With postural drainage, you get into a position that helps drain fluid out of the lungs. It may help:

• Treat or prevent an infection
• Make breathing easier
• Prevent more problems with the lungs

A respiratory therapist, nurse, or doctor will show you the best position for postural drainage.

The best time to do postural drainage is either before a meal or an hour and a half after a meal, when your stomach is emptiest.

Use one of the following positions:

• Sitting
• Lying on your back, stomach, or side
• Sitting or lying with your head flat, up, or down

Stay in the position for as long as your provider instructed (at least 5 minutes). Wear comfortable clothes and use pillows to get as comfortable as possible. Repeat the position as often as instructed.

Breathe in slowly through your nose, and then out through your mouth. Breathing out should take about twice as long as breathing in.

Your doctor may also recommend doing percussion or vibration.

Percussion helps break up thick fluids in the lungs. Either you or someone else claps a hand on your ribs while you are lying down. You can do this with or without clothing on your chest:

• Form a cup shape with your hand and wrist.
• Clap your hand and wrist against your chest (or have someone clap your back, if your doctor tells you to).
• You should hear a hollow or popping sound, not a slapping sound.
• Do not clap so hard that it hurts.

Vibration is like percussion, but with a flat hand that gently shakes your ribs.

• Take a deep breath, then blow out hard.
• With a flat hand, gently shake your ribs.

Your provider will show you how to do this the right way.

Do percussion or vibration for 5 to 7 minutes in each area of the chest. Do this on all of the areas of your chest or back that your doctor tells you to. When you finish, take a deep breath and cough. This helps bring up any phlegm, which you can then spit out.

Call your doctor if you have:

• Indigestion
• Vomiting
• Pain
• Severe discomfort
• Difficulty breathing

Chest physical therapy; CPT; COPD - postural drainage; Cystic fibrosis - postural drainage; Bronchopulmonary dysplasia - postural drainage

Celli BR, ZuWallack RL. Pulmonary rehabilitation. In: Broaddus VC, Mason RJ, Ernst JD, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine. 6th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 105.

Tokarczyk AJ, Katz J, Vender JS. Oxygen delivery systems, inhalation, and respiratory therapy. In: Hagberg CA, Artime CA, Aziz MF, eds. Hagberg and Benumof's Airway Management. 4th ed. Philadelphia, PA: Elsevier; 2018:chap 1.

Updated by: Neil K. Kaneshiro, MD, MHA, Clinical Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.