Why am I out of breath when I walk?
On stairs or a hill, it can be normal. On flat ground, or if it’s new or getting worse, see a GP. Doctors grade it by how little it takes to leave you breathless.
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Is it normal to be out of breath when walking?
Up stairs or a hill, often yes. Asthma + Lung UK says it’s normal to get out of breath when you exert yourself (push yourself hard).
The NHS says shortness of breath might not be anything to worry about, but sometimes it can be serious. What matters is how little effort brings it on.
Think of a car. Slowing on a steep hill doesn’t mean the engine is broken. Struggling on a flat road is the time to get it looked at.
| Step | When you get breathless |
|---|---|
| 1 | Only with hard exercise. |
| 2 | When you hurry, or walk up a slight hill. |
| 3 | You walk slower than people your age on flat ground, or stop for breath at your own pace. |
| 4 | You stop for breath after about 100 metres, or a few minutes, on flat ground. |
| 5 | Too breathless to leave the house, or breathless when dressing. |
Source: NICE NG115
That grading is the MRC breathlessness scale. NICE tells doctors to use it in COPD (a long-term lung condition) to grade breathlessness by the effort it takes to bring it on.
It shows how bad breathlessness is. It is not a test of what is normal.
Steps 3 to 5 mean flat ground leaves you breathless. That’s the time to see a GP.
On a hill and it’s new for you, or getting worse? The NHS says don’t try to work out the cause yourself. See a GP.
Why do I get out of breath walking up stairs?
The NHS lists five common causes: asthma, a chest infection, being overweight, smoking and a panic attack.
| Cause | Other clues |
|---|---|
| Asthma | Wheezing, coughing or a tight chest. Often comes and goes, and may be worse at night and early morning. |
| Panic attack | A racing heartbeat, sweating, trembling or feeling faint. |
| Iron deficiency anaemia | Tiredness, noticeable heartbeats, paler skin than usual or headaches. |
| Smoking or being overweight | The NHS lists both as common causes. |
Sources: NHS: shortness of breath; NHS: asthma; NHS: panic disorder; NHS: iron deficiency anaemia
Iron deficiency anaemia is caused by lack of iron, often from blood loss or pregnancy. The NHS lists shortness of breath as a symptom. A blood test can check, so read our anaemia blood test guide.
Less activity can feed itself. Asthma + Lung UK says moving less makes your muscles weaker, and this can make breathing harder.
Worry adds to it too. A worrying thought can make you feel breathless. If your heart races as well, see palpitations.
When is it something more serious?
Sometimes it’s a sign of a lung or heart condition. The NHS names COPD, scarring of the lungs, heart failure and lung cancer.
| Condition | Clues the NHS lists |
|---|---|
| COPD (long-term lung damage) | A chesty cough with phlegm that won’t go, chest infections and wheezing. Breathlessness may only happen with exercise at first. |
| Heart failure | More breathless than you’d expect, breathless lying down, swollen ankles or feeling very tired. |
| Angina (heart pain) | Chest tightness or pressure with breathlessness, often on exercise or in the cold. Usually stops after a few minutes’ rest. |
Sources: NHS: COPD; NHS: heart failure; NHS: angina
Over 35 and smoke, or used to? NICE says doctors should suspect COPD if you’re breathless with effort or have a long-term cough.
Most people with COPD notice nothing until their late 40s or 50s. If you’re over 35 and smoke or used to, and it keeps going, see a GP rather than waiting to see if it passes.
Ankles puffy too? Read swollen ankles before your appointment.
What will a GP check?
What a GP may check
- 1
Questions
Your symptoms, lifestyle and medical history. They’ll listen to your chest.
- 2
Breathing test
A simple breathing test helps check for asthma or COPD.
- 3
Blood test
A full blood count checks your red blood cells for anaemia.
- 4
Heart checks
If angina is likely, a heart specialist may do an ECG, which records your heartbeat.
Sources: NHS: asthma; NHS: COPD; NHS: iron deficiency anaemia; NHS: angina
Take a note of your step on the scale above and when it started. Say if it’s worse lying down, and whether you smoke.
Got your blood results back? Our full blood count guide explains each line.
How can I get less out of breath when walking?
Get the cause checked first. Then these can help you cope day to day.
Five ways to walk with less puff
- Stay as active as you can. Moving less makes your muscles weaker.
- Start with a brisk 10-minute walk a day. Brisk means you can talk but not sing.
- On stairs, breathe in before a step and out as you push up.
- Breathe out through pursed lips, as if you’re blowing out a candle.
- Stop smoking. Within 3 to 9 months, breathing problems improve as lung function rises by up to 10%.
Sources: Asthma + Lung UK; NHS: walking for health; NHS: quit smoking
The stair tip is what Asthma + Lung UK calls blow as you go. It also suggests counting one as you breathe in and two as you breathe out.
Using an inhaler? Never stop or change a prescribed medicine without your prescriber.
To build up walking, see how many steps a day. For worry, try these relaxation techniques.
When to speak to a GP
The NHS says always see a GP to find the cause. Book soon if:
- Your breathlessness gets worse during your normal activities, or when you lie down.
- You’re short of breath and have swollen ankles.
- You’ve been coughing for 3 weeks or more.
- You’re over 35, smoke or used to, and the symptoms keep going.
- You have asthma and treatments aren’t helping, or you need your inhaler more often.
The NHS heart failure page says ask for an urgent GP appointment or call 111 if you’re breathless lying down or from everyday activity. The same goes if you cough up frothy pink phlegm or suddenly gain weight. Call 111 too if you’re more short of breath than usual, or feel or are being sick.
The same goes if you cough up blood, have pain or swelling in 1 leg, or have palpitations.
Call 999 or go to A&E if you’re gasping, choking or can’t get words out. The same goes for a chest that feels tight or heavy, or pain spreading to your arms, back, neck and jaw.
Call 999 too if your lips or skin turn very pale, blue or grey, or you feel suddenly confused. On brown or black skin, the colour change may be easier to see on your palms. Don’t drive yourself.