pulmonary disease (COPD)?

Upon a COPD diagnosis, your entire life is flipped upside down. What you may have thought was attributed to aging, has been diagnosed as a full fledged respiratory disease.

As COPD affects your lungs, causing scarring, inflammation, and an excess production of mucus that makes it increasingly difficult for your lungs to absorb oxygen.

With a constant presence of shortness of breath, you may feel that exercise would only worsen one of the top symptoms of COPD, shortness of breath.

But in fact, it’s quite the contrary…

Though exercise may seem like an extremely difficult challenge. Following a regular exercise routine can help to strengthen your respiratory muscles. While improving physical fitness levels, circulation, energy levels, oxygen use, and can also help to decrease the severity of your COPD symptoms.

Still not convinced? According to a study by ATS Journals, a regular exercise routine can help to protect you against COPD development as well as progression. What’s more, physical activity was also shown to slow down the decline of lung function.

So what does this mean? With higher levels of exercise you can experience increased disease and lifestyle benefits.

But first lets get this common question out of the way. Can exercise reverse COPD? The answer is no.

However, exercise can vastly improve the quality and management of your COPD.

Let’s dive into the steps you should take before you begin to exercise, COPD friendly exercises and which to avoid, plus much, much more!

Getting Started: Talking with Your Doctor In Regards to

Exercising with COPD

Before you can begin improving your COPD and overall quality of life through exercise. You should first check with your health care provider.talking-to-your-doctor-about-exercising-with-copd.jpg

By talking to your health care provider beforehand, they will be able to develop an exercise routine that matches your fitness and physical condition.

Here are a few questions that you should ask your doctor when looking to start an exercise routine:

  • How much exercise should I do each day?
  • How much exercise can I handle each week?
  • What types of exercises should I perform?
  • Which activities should I avoid?
  • Do I need to take my medication at a specific time around my exercise schedule?

Benefits of Exercising with COPD

Still hesitant to start exercising after receiving your COPD diagnosis?

Below you can find the numerous health and lifestyle improving benefits that can be experienced by sticking to a regular exercise routine:

  • Allows you to better control your weight
  • Improves COPD symptoms (shortness of breath, fatigue)
  • Lowers your blood pressure
  • Improves sleep while helping you to relax
  • Improves mental & emotional outlook
  • Increases your ability to do daily activities such as getting dressed or showering

Consequences of Not Exercising with COPD

By choosing to allow your chronic respiratory disease to restrict you from exercising, you should expect to experience one or many of the following side effects:

  • Decreases Physical Strength
  • Increases in Shortness of Breath
  • Depression
  • Loss of Independence
  • Unwanted Weight Gain

Types of Exercise

Now that we have given you some insight into the incredible disease & lifestyle benefits you can obtain through regular, and consistent exercise.

It’s now time to discuss which forms of exercise are the most ideal when diagnosed with a progressive respiratory disease such as COPD.

Check out these 6 low-impact exercises as you age from WebMD.


stretching-before-exercising-with-COPD.jpgIt’s extremely important that before you start and after you finish your exercise regimen that you set aside 5-10 minutes to stretch.

Stretching can help to improve your range of motion and flexibility gradually.

When talking about stretching, we are referencing the process of slowly bending and extending your muscles.

By stretching your muscles before you exercise, you are helping to prepare your muscles for increased activity and help prevent injury.

While stretching after completing an exercise will help to prevent muscle strain. Yoga is extremely beneficial for the stretching phase, but also the aerobic/cardio phase. Check out this list of COPD friendly stretches.

Aerobic/Cardio Exercises

Activox_Pro_Exercise.jpgThese types of exercises deliver steady physical activity, that require the use of large muscle groups, while greatly improving the overall strength of your heart and lungs.

Helping to enhance your body’s ability to deliver oxygen to your muscles. Enabling you to do more activities for longer periods of time.

Through a consistent effort of aerobic and cardiovascular exercises, you will begin to experience a lower heart rate and blood pressure.

This means that your heart won’t have to work as hard while being active, as a result your breathing can improve.

Low Impact Aerobic Exercises:

  • Walking/Jogging on the Treadmill
  • Walking Outside
  • Biking
  • Elliptical Training
  • Swimming
  • Walking Your Dog
  • Playing with the Grandchildren
  • Running Errands
  • Using an Exercise Peddler

High Impact Aerobic Exercises:

  • Jumping Rope
  • Step Aerobics
  • Running

Strengthening Exercises


These types of exercises focus on building muscle mass by strengthening your muscles through repeated sets of muscles contractions.

Through receptive weight lifting you can improve your upper & lower body strength, while increasing the strength of your respiratory muscles.

You may be turned off from strength exercises due to your physical abilities, but you should know that this doesn’t require you to lift a level of weight equivalent to that of a body builder.

Instead you can start out with a 3-5 pound dumbbell and slowly work your way up to heavier weight as your strength improves.

Later on in the post, we will discuss specific COPD friendly exercises that you can do from the comfort of your own home.

Breathing Exercises for COPD Patients

When your symptoms of shortness of breath begin to worsen, there are specific breathing techniques that you should use both during and after you workout. These COPD breathing techniques will help you regain control of your breathing.

Pursed Lip Breathing

For the first breathing technique, we will discuss pursed lip breathing. This easy to do breathing exercise offers a seamless way to take control of your shortness of breath.

Additional benefits include improving ventilation, removing trapped air in the lungs, keeps your airways open longer and decreases the work of breathing, and relieving shortness of breath to name a few. 

Pursed lip breathing is designed for times of physical activity. This can include exercising, climbing stairs, bending down, or when faced with random bouts of shortness of breath during your everyday activities.

To prepare for events of breathlessness, you should practice this breathing technique 4-5 times per day at first. You may perform this breathing technique either sitting down or standing up.

How to Perform Pursed Lip Breathing

  • Step 1: Sit up straight in a chair or stand up and relax your neck and shoulders

  • Step 2: Inhale deeply through your nose for 2-5 seconds (count to 5 on one hand)

  • Step 3: Purse your lips, such as if you are going to whistle

  • Step 4: Exhale through pursed lips 3 times longer than your inhale (count to 5 three times on your hand) make sure you are not forcing the air out.

Check out our pursed lip breathing video, to learn how to properly perform this extremely helpful breathing technique:

Remember that though exercise may induce increased levels of shortness of breath, it will not harm your lungs.

If you are experiencing shortness of breath, it’s a sign that your body needs more oxygen.

Meaning you should slow your breathing rate and focus on exhaling through pursed lips. Helping to restore oxygen to your body at a higher rate. 

Diaphragmatic Breathing

For the second breathing technique we will be discussing the diaphragmatic breathing technique that is used in many practices.

In fact, if you have ever participated in yoga you have already used this technique. What’s more, diaphragmatic breathing assists in reducing anxiety, sleep disorders, and many other respiratory conditions besides COPD.

With a COPD diagnosis, you are well aware how exhausting breathing can truly be.

Diaphragmatic breathing is designed to specifically help strengthen your diaphragm muscle.

Through a consistent effort and practice, you will spend less energy trying to breathe, and have more energy to do the things that make life exceptional!

For the greatest efficiency, you should perform this breathing exercise for at least 5 minutes per session, 3 times a day. This technique can be used before and after you finish your exercise routine.

Again, when first learning this technique you should practice multiple times throughout the day so you are prepared when faced with rising levels of breathlessness.

Diaphragmatic Breathing Instructions

  • Step 1: Lie on your back with your knees bent and feet placed firmly on your bed or floor

  • Step 2: Place one of your hands on your upper chest, while the other should be placed on your abdomen

  • Step 3: Inhale through your nose and exhale through your mouth, 3 times

  • Step 4: While breathing in, the only hand that should move is the one on your abdomen. Try your best to keep your chest as still as possible, it’s vital that you only use your stomach to breathe

  • Step 5: Practice makes perfect


Exercise Duration & Frequency

Your main priority when exercising with a chronic respiratory disease like COPD is to avoid over exerting yourself.

The point of exercising is to get you active and moving, not to induce increased feelings of shortness of breath.

When first beginning your exercise routine, focus on slowly increasing the duration and difficulty of your exercises.

Don’t get frustrated if you are unable to complete an exercise session, remember that you have a respiratory disease. But with regular practice and dedication, you will begin to see improvements in your physical abilities.

To help you better manage your shortness of breath while exercising, you should also practice the breathing techniques from above in your day to day life.

This way if shortness of breath arises during physical activity, you can put your mastered breathing techniques to work effectively.

After you have talked to your doctor and been cleared for exercise, you should set a goal of exercising for 20-30 minutes per session, 3-4 times per week. Unless instructed otherwise by your health care provider.

To start working towards obtaining your goal try a light walk around the block to see how far you can go until you become mildly out of breath. And each day after that you should attempt to increase your walking distance by 5-10 feet.

On the other hand, you could start with strengthening exercises such as lifting lightweight dumbbells. Then as your strength improves you can gradually progress to heavier weights.

Anytime you begin to feel short of breath, you should stop exercising and rest.

What You Must Include in Your Exercise Routine

Every time you begin an exercise session, it’s extremely important that your routine includes a warm-up, conditioning, and cool down phases.

But what do these different phases look like and contain?

Warm-Up Phase

To prevent putting excess levels of stress on your heart and muscles a 3-5 minute warm-up routine is essential.

Not only that, but warming up before you go into your full fledged routine will help to gradually increase your breathing to reduce the occurrence of exacerbating your symptoms.

Additionally, a warm-up phase will also slowly increase your circulation (heart rate), body temperature, while increasing flexibility and minimizing muscle soreness.

Ideal Warm-Up Routines for COPD:

  • Stretching
  • Move through Your Daily Planned Activities at a Low Intensity

Conditioning Phase

After you have given your body and muscles a chance to warm-up, next comes the conditioning phase. Often the most strenuous phase, the conditioning phase is when the true results of exercising are experienced and calories are burned.

During the conditioning phase of your routine, monitoring your intensity level is priority number 1 to reduce your chances of exacerbating your breathlessness!

When in this phase, you will be performing both aerobic and strengthening exercises such as the ones discussed above.

As you begin to make progress in your exercise tolerance, you can gradually begin to increase the duration of each exercise session.

Cool Down Phase

Following the completion of the conditioning phase you should now transition into a 3-5 minute cool down phase to allow your body to rest and recover. Additionally, your blood and heart rate will begin to return to a normal rate.

With a name such as cool down phase, you may think that means sit down and relax. In fact it’s quite the opposite.

You should avoid sitting, standing, or laying down during this phase of your routine. Doing so could lead to you experiencing feelings of dizziness, lightheadedness, or a fluttering heart rate (heart palpitations).

And with heart palpitations comes a risk of worsening your anxiety that can lead to worsening levels of shortness of breath.

Your cool down phase will often contain the same stretching activities performed in your warm-up phase, as these are exceptional exercises to slowly decrease the intensity of your workouts.

COPD Exercise and Activity Guidelines You Need to Follow

During all phases of your exercise routine, you should keep each of the following exercise guidelines in mind to ensure a safe and effective exercise session:

  • Slowly and steadily increase your activity level

  • Set goals for yourself; Ex. Do you want to improve strength, lose weight, or increase flexibility?

  • Make your exercise routine enjoyable with activities you actually like to do

  • Are there any physical conditions that eliminate certain exercises?
  • After eating, wait at least an hour and a half before beginning physical activity

  • Stay hydrated but still follow your fluid restriction guidelines

  • Incorporate exercise into your daily routine; Exercise at the same time every day

  • Switch up your exercise routine to avoid boredom

  • Find an exercise buddy to help keep you motivated

  • Maintain a steady exercise pace that allows you to talk while performing the activity

COPD Exercise Precautions

  • Avoid exercising in extreme temperatures. Hot, humid, and cold temperatures can worsen your levels of shortness of breath, affect circulation, and can even lead to chest pain

  • Wear loose fitting clothing that offers free range of movement, and make sure you are dressed appropriately for current weather conditions

  • Stay clear of hilly areas to help prevent over-exertion. If you are faced with an incline, you should walk slowly and monitor your heart rate consistently. Stopping and resting if necessary

  • At any point during your exercise you begin to feel dizzy, short of breath, or weak, you should stop exercising and give your body a break. Contact your doctor if symptoms persist. He/she can then make adjustments to your routine, medications, diet, or your fluid consumption if required

  • Try to avoid lifting or pushing excessively heavy weight. When lifting any object, make sure you are exhaling in the process, and lifting with your knees

  • When beginning new medication(s), ask your doctor how they will affect your ability to exercise

Signs You Should Stop Exercising

signs-to-stop-exercising-with-COPD.pngIt’s important to listen to what your body is telling you, especially when exercising with COPD.

If you experience any of the following symptoms, you should immediately stop exercising and sit down with your feet elevated.

If you are still unable to regain control of them, call 9-1-1.

However, even if you do feel better, you should still report these symptoms to your doctor.

  • Experiencing Troubles Walking, Talking, or Thinking
  • Nausea
  • Dizziness
  • Lightheadedness
  • Irregular or Rapid Heart Rate
  • Overall Weakness
  • Extreme Shortness of Breath, Even After Taking Medications
  • Severe Pressure or Pain in Your Arms, Chest, Neck, Jaw, or Shoulder

Rated Perceived Exertion (RPE) Scale

What is the rated perceived exertion (RPE) scale? To put it easiest, it’s used to measure the intensity of your exercises. The RPE scale is based on a 1-10 scale. 0 being least intense and 10 meaning most intense.

To put the RPE scale into perspective, 0 is the equivalent of sitting in a chair, while 10 would equate to performing a highly physical activity.

  • 0: Nothing at All
  • 0.5: Just Noticeable
  • 1: Very Light
  • 2: Light
  • 3: Moderate
  • 4: Somewhat Heavy
  • 5: Heavy
  • 6:
  • 7: Very Heavy
  • 8:
  • 9:
  • 10: Extremely Heavy

This rated perceived exertion scale is from the Cleveland Clinic. You should aim to exercise anywhere between 3 and 4 on the RPE scale. Make sure you are taking your shortness of breath and muscle fatigue into consideration.

Pulmonary Rehabilitation

what_to_expect_from_pulmonary_rehab.jpgIf you are struggling to exercise on your own, pulmonary rehab is an ideal option for you.

Not only that, but it’s highly recommended that all COPD patients enroll in pulmonary rehab.

Here is where you will learn about exercise, nutrition, COPD symptom management, breathing techniques, disease education, and more.

All with the help and support of trained medical specialists every step of the way.

Keep Yourself Accountable to Exercise

staying-accountable-to-exercise-with-COPD.jpgThis is such an extremely important aspect in order for you to stick to your recommended exercise routine.

When beginning an exercise routine with COPD, it’s important to make yourself accountable for exercise.

Exceptional ways to stay accountable to exercise include planning and staying committed to exercising with friends, family, gym classes, or entering events.

Often times to get the ball rolling, having someone else there to support and encourage you can help make exercise become a regular habit for you.

What's more, you need to also keep yourself accountable to stick to a COPD friendly diet. What you eat can directly impact your overall ability and the effectiveness of your exercise sessions.

Food is energy to your body, and your COPD ridden body can require up to 10 times the caloric intake than that of a non COPD patient.

However, you can't just consume copious amounts of junk food, instead you need to include vegetables, fruits, protein, and vitamins in your daily diet. Doing so will improve your exercise tolerance, quality, and overall experienced results.

Learn what a COPD friendly diet consists of in our Official Guide to COPD Nutrition.

Medications That Help You Exercise

With a diagnosis of chronic obstructive pulmonary disease (COPD), you may already be prescribed a metered dose inhaler and/or medical oxygen such as a portable oxygen concentrator.

However, if you’re not prescribed either, and notice your shortness of breath increases dramatically while exercising, mention this to your doctor.

They may prescribe you a metered dose inhaler to use before you exercise, and/or a prescription for medical oxygen to be used during peak physical activity.

Your doctor may also prescribe regular, daily and possibly even nightly use of a portable oxygen concentrator, depending on the severity of your shortness of breath.

It’s important that if your doctor prescribes medications to be used during exercise, that you actually use these medications to help reduce symptoms of breathlessness. You need to keep your self accountable for medication compliance.

COPD Friendly Exercises You Can Do At Home


We discussed the 3 exercise categories you should perform above, however, you may not have the want or ability to commute to a gym to exercise each day.

But that doesn’t mean you can’t receive the same benefits of exercise from the gym at home.

These at home exercises discussed below will all help to improve your breathing (lung capacity), strength, and mobility from the comfort of your own home.

Lower Body Exercises

Before starting any of the following exercises, you must consult with your doctor. They will be able to assess how long and how often you should perform these exercises. Additionally, you and your doctor will work to set your long term exercise goals.

Modified Knee Bends

Modified knee bends focus on improving the overall strength of your hips and knees. If you suffer from arthritis in your knees or hips, modified knee bends can also help with pain relief.

How to Do Modified Knee Bends

  • Step 1: Grab a chair from your kitchen table and sit down

  • Step 2: Cross your arms over your chest, while sitting up straight

  • Step 3: Now tighten your stomach muscles and bend forward slightly, while simultaneously standing up. You should be exhaling during this step

  • Step 4: Breathe in while you sit down and repeat these steps 10 times

  • Step 5: Set a goal of reaching 20 repetitions

Knee Extensions

how-to-do-knee-extensions.jpgKnee extensions are another lower body exercise that will help improve your overall mobility, so you are able to run errands, exercise, and socialize for longer periods of time.

While doing knee extensions, keep track of how many you can do before you become mildly out of breath.

Then each week you should either increase the number of knee extensions you do or the time you do them for.

Remember to gradually increase the time and/or length you perform knee extensions for.

How to Do Knee Extensions

  • Step 1: Pull up a chair and sit down with your feet spread slightly apart on the ground

  • Step 2: Raise your lower leg and straighten one of your knees, make sure you are exhaling while doing this step

  • Step 3: Now inhale as you slowly bend your knee and return your foot to the floor

  • Step 4: Repeat for each leg and stop just before you become mildly out of breath

Leg Lifts

Try leg lifts as an additional COPD friendly exercise option to boost your overall mobility, and your balance from the comfort of your home.

How to Do Leg Lifts

  • Step 1: Pull up a chair and sit down with your feet slightly apart, placed on the ground

  • Step 2: Exhale while lifting one leg off the ground towards your shoulder

  • Step 3: Inhale when returning your foot to the ground

  • Step 4: Repeat



Step-ups focus on improving and maintaining your balance and overall leg strength. While performing step-ups, you should focus on your breathing and make sure you are not holding your breath.

How to Perform Step-Ups

  • Step 1: Grab a small platform that is 8 to 9 inches above the ground. Place the platform near a hand rail or counter top for support; You can also opt to use a staircase in your home for this exercise

  • Step 2: Slowly step up onto the platform with your right foot, followed by your left foot

  • Step 3: Return both feet to the ground, and repeat this exercise 10 times starting with your right foot

  • Step 4: Repeat 10 more times, except leading with your left foot


Upper Body Exercises

As with lower body exercises, or any exercises for that matter, you must first schedule an appointment with your doctor to discuss if these exercises are right for you.

Furthermore, your doctor will be able to tell you how often and for how long you should participate in these exercises.

Axial Extensions

Axial extensions are beneficial for improving your posture, range of motion, mobility, and comfort by lengthening your spine. The improved posture obtained through axial extensions can help to improve your breathing efficiency.

How to Perform Axial Extensions

  • Step 1: Look straight forward and sit up straight

  • Step 2: Tuck your chin to align your ears over your shoulders. This should create a double chin

  • Step 3: Hold position for 10 seconds

  • Step 4: Repeat 5-10 times

Shoulder Blade Squeeze

The shoulder blade squeeze exercise helps to improve your posture, while opening up your chest muscles to help improve your symptoms of shortness of breath.

How to Perform the Shoulder Blade Squeeze

  • Step 1: Stand or sit in a straight and tall position

  • Step 2: Bring your elbows back and inward by pulling your shoulders back in a slightly downward position

  • Step 3: Return to original position

  • Step 4: Repeat 10 times

shoulder-blade-squeeze-exercise.jpgsource: Healthwise

Dowel Exercise

By requiring you to use your diaphragm and abdominal muscles to breathe, the dowel exercise is effective for strengthening your breathing muscles. Thus minimizing your feelings of shortness of breath. The dowel exercise will also help to improve your arm strength.

How to Perform the Dowel Exercise

  • Step 1: Grab a chair and sit down with your arms slightly benthow-to-do-dowel-exercises-for-copd.jpg

  • Step 2: Raise a dowel rode above and below your head. Dowel rods can be purchased from your local Walmart or for a life hack you could use a broom handle with the head cut off

  • Step 3: While lifting the dowel rod inhale for one second; now exhale for two seconds while you lower the dowel rod

  • Step 4: Continue to do this exercise for 2 minutes

  • Step 5: Every 2 to 3 days you should increase this exercise by 15 to 30 seconds, with a goal of reaching 15 minutes per session. As your strength improves you should add a 1/2 pound of weight to each wrist using wrist weights. But remember to do this gradually

Shoulder Horizontal Abduction

Shoulder horizontal abduction focuses on improving the strength of your arms and shoulders with the use of a resistance band.

How to Perform Shoulder Horizontal Abductions

  • Step 1: Grab a resistance band or lightweight dumbbell

  • Step 2: Using a resistance band or lightweight dumbbell, reach forward with your hands directly in front of you at shoulder height

  • Step 3: Keep your palms facing down

  • Step 4: Reach out to the side of your body with both hands simultaneously

  • Step 5: Hold for 3-5 seconds

  • Step 6: Repeat 10 times

  • Step 7: Each week you should make it a goal to add 3 repetitions, until you reach 20. Once achieved you should now move onto the next level of resistance band


Arm Extensions

Arm extensions are an ideal exercise to improve the strength of your arm and shoulder muscles. As a result your overall breathing can improve, and help reduce the strain of daily chores and activities.

You should perform arm extensions slowly and gradually. Keep track of how long you can perform arm extensions or the number of arm extensions you can do before becoming mildly out of breath.

How to Properly do Arm Extensions

  • Step 1: Sit down and place your arms by your side

  • Step 2: Raise one arm to shoulder height while exhaling, make sure your arm is straight and pointing outwards

  • Step 3: Inhale while you bring your arm down to your side

  • Step 4: Repeat for both arms; stop just before becoming mildly out of breath

  • Step 5: You should aim to increase the duration of arm extensions or the number of sets you do each week


Source: Healthwise.org

Elbow Circles

Looking to strengthen your arm and shoulder muscles? Elbow circles are exceptional for targeting both muscle groups, and as a result your breathing can improve. This upper body exercise can be performed either sitting down in a chair or standing up.

How to Do Elbow Circles

  • Step 1: Either sitting or standing, place your feet slightly apart on the ground

  • Step 2: Place your hands on your shoulders, keep your elbows level to your shoulders, pointing in an outward direction

  • Step 3: Move your shoulders in a circular motion. You should exhale at the beginning of the circle and inhale at the end

  • Step 4: Repeat; each week you should increase either the duration you perform elbow circles or the total number of repetitions



We have covered every aspect of exercising with COPD, but now that you are equipped with the knowledge on how to approach exercising, it’s up to you to put this knowledge into action.

By following the exercise tips in this guide you can take an actionable approach to improving your physical fitness, COPD symptoms, and more importantly your overall quality of life.

Remember that before starting any form of exercise, you must speak with your doctor to ensure that exercise is right for you. Doing so will also allow you to set attainable long-term exercise goals.

How has exercise improved your quality of life with COPD? Which specific exercises provide the most and least benefits for you? Leave your response in a comment below to help encourage other patients to jump on the exercise bandwagon. I look forward to reading about all of your improvements!

Topics: COPD, Exercise

Cory Luckner

Written by Cory Luckner

[Blog 2nd part here]