Breathing Exercises

Breathing complications, such as a chest infection, are one of the main problems that can occur following surgery. They happen for many reasons but can happen after surgery due to the effects of anaesthesia, postoperative discomfort and reduced mobility post-surgery.

It is important that you do what you can to reduce your risk of developing breathing complications after your operation. Breathing exercises are simple techniques that you can do regularly both before and after an operation to help keep your lungs clear. The following exercises should be practiced daily before your operation to help keep your airways clear and improve overall lung health. These exercises are easy to do and should only take a few minutes each day. Breathing exercises can also make a big difference in your recovery so it will be important to continue these exercises in the time after your operation.

The set of breathing exercises are commonly known as the Active Cycle of Breathing, or ACBT. The cycle can be used in any position that you are comfortable in and is as follows:

Relaxed breathing/breathing control

This is normal, gentle breathing using the lower chest. With your arms relaxed, rest one hand on your abdomen so that you can feel it rise and fall with your breathing. Breathe in gently through your nose, if possible, rather than your mouth feeling your hand rise and your lower chest expand. Breathe out gently through your mouth, allowing your shoulders to relax down. The breath out should be slow, like a “sigh”.

Deep breathing

Breathe in deeply feeling your lower chest expand and your lungs filling as far as possible. Try to keep your neck and shoulders relaxed. Hold the breath for up to 3 seconds. Let the air out gently. Repeat 3 to 5 times.

Forced expiratory technique/Huff (+/- cough)

This is a short sharp breath out through an open mouth that helps force secretions out. To ‘huff’ you squeeze air quickly from your lungs, out through your open mouth and throat, as if you were trying to mist up a mirror or your glasses. Using relaxed breathing to recover in between huffs.

Coughing and huffing can be uncomfortable after surgery, particularly if you have an abdominal or chest incision. It helps if you can support your wound as you huff/cough, either with your hands on either side of your wound giving firm pressure towards your wound, OR by placing a clean, folded towel over your wound and giving gentle pressure as you cough.

References

East Sussex Healthcare NHS Trust (2019)
Patient Information: Active Cycle of Breathing Technique (ACBT)

North Cumbria Integrated Care NHS Foundation Trust (2023)
Physiotherapy after major abdominal surgery

Association of Chartered Physiotherapists in Respiratory Care
The Active Cycle of Breathing Techniques (Leaflet No. GL-05)