Breathing Exercises After Surgery: What Helps and When to Wait
This guide is maintained by the team behind Vayu, a breathwork app built by Prana Labs. It applies the same standard we use to decide which techniques the app recommends, to whom, and which it holds back. It is general education rather than medical advice, and it does not diagnose or replace the judgement of a clinician who knows your history.
Short answer: after most operations, gentle deep breathing is something your care team will actively encourage, often with a device called an incentive spirometer, to help keep your lungs expanded while you are less mobile. Follow their instructions first. What can wait until your surgical team clears you: forceful breathwork such as Kapalbhati and Bhastrika, long breath holds, and anything that makes you strain, particularly after abdominal, eye, or heart surgery. In the meantime, slow, relaxed diaphragmatic breathing within your comfort is usually the right choice.
This is general education, not medical advice. Recovery instructions differ between operations and between surgeons. Your surgical team's advice always takes priority over this guide, and if you are unsure whether something is allowed, ask them.
Why do hospitals ask you to do breathing exercises after surgery?
After an operation, pain, anaesthesia, and lying still all make breathing shallower. Small areas of the lungs can partly collapse (atelectasis), which is one reason care teams encourage deep breathing and coughing and often provide an incentive spirometer, a handheld device that shows how deeply you are inhaling. It is recommended after surgery to the chest or abdomen to help prevent problems such as pneumonia and partial lung collapse [1]. Deep, sustained breaths help expand the lungs and move secretions [2]. The aim is slow, deep breaths, not fast or forceful ones.
The evidence suggests the breathing matters more than the device. Cochrane reviews found no clear evidence that an incentive spirometer beats deep breathing exercises or other physiotherapy after upper abdominal or heart bypass surgery [3][4]. Deep breathing itself has better support: in one trial after bypass surgery, 30 slow deep breaths an hour for four days roughly halved areas of lung collapse on CT [5], and in another, a single physiotherapy session before abdominal surgery, teaching breathing exercises to start on waking, halved lung complications [6]. Getting up and moving as soon as your team allows is part of the same goal.
What about breathing exercises after abdominal surgery?
Gentle deep breathing is usually encouraged. Holding a pillow firmly against the incision when you cough or take a deep breath (splinting) reduces pain and supports the wound [1]. What to hold off on is anything that loads the abdominal wall: forceful exhalation techniques like Kapalbhati and Bhastrika, strong abdominal bracing, and straining with a held breath. A hernia at the incision site is a recognised complication of abdominal surgery, and being very active too soon afterwards can slow healing and raise the risk, which is why surgeons ask you to hold off on strenuous activity [7]. Ask your surgeon when these become appropriate again.
What about breathing exercises after eye surgery?
Slow, relaxed breathing is fine. The concern after eye surgery is anything that raises pressure in the eye. After cataract surgery, the American Academy of Ophthalmology advises no strenuous exercise, no heavy lifting, and no yoga positions that put your head below your waist; after some glaucoma surgery, no lifting, bending, or straining; and it notes that holding your breath can raise eye pressure [8]. The NHS gives similar cataract advice [9]. Forceful breathwork and long breath holds belong in that category, so leave them out until your eye surgeon says otherwise. If you have had retinal surgery with a gas bubble, activities are restricted until the bubble clears [8]; follow the instructions you were given.
What about breathing exercises after heart surgery?
Deep breathing and supported coughing are a normal part of recovery after heart surgery, and slow deep breathing after bypass surgery has trial evidence behind it [5]. If your breastbone was divided (sternotomy), hug a pillow to your chest when you cough or sneeze and follow your sternal precautions [10]. Those precautions differ between hospitals, and a trial found less restrictive, pain-guided precautions worked about as well as standard ones [11], so follow your own team's version. Forceful breathing, breath-held straining, and rapid breathing methods can wait. Many people are referred to cardiac rehabilitation, which is the right place to build activity back up, including any structured breathing practice.
When can you return to your usual breathwork practice?
Slow, relaxed breathing can usually start as soon as you feel able, within any instructions from your team. Forceful techniques, long breath holds, and hyperventilation methods should wait until your surgeon or care team has cleared you for strenuous activity, which is often later than you would expect. When you return, start with short, gentle sessions and build up gradually.
| Type of practice | Early recovery | After clearance |
|---|---|---|
| Deep breathing and incentive spirometer, as instructed | Encouraged | Continue as advised |
| Slow diaphragmatic or extended-exhale breathing | Usually fine within comfort | Fine |
| Box breathing or 4-7-8 with short holds | Keep holds brief, no straining | Fine for most people |
| Kapalbhati, Bhastrika, Wim Hof-style breathing, long retention | Wait | Reintroduce gradually once cleared |
When should you talk to a clinician?
Contact your surgical team or seek medical help promptly if you notice:
- new or worsening shortness of breath, or chest pain
- coughing up blood
- a fever, or a wound that becomes red, hot, swollen, or starts to leak
- pain, swelling, or warmth in one calf
- a new bulge near an abdominal incision, especially if it is painful
- after eye surgery: increasing pain, worsening vision, new floaters or flashes, or a shadow across your vision
Sudden breathlessness with chest pain, or coughing up blood, after surgery can signal a blood clot in the lungs and needs urgent attention, not a breathing exercise.
Key points
- Gentle deep breathing after surgery is usually encouraged; follow your care team's instructions and use the incentive spirometer if you were given one.
- Splint the incision with a pillow when coughing after abdominal or heart surgery.
- Forceful breathwork, long breath holds, and straining can wait until you are cleared, especially after abdominal, eye, or heart surgery.
- Slow, relaxed breathing within comfort is the right choice in the meantime.
How Vayu applies this
Vayu leads with slow, low-intensity breathing and paces it with haptic cues on Apple Watch and Wear OS, so a session works from a hospital bed or a recliner without watching a screen. It reads HRV from the watch after each session to inform what it suggests next. It is a wellness tool, not a rehabilitation programme, and recent surgery is one of the conditions in our breathwork safety guidelines and breathwork contraindications guide where forceful techniques should wait. When you are ready for more structure, gentle alternate nostril breathing without holds is a good bridge back.
Sources
- Cleveland Clinic. Incentive Spirometer: Purpose, Goals and How To Use. my.clevelandclinic.org/health/drugs/4302-incentive-spirometer
- Franklin E, Anjum F. Incentive Spirometer and Inspiratory Muscle Training. StatPearls. NCBI Bookshelf. www.ncbi.nlm.nih.gov/books/NBK557464/
- do Nascimento Junior P, Módolo NS, Andrade S, et al. Incentive spirometry for prevention of postoperative pulmonary complications in upper abdominal surgery. Cochrane Database Syst Rev. 2014;(2):CD006058. doi.org/10.1002/14651858.CD006058.pub3
- Freitas ER, Soares BG, Cardoso JR, Atallah AN. Incentive spirometry for preventing pulmonary complications after coronary artery bypass graft. Cochrane Database Syst Rev. 2012;(9):CD004466. doi.org/10.1002/14651858.CD004466.pub3
- Westerdahl E, Lindmark B, Eriksson T, et al. Deep-breathing exercises reduce atelectasis and improve pulmonary function after coronary artery bypass surgery. Chest. 2005;128(5):3482-3488. doi.org/10.1378/chest.128.5.3482
- Boden I, Skinner EH, Browning L, et al. Preoperative physiotherapy for the prevention of respiratory complications after upper abdominal surgery: pragmatic, double blinded, multicentre randomised controlled trial. BMJ. 2018;360:j5916. doi.org/10.1136/bmj.j5916
- Cleveland Clinic. Incisional Hernia: What It Is, Symptoms and Treatment. my.clevelandclinic.org/health/diseases/incisional-hernia
- American Academy of Ophthalmology. When to Resume Exercise After an Eye Surgery or Injury. www.aao.org/eye-health/tips-prevention/resume-exercise-sports-after-eye-surgery-injury
- NHS. Cataract surgery. www.nhs.uk/tests-and-treatments/cataract-surgery/
- UW Medicine. Activities of Daily Living with Sternal Precautions (patient handout). healthonline.washington.edu/sites/default/files/record_pdfs/Activities-of-Daily-Living-with-Sternal-Precautions_02-2026.pdf
- Katijjahbe MA, Granger CL, Denehy L, et al. Standard restrictive sternal precautions and modified sternal precautions had similar effects in people after cardiac surgery via median sternotomy (SMART Trial). J Physiother. 2018;64(2):97-106. doi.org/10.1016/j.jphys.2018.02.013
Frequently Asked Questions
Why do I have to do breathing exercises after surgery?
Pain, anaesthesia, and lying still make breathing shallower after an operation, and small areas of the lungs can partly collapse. Care teams encourage slow, deep breaths and coughing, often with an incentive spirometer, to keep the lungs expanded and clear secretions. Trials suggest the deep breathing itself matters more than the device. Follow your team’s instructions.
When can I do Kapalbhati or other breathwork after surgery?
Forceful techniques like Kapalbhati and Bhastrika, long breath holds, and hyperventilation methods should wait until your surgeon or care team clears you for strenuous activity. They load the abdominal wall and raise pressure in the chest and head. Slow, relaxed diaphragmatic breathing within your comfort is usually fine much earlier in recovery.
Is it safe to hold my breath after eye surgery?
The American Academy of Ophthalmology notes that holding your breath can raise eye pressure, and advises against straining, heavy lifting, and strenuous exercise after eye surgery. Keep breathing slow and relaxed, leave forceful breathwork and long breath holds out until your eye surgeon says otherwise, and follow any positioning instructions you were given.
How do I cough and breathe deeply after abdominal or heart surgery?
Hold a pillow firmly against your incision or chest before you cough or take a deep breath. This splinting supports the wound and reduces pain. Take slow, deep breaths rather than forceful ones. After heart surgery with a sternotomy, follow the sternal precautions your team gave you when coughing and moving.
What breathing symptoms after surgery need urgent attention?
Seek help promptly for new or worsening shortness of breath, chest pain, coughing up blood, fever, or pain and swelling in one calf. Sudden breathlessness with chest pain after surgery can signal a blood clot in the lungs. These need medical assessment, not a breathing exercise, so contact your care team or emergency services.
