Respiratory muscles can be trained like any other skeletal muscle. Just as the biceps responds to working against resistance, the muscles of inspiration can be trained against an appropriately set load.
The diaphragm is our main respiratory muscle and works without pause throughout the day. Its strength can nevertheless decline with chronic lung disease, prolonged immobility, an intensive care admission, neurological conditions and ageing. When strength falls, the same work requires more effort — and that effort is experienced as breathlessness.
Inspiratory Muscle Training (IMT) works these muscles by breathing in against a small handheld device. The key to the method is setting the resistance from measurement rather than at random.
Why measure first?
If the resistance is set too low the work provides no stimulus; if it is set too high the person breaks technique and compensates with the neck and shoulder muscles, becoming fatigued while reinforcing a faulty pattern. Respiratory muscle strength is therefore measured before starting and the resistance is set from that value.
The measurement is repeated at intervals throughout the programme and the resistance adjusted as values change. It is also the only way to track progress.
Correct technique
- Sit upright with your back supported and shoulders relaxed
- Use a nose clip and seal your lips fully around the mouthpiece — there should be no leak
- Breathe in slowly and deeply; a sharp, sudden pull is not effective
- Keep the shoulders down and avoid recruiting the neck muscles
- Let the out-breath go freely, without forcing
- Pause if you feel dizzy, tingly or noticeably fatigued
- Clean the device regularly and do not share it
Repetitions, sets and weekly frequency are planned individually; there is no standard prescription.
Who might it be considered for?
- People whose measured respiratory muscle strength is low
- People living with COPD and other chronic lung conditions
- People with heart failure and reduced exercise capacity
- People preparing for surgery
- People after prolonged bed rest or intensive care
- Selected neurological conditions, with medical approval and close monitoring
- Athletes seeking to develop breathing performance
Recent pneumothorax, uncontrolled asthma, eardrum problems and certain acute conditions may make IMT unsuitable. Suitability is therefore decided together with medical and physiotherapy assessment.
The information on this page is for general guidance and does not replace individual advice. A physiotherapist does not diagnose; they assess and plan a programme within the framework of medical referral. Which techniques are suitable for you is determined through a face-to-face respiratory assessment. Please consult your doctor and physiotherapist before starting.
Frequently Asked Questions
These devices are available to buy, but setting the resistance without measurement is not sound practice. It is also important to know when the technique is unsuitable. Starting after an assessment is therefore recommended.
That depends on starting strength, the underlying picture and how regularly the programme is kept up. No promise is made about duration or outcome; progress is tracked with repeated measurements.
Frequency is planned individually. Recovery is part of muscle training, so working at maximum intensity every day is generally not preferred.