Physiotherapy
This booklet is designed to give some guidelines and information about how the physiotherapy team at The James Cook University Hospital will help you in your recovery following your operation.
Physiotherapy plays an important part in your recovery after your operation. Your physiotherapy treatment will focus on three main areas:
- Chest care
- Postural advice
- General mobility
The exercise instructions in this booklet are given as a general guideline only as each patient is treated as an individual and the exercise regime may vary slightly depending on the type of operation or your consultant’s instructions.
If you are in doubt about the information given in this booklet, please ask your physiotherapist. All the exercises contained within this booklet will be taught to you by your physiotherapist.
Physiotherapy before your operation
A physiotherapist will see you prior to your operation. They will teach you exercises to practice before and after your operation. This is usually done at your pre-assessment clinic appointment or on the ward at the time of your admission.
Your physiotherapy exercises will include:
- Deep breathing exercises
- Huffing and supported coughing
- Shoulder exercises
- Postural exercises
- General mobility
What to expect after your operation
Following your operation, you may require oxygen support whilst recovering within the high dependency unit. You will be attached to monitors, chest drains, catheters, and lines for your drugs or fluids. This is all routine and it’s nothing to be concerned about.
The physiotherapist will aim to assist you to sit out of bed on the day of your surgery and then plan to steadily increase your walking daily on the ward. It is important that you follow the advice of your physiotherapist and that you continue exercising between their visits.
Your mobility should improve each day, and you will soon be able to walk on your own again – in fact walking soon after your surgery is encouraged as it will improve your lung function. Not walking enough and spending too much time in bed in the early stages after your operation can actually cause pneumonia or chest infection.
It will be normal to initially experience some shortness of breath and, or discomfort on exercise and walking, but it will improve with time as you do more.
Chest care
Deep breathing exercises begin immediately after your operation. Some people become chesty in the first few days following surgery due to extra phlegm production as result of:
- Having an anaesthetic
- The discomfort or pain from your chest wound limiting you from taking in deep breath and coughing.
- Reduced mobility and shallower breathing in the first few days after surgery.
Your physiotherapist will assess your breathing and how your lungs are working. They may advise on the ideal position to improve your comfort and lung function.
If you practice before your operation, it is easier to remember these exercises afterwards.
Following your operation, you need to perform your breathing exercises every hour that you are awake.
Deep breathing exercises
Are aimed at keeping your lungs clear after your operation together with huffing and coughing.
Procedure
- Sit upright with your hands placed over the sides of your chest.
- Take a deep breath in slowly through your nose.
- Hold this breath in for one to two seconds and then breathe the air out slowly through your mouth.
- Repeat five times, then huff five times.
- To do a huff take a breath in then force the air out quickly through an open mouth, as if you are steaming a window or glass.
- If you have any phlegm in your throat, then have a supported cough.
- Coughing – always take a deep breath in and have a good strong cough. It is important that you always use a small supporting pillow over your wound when coughing. Afterwards, take normal relaxed breaths.
If pain after your operation is making it difficult for you to take a deep breath, huff or cough then please inform your nurse.
Exercises
From the day of your surgery, we will encourage you to begin exercising. This may initially involve some gentle exercises to prevent stiffness, help circulation and increase general mobility. Repeat each exercise two to three times per day.
Arm exercises
- While standing or seated, raise both arms up above your head as pain allows, then back down.
- Gentle shoulder shrugs (up and down) and shoulder rolls (forwards and backwards)
- Place your hands on top of your head.
Repeat each exercise 5 to 10 times as tolerated.

above your head

and rolls

of your head
Activities of daily living
The physiotherapist will monitor and assess your ability to mobilise and do simple tasks during your hospital stay. Any problems will be identified and treated as appropriate in conjunction with other members of the team. Routine patients are usually discharged home within four to five days but may be sooner dependant on your surgery.
After discharge from hospital
After your operation, your lung function should improve and your ability to exercise will also gradually increase. Exercises for the first 4 to 6 weeks after discharge will be low intensity and focused on increasing your cardiovascular fitness.
Walking
- Improves your fitness after your operation.
- Should become part of your daily routine.
- Should start immediately after discharge from hospital.
- Distance should be increased steadily each day with gradually increasing speed to make you feel slightly out of breath.
What happens if I have a chest infection?
The signs of a chest infection may be …
- Coughing up more phlegm than normal.
- Your phlegm may change colour – white, yellow or green.
- You may have a temperature.
- You may be more short of breath than normal.
Consult your GP immediately if you suspect that you may have a chest infection, breathing exercises will help you clear phlegm effectively. You will have done these breathing exercises in the early days after your lung operation. However, you may not remember them exactly so please refer to the earlier information in this booklet.
Other advice
Your wound must be given time to heal properly, avoid putting too much strain or tension upon it. Avoid lifting anything heavy for the first four to six weeks whilst your wound heals.
After your discharge from hospital, you may return to gentle hobbies. Avoid contact sports for three months or as advised by your consultant.
Posture
Once you have left the hospital it is your responsibility to check and correct your posture.
Try standing in front of a mirror to help in adjusting and correcting your posture or stand with your back to a wall pushing your shoulders back. Continue doing your shoulder flexibility exercises as shown in the booklet.
General advice
- You will be followed up by your consultant following discharge from hospital by means suitable to your individual circumstances.
- At two to three months after your operation you should be able to do most things you were doing before your operation. Consult your doctor before you participate in any competitive or contact sports.
- You may return to school or work when you feel able to. This should be within four to six weeks. Please discuss return to school or work and driving, if this affects you, either when in hospital or at your follow up appointment.
- Holidays abroad – follow your consultant’s advice from your outpatient appointment.
- Wound pain or discomfort may persist for a few weeks after your operation, this is due to the healing process. Any concerns with persistent or unresolving pain, please seek advice from your consultant or specialist nurse.
The information in this booklet is designed only as a guideline.
If you have any comments on the booklet or the physiotherapy service, please contact the rehabilitation centre on 01642 854453.
Contact us
If you have any concerns or questions, please contact us on:
Telephone: 01642 850850, Extension: 54532
Monday to Sunday, 08.15 until 16.15
Email: [email protected]
Patient experience
South Tees Hospitals NHS Foundation Trust would like your feedback. If you wish to share your experience about your care and treatment or on behalf of a patient, please contact The Patient Experience Department who will advise you on how best to do this.
This service is based at The James Cook University Hospital but also covers the Friarage Hospital in Northallerton, our community hospitals and community health services.
To ensure we meet your communication needs please inform the Patient Experience Department of any special requirements, for example; braille or large print.
T: 01642 835964
E: [email protected]