Building fitness with Aspergillosis

Last reviewed: 20 March 2026
Audience: Patients, carers, families, and non-specialists
Applies to: Allergic bronchopulmonary aspergillosis (ABPA), chronic pulmonary aspergillosis (CPA), Aspergillus bronchitis, severe asthma with fungal sensitisation (SAFS)

Why it feels so hard — and how to improve safely

Why exercise feels so difficult

Many people with aspergillosis find that even simple activity can feel exhausting.

This is not just about fitness. It is often due to changes in how the lungs and body work, including:

• Inflamed or narrowed airways
• Mucus affecting airflow
• Reduced oxygen transfer
• Increased effort needed to breathe

In addition:

• Long-term illness can reduce muscle strength
• Treatments such as steroids may affect weight and energy
• Many people experience post-exertional fatigue (feeling worse after activity)

This means your body is working harder than it used to — even for everyday tasks.

Why “just doing more” can backfire

It is natural to think that pushing harder will improve fitness. However, in aspergillosis this often leads to a cycle:

• Doing too much on a “good day”
• Feeling exhausted afterwards
• Needing longer recovery
• Losing confidence

This is sometimes called a “boom and bust” cycle.

The goal is not to push harder — it is to build steadily and sustainably.

A safer way to build fitness

1. Find your baseline

Start with what you can do without feeling completely exhausted afterwards.

This may be much less than you expect — and that is normal.

2. Use the 70–80% rule

Only do about 70–80% of what you feel capable of.

This helps prevent setbacks and allows gradual improvement.

3. Break activity into smaller chunks

Short sessions (e.g. 10–15 minutes) with rest in between are often easier than one long effort.

4. Use breathing control

Pursed-lip breathing:

• Breathe in through your nose
• Breathe out slowly through pursed lips

This helps keep airways open and reduces breathlessness.

5. Add gentle strength work

Improving muscle strength can reduce breathlessness and improve stamina.

• Sit-to-stand from a chair
• Light squats (with support)
• Step-ups

Start small — 2–3 times per week is enough.

The role of respiratory physiotherapy

Respiratory physiotherapy can be one of the most helpful supports available.

A respiratory physiotherapist can help with:

• Breathing techniques to reduce breathlessness
• Airway clearance to manage mucus
• Tailored exercise plans at the right pace
• Confidence in what is safe to do

You may be offered this as pulmonary rehabilitation.

If you have not been referred, it is worth asking your GP or specialist team.

⚠️ Important safety advice (including bleeding risk)

Exercise is helpful for many people with aspergillosis — but it is not always appropriate to increase activity without guidance.

Be especially cautious if you have:

• Coughing up blood (haemoptysis) — current or recent
• An aspergilloma (fungal ball)
• Lung cavities
• A recent flare or worsening symptoms

Why this matters

In some forms of aspergillosis, blood vessels in the lungs can become fragile. Strain or increased pressure in the chest can increase the risk of bleeding.

When to stop and seek advice

• Coughing up blood (even small amounts)
• Sudden increase in breathlessness
• Chest pain or tightness
• Feeling significantly worse after activity

How to exercise more safely (if stable)

• Keep activity gentle and controlled
• Avoid heavy lifting or straining
• Avoid holding your breath during exertion
• Build activity gradually

If you are unsure, seek advice from your specialist team or a respiratory physiotherapist before increasing activity.

What progress really looks like

Improvement is rarely a straight line.

• Some days will be better than others
• Setbacks are common
• Progress may be slow but meaningful

This is normal in chronic lung conditions.

When to seek medical advice

Contact your healthcare team if you experience:

• New or worsening breathlessness
• Changes in cough or sputum
• Chest pain
• Coughing up blood
• Severe or persistent fatigue

Final message

Living with aspergillosis changes how your body responds to activity.

But improvement is possible — with the right approach.

Build slowly, pace yourself, and get the right support — especially from a respiratory physiotherapist.

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