As many of you know, I am a respiratory therapist and I work with people with lung conditions at an outpatient pulmonary rehabilitation center. When we schedule a new patient, their initial visit not only gives us a good story of their health history but it also lets the therapist know what things each day are causing breathlessness and what areas of strength and endurance are problematic. In that first visit, which we call our assessment, the therapist sits down with the patient one on one for at least an hour to discuss what they find causes their breathlessness on a daily basis. Having done this often for many years I have found that I can identify some of the top answers I get from lung patients in regards to many topics. Upper body weakness is a common area of concern for many of my patients. Some of the top responses I get from lung patients when we discuss daily activity are:
“I get very breathless when I carry anything.”
“I get short of breath when I try lifting anything over my head like putting a stack of dishes away”
“I get breathless lifting my oxygen tank or concentrator out of my car.”
“I get winded when I am holding my arms up in the air trying to fold laundry.”
“I get short of breath holding my arms up to wash my hair and moving them around to bathe.”
Many of these activities of daily living are a constant struggle for lung patients. Trust me… I believe it. Much of the breathlessness is coming from not only the activity but the required arm strength that it takes to accomplish the task. It is very popular to solely focus on the endurance piece when we are exercising and not make strength training a priority. Sometimes my patients will tell me after completing their cardio workout that they are going to “skip the weights” and do them the next visit. And that’s okay occasionally, but it is so important on a routine basis that people with lung conditions incorporate upper body strengthening into their workouts.
I’m going to give you 6 exercises today that will help to increase your upper body strength and let you know how each exercise is applicable to your activities of daily living.
*** As with all exercise programs, please make sure it is fine with your doctor to start any new exercise routines. Also, if you have experienced any shoulder injury in the past, please check with your doctor if there are limitations to your range of motion as well as any weight restrictions before trying any of these exercises. I also recommend trying each movement without any weight to make sure the range of motion is comfortable for you. If you have any pain, stop the exercise immediately and see your doctor for recommendations.***
Before you begin, I want to give you 3 BASIC RULES I tell each of my patients when doing any strengthening exercises.
1. “If it hurts, don’t do it” – If you have range of motion issues in your joints, doing a weight lifting exercise that causes you pain is not going help resolve this, in fact you may cause more problems in your joint if the range of motion issue isn’t resolved first. Prior to putting any weight in your hands… check to make sure you can perform the movement without any pain. If you experience any pain while lifting weights, STOP IMMEDIATELY and notify your doctor for recommendations. DO NOT keep going. “No pain, no gain” IS NOT our focus!!!
2. “Go slow” – Going slow is a great way to make sure you are performing the exercise with proper technique and will ultimately prevent any injury or sprain. If you haven’t been using any weight lifting in your exercise routine, start with very light weights and slowly work up in number of repetitions.
3. “Breathe” – We all have a tendency to hold our breath while lifting weights. Make sure you use your breath to help fuel your muscles and breathe in and blow out through each repetition. This is another great opportunity to practice using a breathing technique (See Breathing Techniques Blog).
Many of these exercises can be done standing or sitting. For many of my patients, standing alone makes them breathless or they get “wobbly” so I tend to instruct these exercises sitting. As the patient gains strength we can often time transition them to standing. The benefit if you are sitting on a seat with a back to it is that you can press your spine to it and give yourself a little more back support.
Okay now that you are prepared…on to the exercises!!!
1. Overhead Press (This exercise is great for increasing strength to lift things overhead. It strengthens back and shoulder muscles.) – If standing, stand with your feet shoulder length apart. If sitting, sit straight up with your back supported. Start with your arms at shoulder level. Raise them up over your head (while exhaling) and lower them back down to shoulder level. Repeat 10 times.
RULE OF THUMB: If you can not do 8 repetitions… the weight that you have chosen is too heavy for you. As you get stronger, increase you repetitions adding 1 or 2 each session. When you get to 20 easily… advance your weight.
2. Bicep Curl (This exercise is great for increasing strength in your arms for lifting and carrying.)- If standing, stand with your feet shoulder length apart. If sitting, remember to slide back in your seat and support your back with your chair. Hold the weights in your hands at your sides and breathe in. Keep your elbow tucked in and exhale as you lift the weight up by bending your elbows. Do not swing the weight at your shoulder to lift it. Lower the weight back down while breathing in. Repeat 10 times
3. Upright rows (This exercise increases strength in your shoulders and back allowing you to lift heavier things like grocery bags and full laundry baskets.) This exercise is best accomplished standing so that you can have full range of motion and keep your back straight. Stand with weights in front of your hips and take a deep breath in. Exhale while lifting the weight up bending your elbows and then inhale while returning back down to your hips. You will see in the picture that I kept my shoulders down and trying not to arch my back. Repeat this exercise 10 times.
4. Side Shoulder Raise (This exercise is great for increasing strength in your shoulders and back. We use these muscles for lifting groceries and opening heavy doors.) You can do this exercise standing or sitting. Remember to keep your back straight or supported. Do not arch your back. I like to instruct this exercise one arm at a time. As you increase your strength, you may want to see if you can try both arms at a time but DO NOT compromise your technique. Hold the weight down by your hip on either side and breathe in. Breathe out as you slowly raise each weight to shoulder height. DO NOT go any further than a 90 degree angle. You do not want to hyper-extend the shoulder. Inhale as you lower the weight back down to your side. Repeat 10 times.
5. Front Shoulder Raise (This exercise is great for increasing strength in your shoulders and back. You will use these muscles lifting objects, pushing shopping carts and holding your arms up on a steering wheel.) Standing or sitting with back straight or supported. Hold the weight in each hand side your hips. Take a deep breath in and blow out as you lift both weights directly in front of you. Again do not raise them higher than a 90 degrees. Inhale as you slowly lower the weight back down to your hips. Repeat 10 times.
6. Tricep Kickbacks (This exercise will strengthen your arms to help assist you in getting up from a chair and reaching above your head.) Stand with your feet shoulder length apart and bend slightly at your hips. Lean over a chair for balance if you need it. Hold the weight in your hand then slowly straighten your elbow behind you as far as comfortable. Do not swing the weights. Exhale as your lift and inhale as you come down. Repeat 10 times. If you can’t do this exercise standing, no big deal! You also have the option to sit, slide back in your chair, and lean over your knees slightly.
Some extra tips:
· You may experience some mild muscle soreness especially if you are new to weight training. This soreness should not prevent you from doing your daily activities. Give yourself plenty of time to recover from your workout. If the soreness is more severe, cut your workout back the next time you exercise or visit your fitness center.
· Lung patients need to make sure they rest between each exercise. You may be surprised how just lifting these weights can increase your heart rate and cause breathlessness. Make sure you give your breathing time to stabilize between each exercise that you do.
· Wear proper footwear to give yourself good balance and to prevent slipping or skidding.
· Hydrate – drink plenty of water during your work out and after your workout. Water will help to flush the muscles of any lactic acid that may cause muscle soreness.
SIDE NOTE: If you liked the weights I was using in the pictures, they are available on Amazon. They are the Bowflex SelectTech 552 Adjustable Dumbbells. We purchased them about 5 years ago because the workout space on our home is small and my husband and I liked the fact they were everything we needed in one set. No need to go out and buy multiple pairs of weights as we increase our strength. It has the option to adjust the weight from 5-52 pounds just by turning a knob. They are definitely on the pricey side and are a bit of an investment but (at the time I posted this blog) seem to be $50 off on Amazon. Feel free to click on the picture below to find out more or to see other options of weights that might interest you.
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