Services
How can I help you?
Discover personalised physiotherapy solutions designed to improve your respiratory health and overall well-being.
What I do
Pulmonary Rehabilitation
Breathing Pattern Re-Education
COPD & Emphysema / Bronchitis
Asthma
Cystic Fibrosis
Lung Cancer
Chronic Heart Failure
Mobility and Balance Work
Interstitial Lung Disease
Chronic Cough
Stop Smoking Services
Pre/ Post surgery rehabilitiation
Respiratory Disease
Many diseases of the respiratory system can be improved with respiratory physiotherapy. Whilst we cannot cure the underlying disease teaching effective breathing techniques can help maximise ventilation and improve oxygen levels helping you feel less breathless.
Anxiety is often a component of respiratory disease making the breathing even more uncomfortable and distressing. Meditation and relaxation sessions can help you manage anxiety which will help improve your breathing. I am trained in hypnotherapy and use this technique to foster a more positive attitude and relieve panic asscociated with breathlessness.
Living with respiratory disease (or other chronic conditions) can make it hard to be as active as you would like. However, with gentle progressive exercises focussed on strength training and improving the cardiorespiratory system, we can help you walk further, improve your activities of daily living and feel better.
Rehabilitation
Pulmonary and cardiac rehabilitation improve exercise tolerance and reduce breathlessness. Typically lasting 8-12 weeks with two sessions per week, these programs involve setting realistic goals and using strengthening and aerobic exercises to achieve them. Each rehabilitation plan is personalized to help you safely increase your activity. Both online and face-to-face options are available.
Falls prevention programme
Falls are a common problem as we get older. Physiotherapy can significantly reduce the risk of falling. With a combination of balance exercises, strengthening exercises and posture work we can help improve balance reactions and give you the confidence to be more active again.
Stop Smoking
Quitting smoking can be hard! However motivational interviewing and goal setting with affirmations have been shown to improve your success rate. I also offer a herbal supplement Cytisine, which is proven to reduce the urge to smaoke and considerably helps you quit for good. I am also trained in hypnotherapy and utilise this during sessions. 3 – 4 sessions are recommended.
Ready to Breath Better?
Respiratory Physiotherapy helps you breathe better, move better, feel better.
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Are you fatigued?
If you have Chronic Obstructive Pulmonary Disease (COPD), other respiratory disease, Long COVID or ME/CFM, then you probably also suffer with fatigue. In medicine we describe fatigue as a “sensation of overwhelming tiredness, lack of energy, and feeling of exhaustion that is not relieved by rest and interferes with usual functioning.” Fatigue is a multi-component symptom, one questionnaire, the Multidimensional Fatigue Inventory (MFI-20) describes subjective fatigue as encompassing five different components; general fatigue, physical fatigue, reduced activity, reduced motivation and mental fatigue, such as having difficulty concentrating.
Many conditions are accompanied by fatigue but it is particularly profound in respiratory disease. There are different reasons for this, the obvious one being a lack of oxygen to the cells, but we now also know that in COPD, and other conditions, the immune system is chronically elevated which causes the “flight or fight” response to remain permanently raised. The damaged lungs release pro-inflammatory cytokines (such as TNF-alpha and Interleukin-6) into the bloodstream. These inflammatory chemicals can cross the blood-brain barrier where they trigger something known as “sickness behavior." This is a coping mechanism - your brain wants to help you heal and it manifests as a profound lack of motivation.
This is all good if the inflammation is short lived (like having a cold that recovers in a week or so) but if the inflammation is chronic and persistent, as it is in COPD, then the “sickness behaviour” can in fact make us sicker.
What can help treat this fatigue? A review paper published last year in Respiratory Medicine by Zhang and colleagues (2025) looked at 35 studies that considered fatigue in COPD and found four things that were effective in significantly reducing it. Pulmonary rehabilitation, aerobic exercise, progressive muscle relaxation and acupressure (although the confidence of this data was lower than the others).
Exercise and pulmonary rehabilitation work by improving the cardiovascular system, building strength in the peripheral and respiratory muscles and helping improve respiratory patterns. Pulmonary rehabilitation is effective for people with high initial levels of fatigue and lower levels and even appears to improve quality of life most in those with high levels of fatigue (Maarten Van Herck et al, 2019).
In one study from my team, we showed improvements in General Fatigue, Physical Fatigue and Reduced Activity after a seven-week pulmonary rehabilitation programme (Lewko et al, 2013). Whilst there were no changes in the Motivation or Mental Fatigue we would argue that seven weeks may be too short a period to achieve change in these areas of fatigue.
In fact, motivation is an interesting concept as we often “wait for the right motivation” to start a new plan or hobby, but motivation is triggered by activity - once we start doing the activity and see results we are more likely to feel motivated to continue.
If you are fatigued, and waiting for the motivation to get started with an exercise programme you’d be better off starting, and perhaps, when the benefits kick in then so will the motivation to continue. Click on the link below to find out more about my online pulmonary rehabilitation programme.
https://betterbreathingphysio.com/pulmonary-rehab-programme/
References
Lewko A, Bidgood PL, Jewell A, Garrod R. Evaluation of multidimensional COPD-related subjective fatigue following a pulmonary rehabilitation programme. Respir Med. 2014 Jan;108(1):95-102. doi: 10.1016/j.rmed.2013.09.003. Epub 2013 Sep 14. PMID: 24084060. https://pubmed.ncbi.nlm.nih.gov/24084060/
Van Herck M, Antons J, Vercoulen JH, Goërtz YMJ, Ebadi Z, Burtin C, Janssen DJA, Thong MSY, Otker J, Coors A, Sprangers MAG, Muris JWM, Prins JB, Spruit MA, Peters JB. Pulmonary Rehabilitation Reduces Subjective Fatigue in COPD: A Responder Analysis. J Clin Med. 2019 Aug 20;8(8):1264
https://pmc.ncbi.nlm.nih.gov/articles/PMC6722504/
Xiaona Zhang, Jiali Xue, Yan Chang, Rui Zhang, Jie Zhao, Xindan Li, Hongyan Lu, Xirui Jiang, Fang Yu, Pengfei Yang. Non-pharmacological interventions for fatigue in patients with chronic obstructive pulmonary disease: a systematic review and network meta-analysis,
Respiratory Medicine, Volume 248, 2025. https://doi.org/10.1016/j.rmed.2025.108409.
Do you suffer from fatigue?
If you have Chronic Obstructive Pulmonary Disease (COPD), other respiratory disease, Long COVID or ME/CFM, then you probably also suffer with fatigue. In medicine we describe fatigue as a “sensation of overwhelming tiredness, lack of energy, and feeling of exhaustion that is not relieved by rest and interferes with usual functioning.” Fatigue is a multi-component symptom, one questionnaire, the Multidimensional Fatigue Inventory (MFI-20) describes subjective fatigue as encompassing five different components; general fatigue, physical fatigue, reduced activity, reduced motivation and mental fatigue, such as having difficulty concentrating.
Many conditions are accompanied by fatigue but it is particularly profound in respiratory disease. There are different reasons for this, the obvious one being a lack of oxygen to the cells, but we now also know that in COPD, and other conditions, the immune system is chronically elevated which causes the “flight or fight” response to remain permanently raised. The damaged lungs release pro-inflammatory cytokines (such as TNF-alpha and Interleukin-6) into the bloodstream. These inflammatory chemicals can cross the blood-brain barrier where they trigger something known as “sickness behavior." This is a coping mechanism - your brain wants to help you heal and it manifests as a profound lack of motivation.
This is all good if the inflammation is short lived (like having a cold that recovers in a week or so) but if the inflammation is chronic and persistent, as it is in COPD, then the “sickness behaviour” can in fact make us sicker.
What can help treat this fatigue? A review paper published last year in Respiratory Medicine by Zhang and colleagues (2025) looked at 35 studies that considered fatigue in COPD and found four things that were effective in significantly reducing it. Pulmonary rehabilitation, aerobic exercise, progressive muscle relaxation and acupressure (although the confidence of this data was lower than the others).
Exercise and pulmonary rehabilitation work by improving the cardiovascular system, building strength in the peripheral and respiratory muscles and helping improve respiratory patterns. Pulmonary rehabilitation is effective for people with high initial levels of fatigue and lower levels and even appears to improve quality of life most in those with high levels of fatigue (Maarten Van Herck et al, 2019).
In one study from my team, we showed improvements in General Fatigue, Physical Fatigue and Reduced Activity after a seven-week pulmonary rehabilitation programme (Lewko et al, 2013). Whilst there were no changes in the Motivation or Mental Fatigue we would argue that seven weeks may be too short a period to achieve change in these areas of fatigue.
In fact, motivation is an interesting concept as we often “wait for the right motivation” to start a new plan or hobby, but motivation is triggered by activity - once we start doing the activity and see results we are more likely to feel motivated to continue.
If you are fatigued, and waiting for the motivation to get started with an exercise programme you’d be better off starting, and perhaps, when the benefits kick in then so will the motivation to continue. Click on the link below to find out more about my online pulmonary rehabilitation programme.
https://betterbreathingphysio.com/pulmonary-rehab-programme/
References
Lewko A, Bidgood PL, Jewell A, Garrod R. Evaluation of multidimensional COPD-related subjective fatigue following a pulmonary rehabilitation programme. Respir Med. 2014 Jan;108(1):95-102. doi: 10.1016/j.rmed.2013.09.003. Epub 2013 Sep 14. PMID: 24084060. https://pubmed.ncbi.nlm.nih.gov/24084060/
Van Herck M, Antons J, Vercoulen JH, Goërtz YMJ, Ebadi Z, Burtin C, Janssen DJA, Thong MSY, Otker J, Coors A, Sprangers MAG, Muris JWM, Prins JB, Spruit MA, Peters JB. Pulmonary Rehabilitation Reduces Subjective Fatigue in COPD: A Responder Analysis. J Clin Med. 2019 Aug 20;8(8):1264
https://pmc.ncbi.nlm.nih.gov/articles/PMC6722504/
Xiaona Zhang, Jiali Xue, Yan Chang, Rui Zhang, Jie Zhao, Xindan Li, Hongyan Lu, Xirui Jiang, Fang Yu, Pengfei Yang. Non-pharmacological interventions for fatigue in patients with chronic obstructive pulmonary disease: a systematic review and network meta-analysis,
Respiratory Medicine, Volume 248, 2025. https://doi.org/10.1016/j.rmed.2025.108409.
Rachel’s CV
Discover how my specialised programs can help you achieve better breathing and well-being. Join for unlimited access to the online resources and community with exercises and information to help you to breathe better.Telephone: +34 699 501 190 Nationality: British...
Projects
Home Services Stop Smoking Dysfunctional Breathing Prices Rachel's CV Testimonials Projects+34 699 501 190rachelgarrod1@gmail.comLinda Vista Baja, Calle Los Eucaliptos 77, San Pedro, Marbella, Spain 29670
Prices
Explore a range of packages designed to enhance your well-being and support your health goals.Includes: Once a week supervised online rehab session in small groups, recorded and sent via email if unable to attend live.Recorded videos of breathing exercises and...
Dysfunctional Breathing
Discover personalised physiotherapy solutions designed to improve your respiratory health and overall well-being.Breathing is essential of course. But not all breathing is good – sometimes it’s downright dysfunctional! Specifically, dysfunctional breathing is when...
Stop Smoking
Rachel Garrod provides the herbal supplement Cytisine, which has been proven to reduce the urge to smoke and helps you quit for good. Stop smoking Quitting smoking can be hard! However motivational interviewing and goal setting with affirmations have been shown to...
Home
Discover personalised physiotherapy solutions designed to improve your respiratory health and overall well-being. Respiratory Physiotherapist, Marbella & San Pedro, Spain.Rachel Garrod is a highly experienced physiotherapist specializing in respiratory care. With...
Contact
Linda Vista Baja, Calle Los Eucaliptos 77, San Pedro, Marbella, Spain 29670