Preparation for the breathing problems that follow surgery begins before the operation. The best time to learn a technique is while you are still free of pain.
After surgery, pain, immobility and the effects of anaesthesia make breathing shallow. In shallow breathing the lower and posterior parts of the lung in particular are poorly ventilated; small air sacs there can close and secretions can collect.
Preparation has two strands: a programme that works the respiratory muscles and — perhaps more critically — learning in advance, while comfortable, what you will be asked to do afterwards. After the operation you will be told to “breathe deeply, cough, use the device”; at that moment you will not be in the best state to learn something new.
Which operations?
- Cardiac surgery (coronary bypass, valve surgery)
- Thoracic surgery (resection, lobectomy)
- Upper abdominal surgery (stomach, liver, gallbladder, pancreas)
- Bariatric surgery
- Major orthopaedic surgery and operations involving prolonged immobility
- Aortic and major vascular surgery
Preparation matters more still for people who smoke, who have a known lung condition such as COPD, who are older, or whose mobility is limited.
Before the operation
- Measuring respiratory muscle strength and, where suitable, resistance-based breathing work
- Learning to use an incentive spirometer — a slow and long draw, not a fast one
- Rehearsing the supported cough technique with a pillow or the hands at the wound line
- Learning safe turning and sitting up in bed
- Discussing the early mobilisation plan
- General conditioning work
After the operation
- Deep breathing and holds, in short sessions repeated frequently
- Incentive spirometry
- Supported cough, with a pillow or the hands at the wound line
- Early mobilisation: movements in bed, sitting on the edge, short walks
- Positioning and regular position changes
- Airway clearance techniques for people with secretions
Everything is planned within the limits your surgeon allows, taking the wound and any drains into account.
Treatments used in this group
Preoperative Respiratory Preparation
Read morePostoperative Respiratory Physiotherapy
Read moreInspiratory Muscle Training (IMT)
Read moreAirway Clearance Techniques
Read moreThe information on this page is for general guidance and does not replace individual advice. A physiotherapist does not diagnose; they assess and plan a programme within the framework of medical referral. Which techniques are suitable for you is determined through a face-to-face respiratory assessment. Please consult your doctor and physiotherapist before starting.
Sudden or rapidly worsening breathlessness, chest pain, bluish discolouration of the lips or nails, or confusion may signal an emergency. Do not attempt exercises in such a situation; call the emergency number (112 in Türkiye) or go to the nearest emergency department without delay.
Frequently Asked Questions
The earlier the better, but even a few days is valuable — particularly for learning the techniques. The exact period depends on your surgery date, your current capacity and your surgeon's plan.
This is a very common worry, and the supported cough technique exists precisely for it: coughing with the wound supported reduces pain and supports the area. The technique needs to be demonstrated and rehearsed.
Yes. Discharge does not mean the end of respiratory work. The home programme and a graded walking plan are written down before you leave.