Breathing exercises after surgery prevent parts of your lungs from collapsing and help you avoid pneumonia and other complications. General anesthesia, pain medications, and lying still in bed all work against your lungs in the hours and days following an operation. The exercises counteract these effects by keeping your air sacs open, clearing mucus, and restoring normal oxygen levels.
What Anesthesia Does to Your Lungs
Under general anesthesia, your diaphragm loses its normal muscle tone. This large dome-shaped muscle normally does most of the work of breathing, pulling air deep into your lungs with each inhale. When anesthesia relaxes it, the weight of your abdominal organs pushes upward against it, compressing the lower portions of your lungs. This creates what’s called atelectasis: small air sacs in the lung tissue collapse and stop participating in gas exchange.
The problem doesn’t end when you wake up. Sedatives, opioid pain medications, and residual effects of muscle relaxants continue to suppress your breathing drive after surgery. Your breaths become shallower and less frequent than normal, which means those collapsed air sacs stay closed. If enough of them remain shut, oxygen levels in your blood drop and the stagnant, airless tissue becomes a breeding ground for bacteria.
Pain Makes the Problem Worse
Surgical pain creates a vicious cycle. It hurts to take a deep breath, so you instinctively breathe shallowly to avoid stretching the incision site. This is especially pronounced after upper abdominal surgery, where complication rates from lung problems can range from 15% to over 50% depending on the procedure. Even hip replacement surgery carries a 2.6% rate of lung complications including pneumonia.
Research on patients after abdominal surgery found that when pain was effectively controlled with epidural analgesia, both vital capacity and the volume of air remaining in the lungs between breaths improved. With less pain, patients could breathe deeply enough to reopen collapsed air sacs and cough effectively to clear secretions. This is why your care team works to manage your pain alongside asking you to do breathing exercises. One supports the other.
How Breathing Exercises Protect You
Deep breathing exercises work through a few straightforward mechanisms. First, they physically reinflate collapsed air sacs by pushing air into areas of the lung that have shut down. Second, they help loosen and move mucus that accumulates when you’re lying still and breathing shallowly. Normally, your body clears mucus through regular deep breaths, coughing, and movement. After surgery, all three are diminished.
The oxygen benefits are measurable. A randomized controlled trial of patients after cardiac surgery found that those who performed 30 deep breaths per session in the first two days had significantly better oxygen saturation (92.7%) compared to patients doing only 10 breaths per session (91.1%). That may sound like a small gap, but in the postoperative window, even modest improvements in oxygenation help tissues heal and reduce strain on the heart.
What You’re Actually Asked to Do
Most hospitals send you home with an incentive spirometer, a simple plastic device with a mouthpiece and a chamber that rises as you inhale. The National Institutes of Health recommends taking 10 to 15 breaths with it every one to two hours while you’re awake. The goal is to inhale slowly and deeply enough to raise the indicator to your target level, then hold the breath for a few seconds before exhaling. This sustained inflation is what pries open collapsed air sacs.
You may also be taught “huff coughing,” which involves taking a deep breath and then exhaling forcefully in short bursts, like fogging a mirror. This technique generates enough airflow to push mucus up and out of the airways without the sharp abdominal contraction of a full cough, which can be painful after surgery. The combination of deep breathing to open collapsed lung tissue and controlled coughing to clear secretions covers both major risks.
Why Walking Alone Isn’t Enough
Early walking after surgery is important for circulation, digestion, and preventing blood clots, but it doesn’t replace breathing exercises for lung recovery. A study comparing deep breathing to walking found a striking difference in how each activity affects the lungs. Deep breathing exercises increased the volume of air per breath by an average of 489 milliliters, a large and meaningful change. Walking, by contrast, increased breath volume by only about 163 milliliters, a much smaller effect. Walking does speed up your breathing rate slightly, but it doesn’t generate the same deep, sustained lung inflation that reopens collapsed tissue.
Think of it this way: walking gets your lungs working a bit harder, but breathing exercises specifically target the parts of your lungs that shut down during and after surgery. You need both, but they serve different purposes.
Who Needs Them Most
Every patient who undergoes general anesthesia benefits from postoperative breathing exercises, but the stakes are highest for certain groups. Upper abdominal and chest surgeries carry the greatest risk because the incisions are closest to the diaphragm, making deep breathing most painful and lung compression most severe. Patients who already have respiratory conditions, smokers, older adults, and those who had complications during surgery face elevated risk regardless of the procedure type.
Even for lower-risk surgeries like joint replacements or outpatient procedures, the basic principle holds. Anesthesia disrupts your normal breathing pattern, and your lungs need active help returning to full function. The exercises feel tedious, especially when you’re tired and sore, but they represent one of the simplest and most effective things you can do to avoid a longer, more complicated recovery.