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postural drainage

How Postural Drainage Can Help Clear Fluid In The Lungs

Some people in quarantine from this new variation of the SARS virus might benefit from simple techniques to drain fluid from their lungs, though not everyone with COVID-19 will have respiratory fluid build-up.

SARS, or severe acute respiratory syndrome, is a form of pneumonia that can be life-threatening. It is caused by a virus called SARS-CoV, and most people who contract the virus will develop pneumonia. This condition causes the alveoli in the lungs to become filled with fluids and pus, making it difficult to breathe.

How Postural Drainage Can Help Clear Fluid In The Lungs
(Credit: Elsevier)

Postural Drainage and Percussion (PD & P), also known as chest physical therapy (CPT), involves the use of gravity (specific body positioning that promotes fluid release) and percussion (a caretaker clapping the person inflicted around the region where the lungs are) to loosen the thick, sticky mucus within so it can then be removed by huffing or coughing. While one should always visit the doctor and make sure to get the proper treatment, those who can’t see one can use these techniques to help them cough out the fluid from the lungs and potentially recover on their own.

The positions are below as follows:

According to instructions from the Cystic Fibrosis Foundation:

“The goal of PD & P is to clear mucus from each of the five lobes of the lungs by moving mucus into the larger airways so that it can be coughed out.


The performance of PD & P involves a combination of techniques including multiple positions to drain the lungs, percussion, vibration, deep breathing and coughing. Once the person is in one of the positions, the caregiver does percussion on the chest wall. This is usually given for a period of three to five minutes and sometimes followed by vibration over the same area for approximately 15 seconds (or during five exhalations). The person is then encouraged to cough or huff forcefully to get the mucus out of the lungs.”

The percussion (clapping) by the caregiver should be performed with cupped hands (scoop position with fingers together and the palm facing down) so as not to sting because the claps should be forceful and with a steady beat. If done correctly, it should sound hollow and shouldn’t hurt. Don’t clap over the breastbone, spine, lower ribs, stomach, or lower back to avoid potential injury to the spleen (left), kidneys (lower back), or liver (right).

Consider using a postural drainage massage device for additional relief and to complement percussion therapy. This device can help enhance the effects of percussion therapy by targeting specific areas of tension and promoting better drainage of the respiratory system.

The foundation explains how to perform the next step, the vibrations, as such:

“Vibration gently shakes the mucus into the larger airways. The caregiver places a hand firmly on the chest wall over the part of the lung being drained and tenses the muscles of the arm and shoulder to create a fine shaking motion. Then, the caregiver applies a light pressure over the area being vibrated. (The caregiver also may place one hand over the other, then press the top and bottom hand into each other to vibrate.) Vibration is done with the flattened hand, not the cupped hand.”

How Postural Drainage Can Help Clear Fluid In The Lungs
(Credit: Saint Luke’s Health System)

For detailed diagrams showing how to do the percussion and vibrations in each position, CLICK HERE.

During this time, the sick person should exhale as wholly and slowly as possible because deep breaths move the loosened mucus and may lead to coughing, which is key to clearing the airway. Huffing is another option; it is less work than coughing and, therefore, less tiring.

Each session of PD&P should last for 20-40 minutes. It is best performed on an empty stomach (before meals) or at least half an hour to two hours after eating; otherwise, the therapy may lead to vomiting. The number of sessions per day varies depending on how congested the sick individual is.

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