Chest Physiotherapy

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Our team of professionals and staff believe that informed patients are better equipped to make decisions regarding their health and well-being. For your personal use, we have created an extensive patient library covering an array of educational topics, which can be found on the side of each page. Browse through these diagnoses and treatments to learn more about topics of interest to you. Or, for a more comprehensive search of our entire website, enter your term(s) in the search bar provided below.

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Spinal cord and nerves. These "electrical cables" travel through the spinal canal carrying messages between your brain and muscles. Nerve roots branch out from the spinal cord through openings in the vertebrae (foramen).

Intervertrebral disks. In between your vertebrae are flexible intervertebral disks. They act as shock absorbers when you walk or run.

Intervertebral disks are flat and round and about a half inch thick. They are made up of two components:

  • Annulus fibrosus. This is the tough, flexible outer ring of the disk.
  • Nucleus pulposus. This is the soft, jelly-like center of the disk.                                                                                                                                                                                                                                                                                                                     

    Cervical radiculopathy most often arises from degenerative changes that occur in the spine as we age or from an injury that causes a herniated, or bulging, intervertebral disk.

    Degenerative changes. As the disks in the spine age, they lose height and begin to bulge. They also lose water content, begin to dry out, and become stiffer. This problem causes settling, or collapse, of the disk spaces and loss of disk space height.

    (Left) Side view of a healthy cervical vertebra and disk. (Right) A disk that has degenerated and collapsed.

    As the disks lose height, the vertebrae move closer together. The body responds to the collapsed disk by forming more bone —called bone spurs—around the disk to strengthen it. These bone spurs contribute to the stiffening of the spine. They may also narrow the foramen—the small openings on each side of the spinal column where the nerve roots exit—and pinch the nerve root.

    Degenerative changes in the disks are often called arthritis or spondylosis. These changes are normal and they occur in everyone. In fact, nearly half of all people middle-aged and older have worn disks and pinched nerves that do not cause painful symptoms. It is not known why some patients develop symptoms and others do not.

    Herniated disk (side view and cross section)

    Herniated disk. A disk herniates when its jelly-like center (nucleus) pushes against its outer ring (annulus). If the disk is very worn or injured, the nucleus may squeeze all the way through. When the herniated disk bulges out toward the spinal canal, it puts pressure on the sensitive nerve root, causing pain and weakness in the area the nerve supplies.

    A herniated disk often occurs with lifting, pulling, bending, or twisting movements.


    In most cases, the pain of cervical radiculopathy starts at the neck and travels down the arm in the area served by the damaged nerve. This pain is usually described as burning or sharp. Certain neck movements—like extending or straining the neck or turning the head—may increase the pain. Other symptoms include:

  • Tingling or the feeling of "pins and needles" in the fingers or hand
  • Weakness in the muscles of the arm, shoulder, or hand
  • Loss of sensation
  • Some patients report that pain decreases when they place their hands on top of their head. This movement may             temporarily relieve pressure on the nerve root.

Chest physiotherapy involves a number of physical techniques to help remove excess mucus from respiratory passages and improve breathing. The goal is to help patients breathe more freely and get more oxygen through the blood stream into all parts of the body.

Normally, mucus helps lubricate the lungs. But infection, trauma or illness can create excess mucus that needs to be cleared for better breathing. This treatment method is applied by physical therapists or respiratory therapists and is often part of the treatment plan for people with:

  • Artificial ventilation
  • Asthma
  • Bronchitis
  • Chronic Obstructive Pulmonary Disease (COPD)
  • Cerebral Palsy
  • Cystic Fibrosis
  • Fractured ribs
  • Head or neck injury
  • Heart attack
  • Pneumonia
  • Post operative
  • Tuberculosis

Typically, chest physiotherapy is done several times a day in either a sitting up or lying down position. There are six different techniques:

Postural Drainage: This technique uses gravity as an aid to draining secretions by optimizing the position of the body to clear mucus.

Chest Percussion: Also known as cupping or clapping, this technique involves the rhythmic striking or hitting of the chest, back and below the arms to loosen up thick mucus and force it from the small airways to the large airways, where it can be expelled.

Controlled Coughing: This technique helps break down thick mucus and then helps expel the mucus.

Deep Breathing: This technique improves the distribution of air throughout the body by expanding lung tissue.

Turning: Like postural drainage, this technique uses the natural force of gravity to help loosen and move mucus from the lungs. It involves turning a patient from side to side to expand the lungs and promote drainage.

Vibration: This technique is performed simultaneously with a patient doing deep breathing exercises. Gentle vibrations are applied to the chest either manually (hands-only) or mechanically to help break up lung secretions.

Coughing and Deep Breathing

Coughing and deep breathing are techniques used to help clear the respiratory system of secretions. The goal of coughing and deep breathing is to increase lung capacity and expand the airways after a period of inactivity or anesthesia. The combination of voluntary coughing and deep breathing helps loosen and clear mucus from the large and small air passages and prevents lung infections – all of which make breathing easier. Coughing and deep breathing are best accomplished in a sitting or standing position.