Pacing Yourself With COPD: Knowing When to Push Yourself vs. Accepting Your Limits

Coping with energy and endurance on a day to day basis when you have COPD is all about balance. It's essential to learn how to balance periods of activity or exercise with sufficient rest to gird yourself for the next active time. Some people describe this as pacing yourself.

But how do you know when you should be pushing yourself a bit more versus when you need to accept your limitations? The answer to this question is that there is no one right answer that applies to everyone. As you settle into COPD, take time to listen to your body and start noticing how you feel as you perform the various activities that make up your daily life.

Why even worry about staying active?

It might be tempting when you have COPD to just become comfortable with not pushing yourself. After all, if being active is going to trigger your symptoms, doesn't it make more sense just to take it easy and rest? The answer to this is definitely not!

Exercise, even if it's just mild, gentle activity, has many benefits, including:

• A stronger, healthier heart and circulation
• Improves your breathing and helps get oxygen throughout the body
• Strengthens and tones your muscles
• Improves balance & joint flexibility
• Builds your energy & increases your endurance over time
• Helps build stronger bones
• Reduces anxiety, depression and stress, while improving mood
• Burns calories, helping with weight control

So, whenever possible, you should push yourself to at least maintain a minimum level of activity each day, even when you're not sure you feel like it. In the end, you're helping yourself to get and/or stay as healthy as possible, even though you have COPD.

How do you know what's enough?

We are still left with the question of how far to push yourself. This is where your healthcare team can help you establish a baseline.  You know best how you feel, but your fear of breathlessness might hold you back from pushing far enough.

A pulmonary rehabilitation program can be quite valuable in helping you assess what you can do safely and how far and how to push yourself. If your doctor has not recommended pulmonary rehab, don't be afraid to ask whether it might be right for you.

If pulmonary rehab is not an option, then you might look into working with a physical therapist or even a personal trainer. Either of these professionals has the skill to help you figure out what your limits might be and how far to push them.

The danger in pushing too far

While regular activity is important, it's also crucial to recognize that because of your chronic illness, you do have limits. Your limits may be very different from other people who have COPD. That's OK. It's not a competition.

But do learn the signs of when you may have pushed too hard or gone too far in your activity level. Or maybe you pushed yourself appropriately, but you haven't allowed yourself sufficient rest and recovery time afterwards, before you push again.

Here are some signs you may have pushed your limits a bit too far. You:

• Are extremely breathless to the point it's hard to recover or you're starting to panic
• Feel exhausted
• Are "out of commission" for the rest of the day
• Have trouble feeling motivated to get up and move

Those are signs that you need to make changes next time, to balance things better. However, if you have any of the danger signs below, stop what you're doing right away and possibly even seek medical attention:

• Nausea
• Chest pain
• Dizziness or feeling lightheaded
• Extreme shortness of breath
• Excessive wheezing
• Coughing up blood

Ways to get more active safely

Besides just building more activity into your day, if you want to push yourself a bit further, you can incorporate actual exercise into your routine. There are three general types of exercise:

1. Stretching. This is gentle, slow lengthening of your muscles. It will build your flexibility and is a great way both to warm up and cool down before other types of exercise.
2. Cardio or aerobic. This is steady physical activity that uses your large muscle groups. It does not have to be fast or strenuous, but it should get your heart rate slightly up above your resting rate. This type of exercise strengthens both your heart and lungs. This includes things like walking, biking, yoga and swimming.
3. Strengthening. This type of exercise involves tightening your muscles for a few seconds until they become tired, then repeating a few times. Strengthening exercises can be done with or without weights. Focusing on your upper body and arms can help strengthen your respiratory muscles too.

All 3 types of exercise are beneficial, but should not all be done at the same time or even on the same day. Again, learning how to pace yourself is key. Here are some general guidelines for exercise when you have COPD:

• Make exercise a regular part of your weekly routine -- shoot for exercise 4 to 5 times a week.
• Have each exercise session last for about 20 to 30 minutes, depending on your activity tolerance and fitness level.
• Shoot for a moderate intensity -- you may be slightly breathless, but not gasping for breath. And your heart should be beating more rapidly, but not pounding.
• Always warm up for 5 to 10 minutes before increasing your intensity. And when you're done, cool down for another 5 to 10 minutes.
• Be sure to drink lots of water during exercise.
• If oxygen is prescribed, use it during exercise as needed.

If you haven't been active, you may need to start slow, with frequent rest periods, to build up your endurance and fitness.

Also, be sure to always get your doctor's okay before starting any new exercise program.

Leading an active, vibrant life

Learning how far you can push yourself without going over the edge as far as your breathing goes will take some trial and error. But never believe that you have to become a couch potato because you have COPD! You can and should still lead an active, vibrant life, as long as you learn how to pace yourself and work within your limits.

If you would like to learn more on this topic and get some ideas on types of exercises and routines, these two publications may be helpful:

Better Living With Chronic Obstructive Pulmonary Disease: A Patient Guide, from the Australian Lung Foundation

COPD: Pacing & Overcoming Fatigue, from My Lungs, My Life (Scotland)