You are out of surgery, in pain, and being told repeatedly to “breathe deeply, cough, use the device”. There is a concrete reason behind that insistence.
Three factors come together after surgery: avoiding deep breaths because of pain, the temporary effects of anaesthesia on breathing, and immobility. Together they make breathing shallow. In shallow breathing the lower and posterior parts of the lung in particular are not well ventilated; small air sacs there can close and secretions can collect.
The purpose of respiratory physiotherapy in this period is to work against that picture. Everything is planned within the limits your surgeon allows, taking the wound and any drains into account.
What the programme covers
- Deep breathing and holds: short sessions repeated frequently, aimed at ventilating the lower parts of the lung.
- Incentive spirometry: a slow, sustained draw, repeated as often as agreed.
- Supported cough: coughing effectively with a pillow or the hands supporting the wound to reduce pain.
- Early mobilisation: movements in bed, sitting on the edge of the bed, standing and short walks — within the limits your surgeon allows.
- Positioning: raising the trunk in bed and planning regular position changes.
- Airway clearance: appropriate techniques for people with secretion problems.
- Coordinating with pain relief: timing exercises for when pain medication is working best.
Why is early mobilisation emphasised so strongly?
Every day spent in bed means a loss of muscle mass and conditioning, and that loss develops faster in older people. Immobility can also affect lung ventilation and circulation.
In terms of supporting lung ventilation, early mobilisation on its own can be more effective than many breathing exercises. Sitting on the edge of the bed and taking a few steps is already meaningful as a start. The mobilisation plan is always carried out within the limits set by your surgeon.
When to stop and when to report
Stop exercising and inform your care team if you experience:
- New or markedly increased breathlessness
- Chest pain, palpitations or dizziness
- Increasing pain, redness, discharge or opening at the wound site
- A rising temperature
- One-sided swelling, redness and pain in a leg
- Coughing up blood
The 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
This is a very common worry, and the supported cough technique exists precisely for it: coughing with a pillow or the hands supporting the wound reduces pain and supports the area. The technique needs to be demonstrated and rehearsed together.
Pain management is part of the programme. Placing exercises in the window when pain relief is working best usually helps. If your pain is not under control, tell your care team — uncontrolled pain also blocks breathing work.
Yes. Discharge does not mean the end of respiratory work. The home programme and a graded walking plan are written down before you leave.