Getting sputum out, with the least effort
Airway clearance is a skill, not a machine. We teach you a simple technique matched to your lungs, your energy and your daily routine — then coach it until you can do it on your own, at home, on a bad morning.
When mucus sits in the airways it blocks airflow, feeds infection and makes every breath cost more. Clearing it well is one of the highest-value interventions a cardiorespiratory physiotherapist delivers — and there are more than a dozen techniques to choose from, most needing no equipment at all. The skill is selecting the right one and getting the detail exact.
How a session runs
Auscultation, oxygen levels and a look at your sputum, alongside what your day actually looks like — when you cough, what tires you, what you have already tried.
Not prescribed from a list. You try it, we watch what happens, and we keep what works for your lungs and your energy.
Bronchodilator, nebulised or mucoactive therapy, clearance, then exercise — sequenced so each one helps the next rather than working against it.
The early signs in your own words — more sputum, a change in its colour or thickness, more breathlessness for the same effort, a poorer walk. What to step up, when a rescue pack or your action plan comes into play, who to ring, and the signs that mean the same day rather than next week. Recognising a flare-up and rescue packs cover it in full.
A written routine, and enough practice in the session that it holds up at home on a bad morning. Reviewed and adjusted as your chest changes.
The techniques we teach
Each of these has a full guide in our resource library, written by the physiotherapist who teaches it.
Breathing techniques
The active cycle of breathing techniques and autogenic drainage — no equipment, done anywhere, and the first technique most people should learn.
Devices & medication
PEP and oscillating devices, and nebulised or mucoactive therapy where it makes clearance easier rather than just wetter.
When the cough is not enough
Assisted cough, mechanical insufflation-exsufflation, suctioning and tracheostomy care — for weak cough from neuromuscular disease, spinal injury or a long ICU stay.
Order matters as much as technique
Where your medications sit around a clearance session changes how well both work. The usual sequence is a reliever or bronchodilator first to open the airways, then any nebulised saline or mucoactive to loosen secretions, then the clearance itself — and inhaled antibiotics last, into airways that are already clear, so the dose reaches the lung surface it is meant to treat rather than settling on mucus. Inhaled corticosteroids are generally taken after clearance, and rinsing your mouth afterwards reduces the risk of oral thrush.
Timing across the day matters too. Clearance sits badly straight after a meal, and a late session can leave you coughing at bedtime — so most people settle on mid-morning and early evening.
Your prescriber decides what you take and when — we work out how your session fits around it. Bring every inhaler you have been prescribed, and any spacer, nebuliser or device you currently use, to your appointment. We will map the order onto your day and write it down. Never change a prescribed dose or stop a medication on the basis of this page.
Who it helps
Anyone whose lungs make more sputum than they can comfortably shift — most commonly bronchiectasis, cystic fibrosis and COPD, and after chest or abdominal surgery when a full cough is painful. Also for weak cough from neuromuscular conditions, and for anyone managing a tracheostomy at home.
If you are having a flare-up, clearance usually needs to change with it — that is worth a review appointment rather than pushing through with the routine that suits you when well.
Other services
Physiotherapy Assessment
A thorough cardiorespiratory assessment to build your individualised plan.
Learn MoreCardiorespiratory Rehabilitation
Supervised exercise and education to build aerobic capacity, strength and confidence.
Learn MoreOxygen, NIV & Sleep Support
Optimised oxygen and non-invasive ventilation therapy, plus sleep assessment.
Learn More