Asthma and Physical Therapy: Talking to My Physical Therapist About Asthma

For those who have been following my writing for a while, I am sure you know that I have a few more health issues than just my asthma.

Ehlers-Danlos Syndrome (EDS) is another big one for me, and it comes with many complications. My EDS has resulted in many orthopedic issues and chronic pain that have landed me in physical therapy many times.

During my last physical therapy session, I brought a list of questions about asthma and physical therapy to ask my physical therapist while I did my exercises.

These are some excerpts from a conversation with my personal physical therapist but talk to your own healthcare provider(s) for information about your asthma and physical therapy.

A discussion with my physical therapist about asthma

Me: Is it important for physical therapists to be aware that their patient has asthma?

My physical therapist (MPT): Absolutely! Like any other health condition, asthma can have a significant impact on the course of therapy. The therapist needs to know if there are limitations so they can adjust the exercise program as needed. Unlike strength training, physical therapy is just as much about what you shouldn’t be doing; mindful of limitations and preventing or exacerbating injuries.

Me: What kind of information is pertinent to disclose to your physical therapist about asthma?

MPT: Knowing what kind of asthma you have can be important. If, for instance, the patient has exercise-induced asthma, it’s really important that I know that so I can adjust, or eliminate aerobic exercise. I don’t want to inadvertently induce an asthma attack because of something I’m having the patient do. It’s also good for me to have a really thorough history of the asthma—any hospitalizations, ER visits, the course of treatment, etc. The more information I have about the patient’s asthma, the better care I can provide. Physical therapists who work for a hospital system are at a greater advantage because they can look through the medical history and find the information that’s pertinent. Smaller practices and stand-alone physical therapy providers don’t have that luxury, so it’s really important to get a thorough history from the patient.

Me: Are there any particular asthma medications that are important for you to know about?

MPT: It’s good to know about steroid use. Steroids can cause the bones to be weak, so there are certain maneuvers and exercises that I should avoid doing, especially if the patient has been on steroids for an extended period of time.

Me: What scares you most about working with patients who have asthma?

MPT: Doing something that would make them worse or cause them to go into an asthma attack.

Me: Is it okay for patients to go to their PT appointment if they are in the middle of a flare?

MPT: Sure, as long as there is a treatment plan in place, which the patient is following, and they feel good enough to participate.

Me: Are there any red flags for when to cancel a PT appointment?

MPT: If the patient is unable to maintain their oxygen at home, it’s probably not a good idea to come to physical therapy. Know your limits. It’s okay to cancel a visit if you are having trouble breathing.

Me: What kind of adjustments can be made for an asthma patient, especially when they are in the middle of an exacerbation, or flare?

MPT: There are lots of ways that exercises can be modified, or eliminated completely, depending on the needs the patient has. I know it can be harder to breathe when you’re lying down, so I can aim for more seated exercises and things that won’t have you on your back. We can also eliminate any kind of aerobic exercise. It’s also easy enough to change the resistance if an exercise is too hard or makes the breathing more labored.

Me: What are some things that asthma patients can do to help you out, as a therapist?

MPT: Communicate with me. Communication is key! Let me know how you’re feeling, if an exercise feels too hard, if you need to take a breather. At the beginning of a session, let me know if you’ve had an asthma flare or have been to the ER or hospital for your asthma. The more you can tell me about your asthma, the better equipped I will be for our sessions, better able to assist you and help you progress with your therapy plan despite your asthma. Oh, and bring your inhaler with you every time you come to PT!

Discussing health conditions with your healthcare professionals

While the initial goal of the conversation was to enable me to write this article, it led to a rich dialogue between my physical therapist and I, not just about asthma, but about underlying health conditions as a whole.

I would encourage you to bring some questions to your next physical therapy appointment and discuss them with your physical therapist. You never know what you might teach them, or what they might teach you, in the process.