Postural drainage is a form of physical therapy that can help people expel excess fluids from the body. It is particularly helpful for people with cystic fibrosis.

Postural drainage is a technique used to help people drain unwanted bodily fluids, such as mucus, from their lungs to aid breathing.

Cystic fibrosis affects approximately 35,000 people in the United States. It is a condition that causes the body to produce too much mucus, affecting breathing and digestion.

This article looks at postural drainage. We discuss how it works, what an appointment may involve, positions, who may need it, effectiveness, and possible risks.

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A person with cystic fibrosis has faulty proteins in their body. This causes the body to produce excess bodily fluids such as mucus and sweat. Mucus may be thick and sticky, causing blockages in some organs, including the lungs.

When the mucus collects in the lung segments, it can cause breathing difficulties and discomfort.

Postural drainage is a process that helps rid excess mucus or other secretions using gravity, percussions, coughing, and other methods. Some people may refer to this as chest physical therapy.

Gravity allows the mucus to exit the lung segments and enter the central airways. With the help of other techniques, the mucus can vacate the body when a person coughs.

Postural drainage may involve techniques such as percussion, vibration, coughing, and deep breathing. We explain these techniques below.


Percussion requires another person, such as a caregiver, to clap over the chest wall area. This breaks up any fluids in the lungs.

The person cups their hand and holds their palm facing downward while clapping the chest. They should do this for approximately 3–5 minutes.

If a person cups their hand properly, this should not be painful for the one receiving the percussion.

People should take care not to clap over the spine, breastbone, stomach, lower ribs, or backbone.


This technique involves a caregiver gently shaking the person’s ribs using a flat hand. This can help the mucus enter the larger airways.


Breathing in deeply and then strongly exhaling can stimulate a cough. This can help remove unwanted mucus from the body once a person has forced it into their airways.

Deep breathing

The act of deep breathing can encourage mucus to move around to the necessary area. It can also stimulate coughing to help mucus exit the airways.

A person should use deep breathing throughout the postural drainage process.

A person can conduct postural drainage in the comfort of their own home with the aid of a caregiver. Some positions may also allow people to perform this technique on their own.

However, a medical appointment may be necessary to learn the technique. During the appointment, a medical professional will show the person and their caregiver how to conduct postural drainage.

A person may be able to perform postural drainage during activities such as watching television or listening to music. This can help make the time pass more quickly.

According to the Cystic Fibrosis Foundation, the following are suitable positions for postural drainage:

  • Self-administered upright position: A person can perform postural drainage by themselves if they sit in an upright position. To perform the technique alone, they can clap over the muscular area between the collarbone and the top of the should blade on both sides.
  • Upright position: A person can also get help from a caregiver in an upright position.
  • Upright position leaning over a pillow: If a person sits upright and leans over a pillow at a 30-degree angle, a caregiver can clap both sides of the upper back to help promote drainage. They should take care not to clap the backbone.
  • Lying on the back: This position requires two people. While the person lies on their back, the caregiver can stand behind their head and clap both sides of the chest between the nipple and collarbone.
  • Lying on the left or right side: This position involves lying on the left or right side with the corresponding arm over the head. The caregiver should clap the lower ribs just below the nipple. They should take care to avoid the stomach or lower ribcage.
  • Lying on the stomach: While a person is lying on their stomach, a caregiver can clap both sides of the back just above the bottom end of the ribcage. They should avoid the lower ribcage and backbone.
  • Lying on the left or right lower side: If a person lies on either side, the caregiver can roll them a quarter turn toward them. They should clap on the lower left or right side of the chest above the bottom edge of the ribcage.

A person may benefit from postural drainage if they have a condition such as cystic fibrosis.

Postural drainage may also help people with spinal cord injury, bronchiectasis, or any other condition that makes it difficult to expel mucus from the lungs.

A 2016 study involving 30 participants compared postural drainage to conventional chest physical therapy in people with bronchiectasis. The researchers conclude that postural drainage was the most effective form of treatment.

One 2021 review points out that the studies on postural drainage have mixed results. Additionally, some people describe it as uncomfortable.

In some cases, postural drainage can result in some complications. These may include brain or heart abnormalities and low blood pressure.

If a person administering postural drainage techniques does not clap with a cupped hand or if they strike the wrong area, this can result in injury or damage to other areas of the body.

If a person carries out postural drainage just after eating, they may vomit. A person should try to conduct the exercises at least 1.5 hours after a meal to prevent this side effect.

In some cases, people may develop the following during or after postural drainage:

  • headaches
  • dizziness
  • physical discomfort
  • heart palpitations
  • fatigue
  • shortness of breath
  • confusion
  • blue skin
  • severe pain
  • indigestion
  • vomiting, or coughing blood

If a person experiences any of the above symptoms, they should seek immediate medical attention.

Postural drainage is useful for people who have a buildup of mucus in their lungs, particularly those with cystic fibrosis.

This process helps a person remove excess mucus from their body using percussion, vibrations, coughing, and deep breathing. A medical professional can show a person and a caregiver how to carry out this procedure correctly and safely.