Preoperative breathing exercise is not a formality but a preparation period. The best time to learn a technique is while you are pain-free and able to concentrate.
After surgery, pain, immobility and the effects of anaesthesia make breathing shallow. The person avoids deep breaths and does not cough because it hurts. Shallow breathing can leave parts of the lung poorly ventilated and allow secretions to build up.
Preparation aimed at reducing that picture begins before surgery. It has two strands: a programme that works the respiratory muscles and — perhaps more critically — learning in advance the things you will be asked to do afterwards.
Why before surgery?
After the operation you will be told to “take deep breaths, cough, use the device”. But at that moment you are in pain, drowsy from medication and in no state to learn something new.
Learned before surgery, in a calm and pain-free setting, the same technique only needs to be remembered afterwards.
What should be learned in advance: use of an incentive spirometer, coughing with the wound supported, safe turning and sitting up in bed, the early mobilisation plan and matching breath to movement.
What does the preparation programme involve?
- Inspiratory muscle training: measurement-based resistance work, for those found suitable
- Incentive spirometry: a slow and long draw rather than a fast one; the aim is a slow, controlled rise of the balls
- Deep breathing and holds: simple techniques that can also be done without a device
- Supported cough technique: rehearsing coughing with a pillow or the hands supporting the wound line
- General conditioning: walking-based preparation at an appropriate intensity
- Smoking: support with stopping before surgery, in line with your doctor's guidance
Which operations?
Preparation matters most where there is a risk of respiratory complications:
- Cardiac surgery (coronary bypass, valve surgery)
- Thoracic surgery (resection, lobectomy)
- Upper abdominal surgery (stomach, liver, gallbladder, pancreas)
- Major orthopaedic surgery and operations involving prolonged immobility
- Bariatric surgery
It becomes more important still for people who smoke, who have a known lung condition such as COPD, who are older, or whose mobility is limited. Content and duration are planned around your surgery date and your surgeon's guidance.
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.
Frequently Asked Questions
The earlier you start, the more time there is. 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.
The most common mistake is pulling fast and hard. The correct technique is a slow, sustained breath in through the mouthpiece; the balls should rise gently and stay up as long as possible rather than shooting upward. How to use it and how many times a day is planned individually.
Yes — the value of the preparation is realised in the postoperative period. The programme afterwards is planned within the limits your surgeon allows.