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Breathing exercises after lung surgery, and how to do them well | CION Cancer Clinics
After a lobectomy, breathing exercises help the remaining lung open up and clear phlegm, which lowers the chance of a chest infection. The core routine is slow deep breaths, a fast huff and a cough with a pillow held against the wound. Walking matters just as much. This page shows how to do each one, how the routine builds and when to stop and ask for help. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
MI
Medically reviewed by Dr. Mohammed ImaduddinConsultant Surgical Oncologist · MBBS, MS (General Surgery), MCh (Surgical Oncology) · last reviewed September 2026, next review due September 2027
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On this page
- Why do breathing exercises matter after a lobectomy?
- How do you do a deep breath, a huff and a supported cough?
- Which other exercises will the physiotherapist show you?
- How does the routine change from the ward to home?
- What do families get wrong about breathing and rest?
- What do the physiotherapy words mean?
- Who needs a different plan, and when should you stop?
- Common questions about breathing exercises after lung surgery
The short answer
Why do breathing exercises matter after a lobectomy?
Breathing exercises help the lung you still have open up fully and clear phlegm after surgery. Done from the first day, alongside walking, they lower the chance of a chest infection and help you get home sooner.
What goes wrong without them
After chest surgery, breathing in deeply hurts, so most people take small, shallow breaths. The anaesthetic and strong painkillers also make the lungs lazy for a while. When the lower parts of the lung are not filled with air, tiny airways close down and phlegm collects there. That is how a chest infection starts, and a chest infection is one of the main things that slows recovery after lung surgery.
They do not replace walking
Getting out of bed, sitting in a chair and walking on the ward do as much for your lungs as any exercise done lying down. Think of breathing exercises and walking as a pair. The physiotherapist will set both.
Starting before the operation helps
If you have time before surgery, learn the exercises then. People who practise beforehand, and who walk daily in the weeks before, often find the first days afterwards easier. Ask about a prehabilitation plan when the date is set.
Step by step
How do you do a deep breath, a huff and a supported cough?
Get into position
Sit upright in a chair or on the edge of the bed, shoulders relaxed. Slumping in bed squashes the lower lung, so sit up as straight as your wound allows.
Take slow deep breaths
Breathe in slowly through your nose, letting your tummy and lower ribs rise. Hold for a moment if you can, then breathe out gently through your mouth. Repeat a few times.
Huff
Take a medium breath, then push the air out fast through an open mouth, as if steaming up a mirror. Huffing moves phlegm up towards your throat without a hard cough.
Cough with support
Hold a pillow or rolled towel firmly against the wound. Then give one or two strong coughs to clear the phlegm. Rest, and repeat the cycle when you are ready.
Not sure whether this applies to you?
Ask an oncologistYour programme
Which other exercises will the physiotherapist show you?
Programmes differ between hospitals. These are the ones most people are taught.
Incentive spirometer
A small plastic device with a ball or piston. You breathe in slowly through the mouthpiece to lift it. It shows you, and your family, how deep each breath is.
Not every team uses one. Deep breathing without it works too.Shoulder and arm movements
Gentle arm lifts and shoulder circles on the side of the operation. They stop the shoulder stiffening, which is common after chest surgery and can last if ignored.
Posture and chest stretches
People tend to lean towards the wound to protect it. Sitting tall and gentle side stretches keep the chest wall moving and help breathing.
Walking
Short walks from the first day or two, with help and the drain carried along, building up each day.
Helps with
- Opening up the lung
- Loosening phlegm
- Preventing clots in the legs
Over time
How does the routine change from the ward to home?
-
The first day
The physiotherapist visits and starts deep breathing, huffing and supported coughs. Sitting out of bed, and a first short walk, often happen very early.
-
The days on the ward
You do the breathing cycle regularly through the day, as often as your team suggests. Walks get longer. Pain relief is timed so you can do both.
-
Going home
You leave with written exercises. Carry on with them at home, and keep walking a little further each day.
-
The weeks after
As breathing eases and phlegm clears, the focus shifts to general fitness, such as longer walks and stairs. Some people are offered a pulmonary rehabilitation class, a supervised exercise course for people with lung problems.
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Commonly believed
What do families get wrong about breathing and rest?
"After an operation he must rest in bed completely."
Lying flat for long periods is one of the main reasons a chest infection develops. Sitting up and walking, as the team advises, protects the lung. Rest between exercises, not instead of them.
"Coughing will tear the stitches."
The wound is closed in layers and is built to cope with coughing. Supporting it with a pillow makes coughing more comfortable and more effective.
"With one lobe gone, the exercises cannot make any difference."
The remaining lung can adapt and work harder over time. Exercises and activity help it do that. How breathless you will feel long term depends on your lungs before surgery as well.
"More is always better, so she should keep going until she is exhausted."
Short, regular sessions work better than long, exhausting ones. Stop and rest if you feel dizzy or very breathless, and follow the plan your physiotherapist gives.
On the ward
What do the physiotherapy words mean?
- Atelectasis
- Parts of the lung that have partly closed down because they are not filling with air. Deep breaths and walking help open them again.
- Sputum
- Phlegm coughed up from the lungs. Tell the team if it turns green, smells bad or has blood in it.
- Huff
- A fast, open-mouthed breath out used to move phlegm without a hard cough.
- Oxygen saturation
- The reading from the clip on your finger, showing how much oxygen your blood is carrying.
- Pulmonary rehabilitation
- A supervised exercise and education programme for people whose lungs need building back up.
Being straight with you
Who needs a different plan, and when should you stop?
Standard exercises suit most people, but not everyone. If you have COPD, heart problems, a frozen shoulder, severe back pain or very poor balance, the physiotherapist will adapt the programme. Someone who needs oxygen at home may be given a slower, more supervised plan.
When to stop and get help
Stop the exercise and tell the team, or at home go to the nearest emergency department, if you have sudden sharp chest pain, breathing that suddenly becomes much harder, blood in your phlegm, a fever with a worse cough, or you feel faint. These are not things to push through.
What this page cannot tell you
It cannot set your own programme. The number of breaths, how often, and when to move on are decided by the physiotherapist who has seen you, your wound and your lung function. Treat this page as a reminder of what you were taught, not a replacement for it.
Questions we are asked
Common questions about breathing exercises after lung surgery
How often should I do breathing exercises after a lobectomy?
Most teams ask for short sessions many times a day while you are awake, often every hour or two in the early days. Your physiotherapist will give you a clear routine. Little and often works better than one long session. Keep going at home until they tell you it is safe to stop.
Is it normal to cough up blood-stained phlegm?
A little old, dark or streaky blood in phlegm can happen in the first days after lung surgery. Fresh red blood, more than a streak, or blood that keeps increasing needs checking the same day. Tell the nurse on the ward, or go to the emergency department if you are home.
Can I do the exercises with the chest drain still in?
Yes, and you should. The drain is designed to stay in place while you breathe deeply, cough and walk. Keep the bottle below chest level and carry it with you. If the tube pulls or you notice a change in the bottle, tell the nurse.
Do I need to buy an incentive spirometer?
Ask your team first. Many hospitals provide one if they use it, and some do not use them at all. Deep breathing and huffing done well work without any device. If you buy one, get the physiotherapist to check that you are using it correctly.
Can family members help?
Very much. Remind the person to do the exercises, help them sit upright, hold the pillow during coughs and walk beside them. Watch one physiotherapy session so you know what good technique looks like. Encourage, but do not push through pain or dizziness.
Will pranayama or yoga breathing help?
Gentle, slow breathing practices can fit in well once you are home and healing. Avoid forceful techniques, breath holding or strong abdominal pumping in the early weeks, because they strain the wound. Tell the physiotherapist what you would like to do and follow their advice.
Why am I still breathless doing them?
Some breathlessness is expected after losing part of a lung and while you heal. It usually improves as fitness returns. Breathlessness that is sudden, getting worse, or happens at rest needs checking. Your lung function before surgery also affects how you will feel longer term.
Are physiotherapy sessions covered?
Physiotherapy on the ward is usually part of the surgical stay. Outpatient sessions or rehabilitation courses may be charged separately. Aarogyasri, CGHS, ECHS, EHS and cashless insurance differ in what they cover, so ask the billing desk or your insurer.
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Sources
- Cancer Research UK — Surgery for lung cancer
- Macmillan Cancer Support — Lung cancer
- American Cancer Society — Surgery for non-small cell lung cancer
- NHS — Lung cancer: treatment
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
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