Chest physiotherapy, also known as lung physio is a specialised branch of physiotherapy aimed at improving lung health. It includes different types of techniques to promote airway clearance and restore normal breathing. Everyone has lived through some form of lung or chest infection, the tightness, coughing, shortness of breath, just feeling awful with mucus dripping out your nose and spitting up dark green blobs of slime. Your body is quite capable of defending itself against these infections, but when oxygenation is compromised for too long, it delays the recovery time and puts you at high risk of developing more serious forms of pneumonia.

This article explores the reasons why chest physio is necessary and explains what you can expect from physiotherapy treatment for a lung infection. The article also highlights the role of chest physiotherapy in managing respiratory conditions, facilitating postoperative recovery, and improving overall respiratory health.

What exactly is Chest Physiotherapy?

Chest physiotherapy encompasses a range of techniques and treatments designed to enhance your respiratory function and remove mucus or secretions from your lungs and airways. This means better oxygen delivery to your bodies’ cells and less cardiovascular reliance.

This specialised approach combines manual techniques, breathing exercises, and positioning maneuvers. Importantly, it plays a crucial role when respiratory conditions limits airflow in and out of your lung. This is to ensure oxygen saturation remains within normal limits.

Why we do this type of physiotherapy:

The primary goal of chest physiotherapy is restore effortless breathing and remove mucus from your lung. It typically combines different types of techniques that loosens your secretions, to get it out of the airways. It helps make coughing easier and remove sticky gunk out of your lungs.

Chest physio is essential in maintaining the lung function in chronic respiratory conditions such as obstructive pulmonary disease (COPD) and cystic fibrosis. Because they tend to have much more frequent episodes and are tend to regress quite fast. These patients has developed a delicate sense to know when they need chest physiotherapy treatment.

I some circumstances patients get regresses faster that their immune system can react to the infection. this is when upper airway infection spreads to the larynx and bronchitis sets in, its only a matter of time before pneumonia sets in and can cause permanent tissue damage to the lungs. Your GP, pulmonologist or specialist will recruit chest physiotherapy to ensure the secretions are extracted from your lungs.

recovering from surgery or prolonged bed rest.

The Healing Effects of Chest Physiotherapy
  • Better perfusion
  • Safe oxygenation
  • Loosens and clears mucus
  • Enhances chest and lung expansion
  • Reduces the risk of infections
  • Less effort breathing
  • Boost lung function

“Breathe easier.”

Types of chest physiotherapy techniques


During a chest physiotherapy evaluation, the physiotherapist assesses your respiratory system to detect abnormalaties.

One important aspect of this evaluation is auscultation. During auscultation, the physiotherapist uses a stethoscope to listen to the sounds produced by your lungs and airways. We place the stethoscope on different parts of your chest to listen for any abnormal sounds. This process helps us gather information about the condition of your lungs and airways.

Additionally, we measure your chest expansion, which involves observing how much your chest expands when you breathe. We visually assess the rise and fall of your chest or use a measuring tape to determine the changes in your chest circumference. Chest expansion serves as an important indicator of how well your lungs are functioning.

We use an oximeter to measure blood oxygen levels. A reading above 95% indicates good oxygenation.

Conventional techniques:

In chest physiotherapy, percussion is a commonly used technique where the physiotherapist rhythmically pats your chest and back. Percussion generates vibrations that loosen and dislodge mucus from your airways. This promotes mucus clearance. Moreover, a physiotherapist can also generate vibrations by shaking our flat hands against your chest or using a device.

For postural drainage (PD), individuals often assume specific body positions to utilise gravity for moving mucus to areas where it can be coughed out or suctioned. It is important to note that different positions target different lung areas for proper mucus clearance. Commonly utilised positions involve lying with your upper body positioned below the lower body, as well as lying on your side with the affected lung facing upwards.

Breathing techniques:

Breathing exercises, including deep breathing, huffing, and controlled coughing, assist in expanding your lungs, improving airway clearance, and maintaining lung function. Slow, deep breaths are especially effective in loosening mucus. These exercises are performed in various positions based on comfort.

The Active Cycle of Breathing Technique (ACBT) includes three phases: breathing control, deep breathing, and forced expiratory techniques. ACBT facilitates increased airflow through your lungs, mobilising mucus. Therefore, this technique helps clear mucus from your airways, improves lung ventilation, and promotes effective coughing.

Instrumental techniques:

Physiotherapists often use suctioning, a technique that involves gently removing mucus or secretions from the nose, mouth, or airways using a small tube or device, to benefit babies who experience difficulty in clearing their airways. Suctioning is performed carefully to avoid any discomfort or harm. However, suctioning can occasionally lead to undesirable effects such as nosebleeds, throat discomfort, and temporary breathing difficulties. Fortunately, they settle quite quickly.

On the other hand, nebulisation is a process where medication is converted into a fine mist that is inhaled into the lungs. This technique helps alleviate congestion and promotes breathing. Nebulisation is carried out with a nebuliser machine.

The specific types of chest physiotherapy techniques that a physiotherapist uses vary based on your condition and age. For adults, we focus on using postural drainage, percussion, and deep breathing exercises to clear mucus and improve lung function. In the case of children and infants, we employ gentle techniques such as manual percussion, vibration, and assisted coughing to ensure safety and comfort. Suctioning is only used in babies’ lung physio sessions.

Anatomical changes you will notice

  • Improved breathing: You will notice easier breathing as mucus is cleared from your airways, allowing air to flow more smoothly through your lungs.
  • Reduced congestion: Chest physiotherapy helps remove excess mucus, reducing congestion and relieving feelings of chest tightness. To prevent upsetting your stomach, your physiotherapist will instruct you to spit out the secretions instead of swallowing them.
  • Decreased coughing: Coughing may increase at first as mucus loosens. However, you will then notice less coughing as irritants and mucus are removed from your airways and lungs.
  • Improved lung expansion: Techniques such as deep breathing exercises help expand your lungs, causing better oxygen exchange.
  • Enhanced chest mobility: Chest physiotherapy promotes mobility and flexibility in your chest wall, allowing for more efficient breathing and greater chest movement.
  • Less effort for activities of daily living: Walking around and sleep quality improves.

These changes contribute to better lung health, increased comfort, and improved overall lung function.

Changes on a cellular level:


  • Enhanced oxygenation: Chest physiotherapy restores oxygen levels to meet the body’s needs. This ensures that cells receive an adequate amount of oxygen supply.
  • Limit inflammation: Chest physiotherapy helps decrease inflammation within the respiratory system, enabling cells to perform better.
  • Clear mucus: Get rid of slime, gunk, and phlegm culturing in your lungs, chest physiotherapy not only, wipes out these harmful substances from your lungs, but eliminates the breeding ground for bacteria.
  • Promotion of cellular healing: Chest physiotherapy creates a more favorable cellular repair and regeneration environment. This creates a healthier environment for healing to take place.

These cellular changes support better lung health, enhance cellular function, and contribute to overall well-being.

What chest physiotherapy feels like:

The experience of chest physiotherapy varies depending on the types of chest physiotherapy techniques used and your sensitivity. You may feel gentle pressure, vibrations, or rhythmic tapping on your chest or back. Percussions feel more distinct and forceful, compared to vibrations that are typically gentle, oscillating movements.

Suctioning feels like a gentle pulling sensation. The sensation is similar to when a small vacuum is used to remove excess mucus from your nose or mouth.

Overall, it should not be painful but may cause slight discomfort or unfamiliar sensations.

How long does a lung physiotherapy session take?

Typically, a session of chest physiotherapy ranges from 30 to 45 minutes. The duration of the sessions is determined by the severity of your respiratory condition, this directs your treatment plan. During the session, multiple lung techniques are applied together and your practitioner will seamlessly switch between them.

How many times should I get chest physiotherapy?

Several factors influence the frequency of chest physio treatment such as severity, risk profile, breathlessness score, oxygenation and your age. Usually, chest physio is administered daily for the same duration as the anti-biotic cycle and for 3 days after finishing.

To give you an idea – ICU patients receive twice a day treatments, while in an outpatient setting once a day is sufficient. Your physiotherapist will justify the frequency and treatment plan, follow it – it’s your breathing depends on it.

What should I do before my treatment?

Try to refrain from eating for 2 hours before your session.

Don’t make the hassle of making yourself hook nice – we’ll be rolling around – there are bigger problems.

Continue using your medication as prescribed by your GP.

What can I do at home to ensure chest physiotherapy is effective?

  • Position yourself properly to help drain mucus from your lungs. Sit in a chair or lie down at an incline, leaning forward slightly with your arms resting on a table or your knees. This position allows gravity to assist in clearing mucus.
  • Practice deep breathing exercises to expand your lungs and increase airflow. Inhale slowly and deeply through your nose, then exhale slowly through pursed lips. This also helps to loosen mucus in your airways.
  • Stay hydrated. Drink plenty of fluids to help thin the mucus in your airways. Water is the best choice, but you can also try warm beverages like herbal tea or warm lemon water.
  • Keep moving, even if you feel like you’re dying. Engage in safe physical activity, within your capability.

It is important to follow personalised advice and ask your physiotherapist if you’re doing it right.

Cost of chest physiotherapy

The different techniques used during chest physiotherapy have specific medical aid rates. You will never pay for a single technique only.

Medical Aid Codes:

Your statement may include some of the following medical aid codes:

701 – Initial basic assessment

301 – Percussions

300 – Vibrations

315 – Postural drainage

319 – Nebulisation

307 – Breathing exercises

323 – Suctioning

507 – Respiratory rehab

006 – Laser

Many reputable medical aid plans provide coverage for the above mentioned codes.

Does it make a difference to have an experienced physiotherapist perform this type of physiotherapy?

Certainly, the involvement of an experienced physiotherapist in applying lung physiotherapy can significantly impact the effectiveness of your treatment. Notably, experienced physiotherapists possess extensive knowledge of various techniques, allowing them to customise the treatment according to your needs. Moreover, experienced physiotherapists ensure the accurate application of techniques, closely monitor progress, and make necessary adjustments to your treatment plan. Consequently, great physios achieve better outcomes.

Is it safe to have my child receive lung physiotherapy at school?

A qualified and well-experienced physiotherapist can safely conduct chest physiotherapy in a school setting. The physiotherapist will typically write treatment notes after each session, summarising the activities performed, noting any observed changes or progress, and providing recommendations for future sessions. Remember to request feedback from the physiotherapist and ask them to explain any unfamiliar terminology.

We do however advise you to accompany your baby to physiotherapy sessions, if your baby is below the age of 2, as lung physio sessions are sometimes traumatic for babies.

Conditions that respond well to chest physiotherapy:

  • Pneumonia

  • Chronic Obstructive Pulmonary Disease (COPD)(chronic bronchitis and emphysema)

  • Cystic Fibrosis

  • Bronchiectasis

  • Asthma

  • Respiratory complications after surgery: Patients may encounter challenges in breathing and expelling mucus following specific surgeries, particularly those involving the abdomen or chest.

  • Neuromuscular Disorders, such as muscular dystrophy, spinal cord injuries, or amyotrophic lateral sclerosis (ALS).

Precautions to chest physiotherapy:

  • Unstable cardiovascular conditions (e.g. severe hypertension or unstable angina)

  • Recent spinal injuries or surgeries

  • Active bleeding in the lungs

  • Uncontrolled or severe respiratory distress

  • Chest pain or discomfort of unknown origin

  • Elevated intracranial pressure

  • Osteoporosis

Other chest physiotherapy answers:

No. It is crucial to visit a physiotherapist. After careful evaluation and treatment, your physiotherapist will provide you with personalised advice and they might teach you some techniques to perform at home.

Babies may cry during chest physiotherapy due to discomfort. The sensation is also unfamiliar to them. Percussion, vibration, and position changes can be uncomfortable or startle the baby.

No. When an experienced physiotherapist performs suction on babies properly, it is safe.

Please collect a “sputum sample bottle” from your nearest Ampath or Lancet lab. Bring the bottle along with the referral form. After the sample has been gathered, you have to drop off the sample at the lab yourself.

Furthermore, your healthcare provider may give you specific instructions to follow before your visit. These instructions may include fasting or avoiding certain medications. In order to guarantee accurate and reliable test results, please carefully adhere to these instructions

Not at all. However, there is a potential for rare complications or adverse effects. When conducted by experienced physiotherapists, the benefits of chest physiotherapy outweigh the risks.

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