Exercises Following Breast Surgery

Following all surgeries on the breast or axillary nodes, whether you had radiation treatment or not, exercises may help you return to your normal activities and way of life sooner. Before beginning any exercise, talk to your caregiver about what type of exercises will be best for you. Your caregiver may recommend getting physical therapy to help you, especially if you do not see any progress in a month of exercising. Some light exercises can be done right after the surgery, but any drains and sutures will be removed before doing the extended or heavy exercises. Generally, the exercises will lessen problems following the surgery. You can usually expect to have full range of motion of your arm back in 4 to 6 weeks.

HOME CARE INSTRUCTIONS

These exercises should be done for the first 3 to 7 days after surgery, but only with your doctor's permission.

  • Use your affected arm (on the side where your surgery was) as you normally would when combing your hair, bathing, dressing and eating.

  • Raise your affected arm above the level of your heart for 45 minutes, 2 to 3 times a day, while lying down. Put your arm on pillows so that your hand is higher than your wrist and your elbow is a little higher than your shoulder. This will help decrease the swelling that may happen after surgery.

  • Exercise your affected arm while it is elevated above the level of your heart by opening and closing your hand 15 to 25 times. Then, bend and straighten your elbow. Repeat this 3 to 4 times a day. This exercise helps reduce swelling by pumping lymph fluid out of your arm.

  • Practice deep breathing exercises (using your diaphragm) at least 6 times each day. While lying on your back, take a slow, deep breath. Breathe in as much air as you can while trying to expand your chest and abdomen (push your belly button away from your spine). Relax and breathe out. Repeat this 4 or 5 times. This exercise will help maintain normal movement of your chest, making it easier for your lungs to expand. Continue to do deep breathing exercises from now on.

  • Avoid sleeping on your affected arm or on that side.

  • Do not lift anything over 5 pounds.

  • Stop exercising if you develop pain in your chest, arm or shoulder, and call your caregiver.

  • Let your caregiver or therapist know if your arm becomes swollen after exercising.

  • Exercise in front of a mirror. This way you can see yourself exercising in a correct posture and using the correct motion that is recommended.

  • Do not use a heating pad on your arm of the side of the surgery.

GENERAL GUIDELINES FOR EXERCISE

The exercises described here can be done as soon as your doctor gives you permission. Be sure to talk to your doctor before trying any of them.

  • You will feel some tightness in your chest and armpit after surgery. This is normal. The tightness will decrease as you continue your exercise program.

  • Many women have a burning, tingling, numbness, or soreness on the back of the arm and/or chest wall. This is because the surgery irritated some of your nerve endings. Although the sensations may increase a few weeks after surgery, continue to do the exercises unless you notice unusual swelling or tenderness. (Tell your caregiver if this occurs.) Sometimes rubbing or stroking the area with your hand or a soft cloth can help make the area less sensitive.

  • It may be helpful to do exercises after a warm shower when muscles are warm and relaxed.

  • Wear comfortable, loose clothing when doing the exercises.

  • Do the exercises until you feel a slow stretch. Hold each stretch at the end of the motion for a count of five. It is normal to feel some pulling as you stretch the skin and muscles that have been shortened because of the surgery. Do not do bouncing or jerky-type movements when doing any of the exercises. You should not feel pain as you do the exercises, only gentle stretching.

  • Do 5 to 7 repetitions of each exercise. Try to do each exercise correctly. If you have difficulty with the exercises, contact your doctor. You may need to be referred to a physical or occupational therapist.

  • Exercises should be done twice a day until you regain normal flexibility and strength.

  • Be sure to take deep breaths, in and out, as you perform each exercise.

  • The exercises are designed so that you begin them lying down, move to sitting, and then finish standing.

EXERCISES IN LYING POSITION

These exercises should be performed on a bed or on the floor while lying on your back. Keep your knees and hips bent and feet flat.

ExitCare Image Wand Exercise

This exercise helps increase the forward motion of the shoulders. You will need a broom handle, yardstick, or other similar object to perform this exercise.

  • Hold the wand in both hands with palms facing up.

  • Lift the wand up over your head (as far as you can) using your unaffected arm to help lift the wand, until you feel a stretch in your affected arm.

  • Hold for five seconds.

  • Lower arms and repeat 5 to 7 times.

ExitCare Image Elbow Winging

This exercise helps increase the mobility of the front of your chest and shoulder. It may take several weeks of regular exercise before your elbows will get close to the bed (or floor).

  • Clasp your hands behind your neck with your elbows pointing toward the ceiling.

  • Move your elbows apart and down toward the bed (or floor).

  • Repeat 5 to 7 times.

EXERCISES IN SITTING POSITION

ExitCare Image Shoulder Blade Stretch

This exercise helps increase the mobility of the shoulder blades.

  • Sit in a chair very close to a table.

  • Place the unaffected arm on the table with your elbow bent and palm down. Do not move this arm during the exercise.

  • Place the affected arm on the table, palm down with your elbow straight.

  • Without moving your trunk, slide the affected arm toward the opposite side of the table. You should feel your shoulder blade move as you do this.

  • Relax your arm and repeat 5 to 7 times.

ExitCare Image Shoulder Blade Squeeze

This exercise also helps increase the mobility of the shoulder blade.

  • Facing straight ahead, sit in a chair in front of a mirror without resting on the back of the chair.

  • Arms should be at your sides with elbows bent.

  • Squeeze shoulder blades together, bringing your elbows behind you. Keep your shoulders level as you do this exercise. Do not lift your shoulders up toward your ears.

  • Return to the starting position and repeat 5 to 7 times.

ExitCare Image Side Bending

This exercise helps increase the mobility of the trunk/body.

  • Clasp your hands together in front of you and lift your arms slowly over your head, straightening your arms.

  • When your arms are over your head, bend your trunk to the right while bending at the waist and keeping your arms overhead.

  • Return to the starting position and bend to the left.

  • Repeat 5 to 7 times.

EXERCISES IN STANDING POSITION

ExitCare Image Chest Wall Stretch

This exercise helps stretch the chest wall.

  • Stand facing a corner with toes approximately 8 to 10 inches from the corner.

  • Bend your elbows and place forearms on the wall, one on each side of the corner. Your elbows should be as close to shoulder height as possible.

  • Keep your arms and feet in position and move your chest toward the corner. You will feel a stretch across your chest and shoulders.

  • Return to starting position and repeat 5 to 7 times.

ExitCare Image Shoulder Stretch

This exercise helps increase the mobility in the shoulder.

  • Stand facing the wall with your toes approximately 8 to 10 inches from the wall.

  • Place your hands on the wall. Use your fingers to "climb the wall," reaching as high as you can until you feel a stretch.

  • Return to starting position and repeat 5 to 7 times.

THINGS TO KEEP IN MIND

Begin exercising slowly and keep going as you are able. Stop exercising and call your caregiver if you:

  • Get weaker, start losing your balance or start falling.

  • Have pain that gets worse.

  • Have new heaviness in your arm.

  • Have unusual swelling, or swelling gets worse.

  • Have headaches, dizziness, blurred vision, new numbness or tingling in arms or chest.

It is important to exercise to keep muscles working as well as possible, but it is also important to be safe. Talk with your caregiver about realistic exercises for your condition. Then set goals for increasing your physical activity level.