Breathe better after a chest cold, flu, pneumonia, or COVID

Winter is almost here, along with an increased risk for infections that can settle in your lungs, such as the flu, pneumonia, COVID-19, or bronchitis. If you get one of these illnesses, beware that it can leave you with two lung problems, even when you're feeling better. One is mucus secretions in the lungs that fester, continue the infection process, and make it hard to breathe. The other is weakness in the respiratory muscles that move the lungs. To recover successfully, take action with a few exercises.

Clear out mucus secretions

If you notice a rattle or congestion in your lungs, try these exercises to clear mucus secretions.

Huffing. Huffing is exhaling like you're trying to fog up a mirror. It's a little more forceful than the way you'd normally exhale. When you have mucus in the lungs, huffing helps keeps the airways open, making it easier to clear secretions. "Take a deep breath in, hold it for a few seconds, then huff slowly, for as long as you can. That will push air out, move secretions, and trigger a productive cough. Repeat the process, but not so many times that it causes discomfort. Huff and cough whenever you need to clear secretions throughout the day. And don't swallow them; spit them out," says Heather Philben, a physical therapist who teaches breathing techniques and helps people regain respiratory muscle strength at Harvard-affiliated Beth Israel Deaconess Hospital.

Using vibrations. You can purchase a small tool online called a flutter valve or an acapella valve (prices start at about $24). It might look like a child's bubble pipe or kazoo. "You blow into it and hear small balls fluttering inside it. The vibrations reach into your airways and help loosen secretions. Try to cough after using the tool," Philben suggests. "The secretions loosened by the vibrations may be coughed up more easily."

Performing an active cycle of breathing. This is a series of breaths and coughs that dislodges mucus in the lungs. "Take four relaxed breaths. Then take four deep breaths, holding each one for three seconds before exhaling. Follow that with four relaxed breaths, then three huffing exhalations, and then a cough," Philben says.

One other exercise to help clear mucus secretions is done with the help of a physical therapist in an outpatient clinic. It's called postural drainage and manual percussion. You lie down, and a physical therapist gently pats your chest like a drum over the congested area of the lungs.

Strengthen your breathing muscles

Your respiratory muscles can lose strength if you have an extended illness or one that requires you to go on a ventilator. If you're feeling short of breath, Philben recommends the following exercises.

Diaphragmatic breathing. For difficulty inhaling, strengthen your diaphragm — the large dome-shaped muscle below your lungs. To tell if you are using your diaphragm, lie on your back, place one hand on your belly, and breathe deeply. Your hand and belly should rise as you breathe in. "Take 10 nice, slow, even breaths and focus on breathing. Rest for a minute, and repeat the process," Philben says. "Once you feel confident that you're using your diaphragm to breathe while lying down, try the exercise while sitting up and eventually while standing. In time, you'll strengthen your diaphragm and train yourself to rely on it instead of muscles at the top of the lungs, which are less effective."

Using a respiratory trainer. Once you're good at diaphragmatic breathing, try using a respiratory trainer. This is another kazoo-like device (about $20 or more) that you place in your mouth. It provides resistance to breathing, which makes your diaphragm work harder. With the device in your mouth, take in a deep breath and then exhale fully. "Set the resistance at a level that you can perform 10 times in a row at a moderate difficulty level. Do this two to three times daily," Philben suggests.

Pursed-lip breathing. If you have difficulty exhaling, pursed-lip breathing will help keep the airways open so you can breathe. "Purse your lips as if you're slowly blowing out a candle or blowing air through a thin straw. While pursing, inhale as much as you can and then exhale fully. If it helps, breathe through an actual straw," Philben says. "Like diaphragmatic breathing, do pursed-lip breathing at rest until you can do it while walking or climbing stairs," Philben says.

With all of these exercises: "The goal is using the proper breathing techniques so that they become second nature and help you breathe better when you're out in the real world," Philben says, "and that will get you back to the activities you love."

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