What Is Chest Physiotherapy –And How Can It Help This Winter?

Winter in Cape Town is not just about colder days and more time indoors. It also marks the start of flu season — when coughs, colds, and chest infections become all too common. If you have noticed that it is harder to shake off a lingering cough or chest tightness this time of year, you are not imagining it.

Our lungs work hard all year round, but they are particularly vulnerable in winter. Fortunately, chest physiotherapy can help your lungs recover faster, reduce congestion, and make breathing easier — even during the peak of flu season.

At Hein Viljoen Physiotherapy, we regularly treat patients with winter chest issues and have seen firsthand how effective this approach can be.

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Why do respiratory illnesses affect the lungs so much?

Understanding how the lungs work helps one understand why chest physiotherapy is so effective.

The lungs comprise a network of branching airways — like an upside-down tree — ending in tiny air sacs called alveoli. These sacs are where oxygen is exchanged for carbon dioxide. For this exchange to happen efficiently, the airways need to be clear and open, and the alveoli need to be free of inflammation or fluid.

During a cold or flu, however, things change:

• Your body produces more mucus to trap viruses and bacteria.
• Airways become inflamed, making breathing feel tight or wheezy.
• Mucus can get stuck in the lungs, especially in people who are already ill or less active.
• This trapped mucus creates an ideal environment for bacteria to thrive, sometimes leading to more serious infections like pneumonia.

Even after the worst of the illness has passed, your lungs can stay congested for weeks, especially if you cough inefficiently or feel too tired to breathe deeply.

That is where chest physiotherapy comes in.

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What is chest physiotherapy?

Chest physiotherapy (also known as respiratory physio) is a set of techniques used to:

• Loosen and move excess mucus out of the lungs
• Improve airflow and oxygen delivery
• Reduce the risk of complications like pneumonia
• Support recovery from infection or inflammation

It is a safe option that works with your body’s natural mechanisms — helping your lungs do what they struggle to do on their own.

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How does chest physio work?

A typical chest physiotherapy session may include:

• Percussion and vibration: Gentle hands-on techniques applied to the chest wall to loosen mucus.
• Postural drainage: Lying in specific positions to use gravity to move secretions toward the larger airways where they can be coughed out.
• Breathing exercises: Deep breathing, huffing, or using breathing devices to expand the lungs and mobilise secretions.
• PEP therapy (positive expiratory pressure): Breathing out against resistance to keep airways open and shift mucus.
• Nebulising: Sometimes, we may use a nebuliser to deliver medication or a saline mist directly into your lungs. Nebulsing moistens the airways, reduces inflammation, and loosens thick mucus, making it easier to clear.
• Education and home care: Advice on positioning, steam inhalation, and managing flare-ups.

These techniques can be highly effective — even for people who feel too tired or breathless to clear their chest alone.

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Who benefits from chest physiotherapy?

While chest physio is often used in hospitals or for people with chronic lung conditions, it is also highly beneficial for:

• People recovering from flu, COVID-19, or bronchitis
• Children and adults with recurrent chest infections
• Asthma, COPD, or bronchiectasis patients
• Post-operative patients, especially after abdominal or thoracic surgery
• Older adults or individuals with reduced mobility

Even if you are generally healthy, a lingering winter cough or heavy chest can respond well to chest physiotherapy. And the sooner you get help, the quicker your lungs can return to full function.

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Why is winter such a challenge for the lungs?

Cape Town's winters bring a perfect storm for respiratory issues:

• Colder air tends to be drier and more irritating to the airways.
• We spend more time indoors, increasing exposure to viruses and bacteria.
• People with asthma or chronic bronchitis often experience flare-ups triggered by cold air and infections.
• General inactivity during winter slows down the natural movement of mucus through the lungs.

These factors all increase the workload on your lungs. Chest physiotherapy offers a gentle but effective way to support lung function, improve comfort, and reduce your risk of secondary infections.

Don't let the cold weather take your breath away. A few sessions with one of our physiotherapists could make this winter much easier.