How Exercise Can Help You Manage Bronchiectasis

Ultimately, the goal is to get into the habit of moving consistently. A personalized exercise routine for bronchiectasis can support airway clearance and improve your quality of life in a way that feels safe and sustainable.

When it comes to physical activity for bronchiectasis, there are a number of things you can try. Consider the following types of exercise to start.

Walking or Cycling

Walking and cycling are good places to start because you can control the duration and intensity, says Marjorie Cullinan, a registered respiratory therapist and registered pulmonary function technologist at the Yale New Haven Hospital in Connecticut, where she specializes in working with patients with conditions like bronchiectasis and cystic fibrosis.

If you’re new to exercise, start with about 10 minutes of walking and work up to 30 minutes per session. A treadmill can help you adjust speed and incline too, Cullinan says.

“We recommend things like intervals where you walk quickly for one minute, then walk slowly for one minute. You can push yourself a little bit then allow yourself a minute of recovery,” she says.

The key is to take deep breaths and make sure you’re challenging the lungs. You shouldn’t be at the point where you’re gasping — you should still be able to speak in complete sentences while pushing your heart, lungs, and muscles a bit harder, she says.

Cycling on a stationary bike, getting on a StairMaster or taking an incline walk can also be beneficial, according to Panagis Galiatsatos, MD, a pulmonary and critical care medicine physician at Johns Hopkins Medicine and a medical spokesperson for the American Lung Association.

“The best exercises are going to be anything that really pushes the thigh muscles because that sends more blood to the lungs and helps the lungs better adapt,” Dr. Galiatsatos says.

Strength Training

Strength training (aka resistance training) can help you preserve muscle mass, stay functional, and make everyday tasks easier, says Christina Hunt, the senior director of education and care delivery at the Bronchiectasis and NTM Association and a Richmond, Virginia–based registered respiratory therapist.

Hunt says the goal isn’t to get into bodybuilding, but to improve your quality of life. “We’re hoping that exercise will translate well into [your] lifestyle … it isn’t ‘How much can you lift?’ it’s ‘Can you carry your laundry basket up a set of stairs to your bedroom?’” she says.

Cullinan recommends trying lower-body movements that use your own body weight to build strength, such as step-ups or squats, sit-to-stand exercises from a chair, and climbing stairs. Upper-body exercises can include lifting light weights, using resistance bands, or gym machines that can help strengthen the chest wall and upper-body muscles involved in breathing.

She suggests starting with 10 repetitions, focusing on form, before working up to three sets of 10.

“You don’t even realize how much you’re taking deep breaths in your exertion of moving weight. It’s really helpful to do [these exercises],” Cullinan says.

Resistance training will help your body strengthen after a long illness, Hunt says. “Having a body that is fit may help compensate for lower lung function. In my career, I’ve seen endless examples of how those with strong bodies have been able to compensate when their lungs didn’t work well,” she says.

Mobility and Chest-Opening Stretches

Stretching can be especially helpful for posture and chest expansion. Cullinan says that in respiratory care, the focus is on chest wall mobility, which means keeping the muscles around the chest open and flexible enough to support deeper breathing.

“We — not just in the bronchiectasis population — spend a lot of time seated and at a desk, where we pull our shoulders forward,” Cullinan says. “We’re in an arched position over our keyboards, and it’s really important to stretch the chest wall muscles for breathing.”

Start with simple posture work, such as rolling the shoulders back and sitting with your head and your chest over your hips. The goal is to stretch the chest wall open so you can take deep breaths, she says.

Chest-opening stretches also include:

• Rolled towel stretch: Lie on your back with a rolled towel placed under your upper back to gently open the chest
• Doorway stretch: Stand in a doorway with one hand or forearm on the door frame, then gently turn your body away to stretch the chest and shoulder
• Arm circles: Slowly move one arm up over your head, then around in a circle to loosen the shoulder and chest
• Corner stretch: Stand facing a corner with each hand on one wall, then gently lean forward to open the chest

You’ll notice an improved posture can make a difference in breathing, she says. “When we have someone sit up straight with their shoulders back, there’s so much more ability to move air in and out of the lungs,” Cullinan says.

And unlike more strenuous exercise, chest mobility work can be easily incorporated into your day. “If somebody could do daily stretches of their chest because it doesn’t require work … that would be optimal,” she says.

It’s also restorative, relaxing, and soothing as you’re opening the body up in gentle stretching, Cullinan says.

Follow Exercise With Breathing and Airway Clearance

Think of exercise as setting the stage for airway clearance, Cullinan says. Movement encourages deeper breathing, which can help loosen mucus. Following exercise, do huff coughing or other breathing techniques, which may then help move that mucus out more effectively.

“You already did the deep breathing, and you’re at a perfect point, either mid-exercise or at the end, to do breathing exercises. It’s like your lungs are warmed up, you’re getting that air in there, and then you can get the mucus out so it’s not bothering you at other points in your day,” she says.

Galiatsatos says some people may need to approach this in stages, if mucus makes exercise difficult at first. Do as much exercise as you can, pause to clear mucus, and then return to the rest of your routine if you feel able.

“Many patients with bronchiectasis, after they've exercised, always discuss how the phlegm and sputum comes out with more ease,” he says.

Either way, exercise is important for weight management, but the goal will depend on the person. “People with bronchiectasis often struggle with either keeping their weight on or losing weight,” Hunt says. “Building muscle mass is an important component of maintaining weight. Exercise can certainly help with weight management, however, nutrition plays a large role,” she says.

Choosing Your Workout

Start with your current symptoms and fitness level. If you haven’t been active for some time, recently had a flare, or get breathless during everyday activities, talk to your doctor before starting, Cullinan says. They may recommend a six-minute walk test or refer you to pulmonary rehabilitation to help you ease back into exercise. In pulmonary rehab, respiratory therapists and physical therapists work with you to safely increase your strength and endurance, Hunt says.

Consider your other health conditions. Joint pain, back pain, heart disease, balance issues, or oxygen use may change which exercises are safest for you. Cullinan says physical therapy can be especially helpful when orthopedic pain or co-occurring conditions limit your movement.

Choose something you will actually do. Exercise doesn’t have to look like going to the gym. Physical activity like walking with a friend, using a stationary bike, or joining a pulmonary rehab program count, too. “The best form of exercise for people with chronic illness is the one that they’ll do,” Cullinan says.

Set a goal that’s tied to a real-life event. Hunt suggests working toward a goal or a timeline to help you stay motivated. For example, one of her patients worked on his stamina and leg strength to prepare for a four-minute dance at his daughter’s wedding, and then for a weekend trip with his wife. “These tangible goals kept this patient consistent with his exercise, all the while improving his quality of life,” she says.

• Talk to your doctor, especially if you’re new to exercise, use oxygen, have recurring flares, or other chronic health conditions
• Start with shorter sessions, such as a 10-minute walk, and build gradually
• Aim for moderate effort — you should be breathing harder, but still able to speak in complete sentences
• Keep water nearby and stay hydrated
• Wear stable shoes like sneakers, and comfortable, breathable clothing
• Keep your phone with you, especially when exercising alone, in case of an emergency

Modifications

Modify your routine on days when symptoms are worse. That might mean walking more slowly, choosing a seated strength exercise, reducing the incline on the treadmill, or doing mobility work like stretching instead of a full workout.

Some muscle soreness is normal, but if you’re especially achy, give yourself an additional day of rest before starting back on your exercise routine, Hunt says.

If you use supplemental oxygen, follow your prescribed oxygen plan during exercise. Cullinan says people who use oxygen should speak with their care team about what flow rate is appropriate during exercise.

And if you’re unsure of how to start, talk to your doctor about pulmonary rehab. It combines monitored exercise, education, breathing strategies, and one-on-one exercise support for people with lung conditions, Hunt says.

Some breathlessness is expected during exercise. Cullinan says a moderate level is the goal — enough that your heart and lungs are working harder, but not so much that you cannot talk.

You should avoid strenuous exercise if you have a fever, an active lung infection, or are recovering from a flare, unless your doctor has cleared you, Galiatsatos says.

• Dizziness or shakiness
• Nausea
• Fever
• Diarrhea
• Chest pain
• Your pulse oximeter shows you have low oxygen concentration
• You run out of portable oxygen or your oxygen concentrator isn’t working properly