Exercising regularly does help in maintaining a healthy body, and it couldn’t be truer that a person who indulges in regular workouts is training their heart, muscles and lungs to use oxygen more efficiently. However, a common belief that regular workouts can make your lungs “bigger” or reverse any existing lung damage is rather false.
Doctors say this is not how the respiratory system actually works. While exercise does not change the structural size of healthy lungs or undo any damage already caused, it does help people breathe easier during their everyday activities over time.
This raises an important question for those living with asthma, COPD or other chronic respiratory conditions: should exercise be avoided altogether out of fear of breathlessness? And how does one tell the difference between breathlessness that is a normal part of physical exertion and breathlessness that signals an underlying problem, rather than simply being "unfit"?
We spoke to two pulmonologists to break down the science behind exercise and lung health.
Exercise trains the body, it doesn’t "grow" the lungs
Exercise does not simply make the muscles stronger; it also trains the body to use oxygen more efficiently, says Dr. Vikas Mittal, Director - Pulmonologist, CK Birla Hospital, Delhi. “When we exercise, our breathing rate and heart rate increase to meet the muscles' higher oxygen demands,” he explains.
With regular physical activity, Dr. Mittal says, the cardiovascular and respiratory systems become more efficient, which can improve exercise tolerance and reduce the sensation of breathlessness during routine activities. Importantly, however, exercise does not literally "increase the size" of healthy lungs or reverse structural lung damage, he clarifies. Its major benefit is improving how efficiently the lungs, heart and muscles work together, he adds.
Dr. Nikhil Rajvanshi, Consultant - Pediatric Pulmonologist, Allergy and Sleep Specialist, Rainbow Children's Hospital, Delhi, agrees, saying that exercise does not necessarily "increase lung size" or reverse established lung damage. Over time, aerobic activity can improve exercise tolerance and reduce breathlessness during routine activities, he adds.
But what kind of exercise helps lung health?
For most adults, a combination of aerobic activity and strength training is useful. “Brisk walking, cycling, swimming or jogging can improve cardiovascular and respiratory endurance, while strength training supports the muscles involved in movement and breathing, Dr. Mittal explains. Even everyday activities such as walking more, taking stairs or gardening can contribute to an active lifestyle, according to him.
Dr. Rajvanshi says, exercise should be appropriate for the individual's age, fitness level and medical condition. “Starting gradually and increasing intensity over time is more sustainable than suddenly undertaking strenuous exercise,” he adds.
Why people with asthma or chronic respiratory conditions shouldn’t avoid exercise
For people living with asthma, COPD, pulmonary fibrosis or other chronic respiratory conditions, “exercise should not automatically be avoided because of breathlessness,” Dr. Mittal says. In fact, appropriately prescribed physical activity and pulmonary rehabilitation can improve exercise capacity, he explains, help people perform daily activities with less breathlessness and enhance quality of life. “Pulmonary rehabilitation combines exercise with education and individualised guidance, particularly for people who struggle with exertional symptoms,” he adds.
For children and adults with conditions such as asthma, exercise is also important and should not be routinely avoided, Dr. Rajvanshi says. In fact, with appropriate treatment and good disease control, most people with asthma can participate in sports and exercise normally, he adds.
When breathlessness is normal, and when it isn’t
At the same time, “more exercise is not necessarily better,” Dr. Mittal cautions. “People with an underlying lung condition should have an appropriate exercise plan, particularly if they experience significant breathlessness, wheezing, chest discomfort, dizziness or a drop in oxygen levels during activity,” he says. Environmental factors also matter, he points out. Exercising outdoors when air pollution is high can expose the lungs to additional irritants, so indoor exercise may be preferable on poor-air-quality days.
If someone consistently develops cough, wheezing, chest tightness, or unusual breathlessness during exercise, it should not simply be attributed to being "unfit", Dr. Rajvanshi says. These symptoms warrant medical evaluation for conditions such as exercise-induced bronchoconstriction or poorly controlled asthma, he explains.
Building healthy habits
For children, Dr. Rajvanshi says, encouraging daily active play and reducing prolonged sedentary time can be particularly valuable for developing healthy habits. Children with chronic respiratory conditions should also have an individualised plan for managing symptoms during physical activity, he adds.
Ultimately, healthy lungs need both protection and movement, Dr. Mittal says. “Avoiding tobacco smoke and pollutants, staying physically active, maintaining a healthy weight, and seeking medical evaluation for persistent respiratory symptoms are all important components of long-term lung health,” he says.
In a nutshell, healthy lungs and a healthy body work together. Exercise may not repair damaged lungs, but it can make the respiratory system function more efficiently, improve fitness and help people lead more active lives. If breathlessness or wheezing is persistent or disproportionate to the level of activity, it is important to look for an underlying respiratory problem rather than simply exercising through the symptoms.
