This webpage gives you exercises to keep your lung healthy.

People with immunodeficiency can be especially prone to respiratory infections such as sinusitis, bronchitis, and pneumonia.

In some extreme cases, these infections can lead to unpleasant feelings of breathlessness, even after short bursts of activity. As a result, it can be tempting to take the easy option and give up trying to lead an active life when you are well and free from infections. Don’t! This in itself can pose problems: to your physical well-being, to your mood and to the way you feel about yourself. Isolating yourself and being confined to the home is not much fun for anyone.

Strange as it may seem, the solution lies not in stopping all exercise but in ensuring that you get enough exercise. Just a few simple exercises performed for a few minutes a day can make all the difference to your physical and mental well-being. Remember though, when you do have an acute infection, it may not be wise to exercise.

Remember, the information on this page is intended only as a guide. Always consult your own doctor or physiotherapist before you start an exercise programme.

Exercises to improve your breathing and to help clear sputum

Although it isn’t usually possible to stop the production of excessive sputum, you can improve the way it is cleared from your chest.

The techniques used to clear the chest are:

  • relaxed breathing control, to avoid tightness of the chest and exhaustion
  • deep breathing exercises, to loosen the sputum
  • huffing.

If you produce only about two or three tablespoonfuls of sputum a day, you can do the exercises either sitting or lying down, first on one side and then on the other.

However, if you have bronchiectasis and produce more than one cupful of sputum a day, you will need to lie in positions in which gravity helps to drain the affected areas of the lungs. This is often known as postural drainage. A physiotherapist must advise you on the postural drainage positions that are most appropriate for you.

Even if you can’t manage to take active exercise, breathing exercises are essential to keep your lungs clear and free of infection. Practising breathing exercises can help you to:

  • breathe more efficiently and make better use of your lungs
  • control the unpleasant, panicky feeling of breathlessness
  • remove sputum from your chest.

Your physiotherapist can show you positions to help reduce your breathlessness when it is bad. However, there are simple exercises that will help your general breathing. These are relaxed breathing control, huffing and deep breathing. Make sure you discuss these with your doctor or physiotherapist.

Relaxed breathing control

This exercise will help you to control breathlessness, particularly after coughing, huffing or taking active exercise.

Follow these steps:

  • Relax your head, neck and shoulders. Your physiotherapist can show you some exercises to achieve this.
  • With your shoulders dropped, place your hands across your stomach, just below your ribs.
  • Breathe out gently through your mouth.
  • After a long breath out, breathe in gently through your mouth or nose, keeping your shoulders relaxed.
  • Repeat this exercise four to six times.

This exercise should not tire you. If it does, ask your physiotherapist for advice, as you might not be doing it correctly.

Huffing

This is a forced breath out of an open mouth that helps to move the secretions upwards; for example, as if creating a mist on a window.

There are two types:

  • Take a medium-sized breath in and try and ‘squeeze’ the breath out.
  • Take a big breath in and do a shorter, sharper breath out. You should start with the first type of huff and as the secretions move upwards then try the second type.

Always remember to allow for an essential short period for relaxation and gentle breathing control after every one or two huffs. Between 15 and 30 seconds should be enough. This will prevent the feeling of tightness in the airways and chest and allow you to relax and recover your breath comfortably. Remember, relaxed breathing control is also helpful after a bout of coughing.

Deep breathing

This exercise helps you make better use of the lower parts of your lungs.

Follow these steps:

  • Relax your head, neck and shoulders.
  • Place your hands across your stomach, just below your ribs.
  • Breathe out gently.
  • Keeping your shoulders relaxed, take a deep breath in through your mouth or nose, feeling your ribs rising under your hands.
  • Hold the deep breath for a second, then breathe out gently through your mouth.
  • Repeat the exercise three or four times; then rest.

Children can be encouraged to take deep breaths through the use of blowing games, for example, blowing tissues, or even by playing a musical instrument.

Clearing sputum in children

Babies and small children will swallow their sputum, but as soon as a child is old enough he or she should be encouraged to cough it up and spit it out (expectorate).

Postural drainage for small children is best performed across the parent’s knee, before a feed. As the child grows older, postural drainage can be performed over a wedge of foam or pillows. It is often difficult to persuade a toddler to remain in one position for any length of time. However, running or jumping up and down between short sessions of postural drainage can actually help, as these activities often stimulate a cough.

Seek advice from your physiotherapist before practising postural drainage on your child.

This information was developed by Professor John Hurst, Professor of Respiratory Medicine at University College London. December 2021.