Lung/Chest physiotherapy involves a range of techniques that address multiple lung problems. It aims to improve lung function, and thus allow patients to breathe more optimally. This is achieved by applying different techniques that assist in reducing and clearing excess phlegm that may build up as a result of infection or other causes. By clearing the lungs of excess phlegm and helping patients breathe more optimally, we make their breathing easier and prevent further complications such as lung collapse
Who can benefit from lung and sinus treatment?
People suffering from any respiratory illness can benefit from chest physiotherapy. These include bronchitis, pneumonia, Chronic Obstructive Pulmonary Disease (COPD), bronchiectasis, cystic fibrosis, Covid-19, and people with neuromuscular disease, cerebral palsy, or spinal cord injury. It can also be very beneficial in maintaining or improving lung function before and after surgery to avoid the negative effect that anaesthesia and post-operative immobility has on someone’s lungs.
Whether someone experiences shortness of breath, excessive phlegm, coughing, or low oxygen saturation levels, chest physiotherapy can help to address these problems. Various techniques may be used depending on the patient’s main problem and clinical presentation. A thorough respiratory assessment is done to determine what the main problems are, and which treatment techniques will be most beneficial. Traditional, manual chest physiotherapy techniques are not routinely done. Our main aim is to help our patients become more independent in the management of their respiratory problems.
Lung and sinus treatment may include:
- Postural drainage
- Percussions and vibrations
- Breathing exercises including the Bradcliff® Breathing Method
- Dry needling and pressure points
Postural drainage, percussions and vibrations
Manual techniques such as postural drainage, chest percussions and vibrations are used where indicated. Postural drainage makes use of specific gravity-assisted positioning, used to assist the clearance of phlegm from an affected area of the lung to the more central airways. From here, phlegm can be coughed up more easily. Percussions and manual vibrations are directly applied by the physiotherapist and involve clapping over the chest wall with cupped hands or rhythmically vibrating the chest wall to aid the movement of phlegm toward the central airways. The principle behind these manual techniques is similar to shaking a tomato sauce bottle to get the sauce out.
More modern, and very effective, techniques such as the Active Cycle of Breathing Techniques (ACBT) and autogenic drainage encourage patients to self-manage their lung problems. The ACBT involves 3 phases: breathing control, chest wall expansion, and forced expiratory techniques. ACBT is best taught by a physiotherapist and can then be used as a self-treatment.
Autogenic drainage is also an active breathing exercise in which the patient is taught to breathe at low to high lung volumes, with inspiratory holds, followed by forced expiration. By breathing at varying lung volumes, phlegm is loosened, then collected, and finally expectorated.
Devices can also be used to aid the removal of phlegm and to strengthen the lungs. Positive Expiratory Pressure (PEP) devices such as the flutter or Broch-U-Vibe are very effective. These devices create a positive pressure against which the patient exhales, assisting the clearance of phlegm. Blow bottles can be used as an alternative, and are especially valuable in treating children with lung problems.
Nebulisation can enhance lung and sinus treatment, especially when phlegm is very thick and not easily cleared. Normal saline solution is usually used. Patients breathe in the vapour, which then moistens their airways and helps to loosen phlegm to allow easier expulsion thereof.
Sinusitis can be successfully treated by physiotherapists. Sinuses are air-filled spaces within the facial bones. They may become infected, inflamed, and swollen, causing discomfort, pressure, or a feeling of heaviness around the face. Other symptoms of sinusitis may include blocked or runny nose, headache, jaw pain, coughing, or loss of smell or taste. Acute sinusitis occurs during cold, flu, or other infections. Sinusitis can become chronic, where symptoms are ongoing due to a variety of factors such as environmental exposure to irritants, or structural abnormalities in the nasal passage.
Ultrasound and laser therapy are used in the treatment of sinusitis to assist in the clearance of mucus from the sinuses. Nebulisation and nasal rinsing further assist with moistening and thus loosening of mucus. Manual techniques such as massage and pressure point stimulation may also be incorporated.
Bradcliff® Breathing Method
At Just Physio, we also use the Bradcliff® Breathing Method to treat a variety of respiratory problems but also incorporate this method into the treatment of many other conditions. The Bradcliff® Breathing Method is an internationally recognised approach, based on scientific evidence that addresses dysfunctional breathing in all areas of healthcare. It was co-founded by Dinah Bradley and Tania Clifton-Smith, who developed this method from their combined vision and clinical experience.
Breathing is central to our physical and psychological being and is vital for survival. Disordered breathing may be the first sign that we are unwell. Breathing pattern disorders may underlie many musculoskeletal pain conditions, sports injuries, and mental health problems e.g. anxiety disorders. Therefore, incorporating breathing assessment and retraining into most of our patient treatments unlocks the opportunity for achieving great success in treatment outcomes.
The Bradcliff® Method is easily taught and requires no or minimal equipment. As certified Bradcliff® practitioners, we teach our patients to control and restore their body’s normal equilibrium state by using breathing retraining techniques. Breathing retraining is initially guided by the physiotherapist. Once the patient successfully grasps the techniques, they can apply them as daily practices to help them heal and flourish, physically and mentally.
The Bradcliff® treatment principles involve educating our patients about the potential underlying mechanisms of their symptoms, teaching them to observe and become aware of their own breathing patterns, and then helping them to achieve optimal breathing. Once optimal breathing is achieved at rest, we teach our patients to integrate this into their daily life, allowing them to maintain their optimal equilibrium state.