Chest physio is something you can do to help your child breathe better. Sometimes there is too much mucus, or it is too thick. It blocks the air from moving in and out of your child’s lungs. Mucus makes it hard for your child to breathe. Mucus that sits too long in the lungs can also grow germs that can make your child sick. Chest physio helps to loosen your childs’ mucus, so your child can cough it up.


Postural Drainage

Postural drainage removes mucus from certain parts of your lungs by using gravity. By placing your child in different positions, mucus drains to the bigger airways where it can be coughed out.

Scheduling the Treatment

Chest physio often works best in the morning. This allows mucus to be removed that has built up during the night. Sometimes chest physio can be done at night to reduce the need for coughing during sleep. Make sure your child waits at least 1-2 hours after eating before starting chest physio. This helps to prevent nausea and/or vomiting. Doing chest physio just before meals may cause your child to become tired and may decrease your childs’ appetite.


Percussion may also be ordered with postural drainage to help remove the mucus.

Perform chest physio by clapping with a cupped hand over the part of the lung that is being drained. The cupped hand forces a cushion of air against the chest wall. This vibrates the lungs, which loosens secretions. Hold your hand as if you were going to drink water from it (see picture below).

Percussion should be done on the round areas shown on each postural drainage picture, and should always be done over the rib cage. Never percuss over the spine, breasts, clavicles, or breast bone (sternum). It should also be done over a thin article of clothing or a towel, never on bare skin.

Percussion should last 3-5 minutes per area that is being drained. Areas that have a lot of mucus may require more time.

If cupping is hard to do, soft plastic hand-held percussor cups or mechanical percussor may be used. Check with your health care team if you wish to try these devices.


Vibration is a technique that also helps the movement of mucus. Place your flattened hand over the area that was percussed. Rapidly but gently shake your the chest while your child exhales. Repeat this procedure three times after percussing each position. Follow all vibration therapies with a cough.

Chest Physio Positions for Infants and Children

Below are the drainage positions for chest physio. The white ovals show you where to percuss. During therapy it is useful to have tissue or a basin handy to collect mucus. A glass of water may also be helpful for those children who can cough better after their throat is wet.

Upper Lobes

Lean forward 30°. Percuss between the clavicle and the shoulder blade on each side of the chest.

Lean back 30° (half way between sitting up and laying flat). Percuss between the clavicle and the nipple on each side of the chest.

Lower Lobes

The body should be positioned with the child’s head down 30°and lying on the right side. Percuss on the left side below the underarm. 

Horizontal Head down 30º

The body should be positioned with the child’s head down 30°and lying on the abdomen. Percuss between the lower edges of the rib cage and behind the underarm on each side of the spinal cord.

The body should be positioned with the child’s head down 30°and lying on the left side. Percuss on the right side below the underarm.

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