Chest Physiotherapy: How It Clears Congestion

When mucus builds up in the lungs, breathing becomes harder and infections can develop. Chest physiotherapy uses techniques to help loosen and clear mucus, so you can breathe more easily.

Chest physiotherapy supports medical treatment and doesn't replace it. See a doctor for a chest infection, especially if you have fever, worsening breathlessness or are coughing up blood.

Who it can help

• People recovering from pneumonia or chest infections, where appropriate
• Long-term conditions with mucus build-up, such as bronchiectasis, COPD and cystic fibrosis
• After chest or abdominal surgery, when deep breathing and coughing are painful
• People with weak coughs due to neurological conditions
• People with reduced mobility who are confined to bed

Common techniques

1. Active cycle of breathing technique (ACBT) A sequence of relaxed breathing, deep breaths and "huffs" (forceful breaths out through an open mouth). It helps move mucus from the smaller airways up to where it can be coughed out.

2. Positioning (postural drainage) Positioning the body so gravity helps drain mucus from specific parts of the lungs. The positions depend on which area is affected and on what is safe for you.

3. Airway clearance devices Handheld devices that create vibration or resistance as you breathe out, helping loosen mucus.

4. Assisted coughing For people with weak coughs, the physiotherapist or carer can support the cough.

5. Early mobilisation Getting up and walking is one of the best ways to get the lungs working and help clear secretions, especially after surgery.

After surgery

After chest or abdominal surgery, people often breathe shallowly to avoid pain, which increases the risk of chest infections. Physiotherapy usually includes:

• Deep breathing exercises, sometimes with an incentive spirometer
• Supported coughing, holding a pillow against the wound
• Early walking

How often?

This depends on your condition. Some people with long-term lung conditions do airway clearance once or twice a day as part of their routine. Your physiotherapist will tailor the plan and teach you to do it independently.

Staying hydrated

Drinking enough fluid, unless you've been told to restrict it, helps keep mucus thinner and easier to clear.