Exercises After Breast Cancer

After breast surgery, it’s important to concentrate on activities that involve your shoulder in order to regain full arm mobility. Ask your surgeon which of the exercises you can do at various stages after surgery. While you are in hospital, your surgeon may ask a physio- or occupational therapist to plan an exercise programme for you. If your surgery included removal of lymph glands under your arm, the general guidelines may help you to regain full movement and strength in your arm. The exercises in this pamphlet require no special equipment - just your own determination to help yourself.

GENERAL GUIDELINES FOR ARM MOBILITY FOLLOWING BREAST SURGERY

1. Use your arm and hands as much as you are able to for your normal activities.
2. For the first few days following your surgery, simply practise deep breathing frequently. Lie on your back, breathe in deeply, and expand your lower chest as much as possible. Then exhale and relax. Let the tension in your body go as the air moves out of your lungs.
Concentrate on relaxing while you exhale. Repeat three or four times, breathing in deeply and then relaxing. Besides helping you to relax, deep breathing will expand and gently move the chest wall on the side of your surgery.
3. Start the exercise to increase your shoulder movement when your doctor gives permission. It’s usually all right to stretch your shoulder until you feel a mild pull. Always stretch slowly and smoothly. The way to regain your movement is to work gradually, doing a little more each day.
4. Do the following routine activities: reach into cupboards, wash and brush your hair, put your arms behind your neck, fasten your bra.
5. The stiffness and tightness in the tissues of the chest and armpit after surgery or radiation therapy will come and go for a while. Continue working to improve your movement at least three times per day until the feeling of tightness is no longer a problem.
6. Normal shoulder movement is achieved when you can reach across the top of your head and touch your opposite ear without feeling a stretch in your armpit (axilla) of the arm on the side of the surgery. Your upper arm should be right next to your ear. Don’t put your arm behind your head so you can touch your ear more easily. Keep your head straight up.
7. Another test to determine if you have achieved normal shoulder movement is to raise your arms as high as possible above your head with the upper arms touching your ears.
8. Shoulders are made to have full movement and your arm will feel best when that is achieved.
9. If your arm has not recovered its full movement and strength after two to three months, ask your doctor for specific instructions or a referral to a physio-or occupational therapist.

STANDARD POSITION FOR SOME OF THE EXERCISES

1. Stand up straight with your head high and your arms at your sides.
2. Place your feet hip width apart for balance. You will have better balance if you do your exercises barefoot or in low-heeled shoes.
3. Flatten your abdomen to avoid a hollow back.
4. Try to make all movements from your shoulder.
5. If possible, exercise in front of a mirror to ensure even posture and correct movement.
6. Breathe deeply before, during and after each exercise.
7. Your ultimate goal is to reach as high as possible and to regain your normal range of shoulder movement.

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HAND WALL CLIMBING
The purpose of this exercise is to increase the forward movement of your shoulder.

1. Facing a wall, start in the standard position, with your toes 13-30cm from the wall.
2. Walk both hands up the wall, parallel to each other, until pulling or pain occurs on the side of your surgery. Mark the spot you have reached with a pencil so you can check your progress.
3. Work hands down to shoulder level. Move feet and body closer to the wall as comfort allows and reach requires.
4. Return to the standard position. Relax with your forehead against the wall before repeating the excersize.

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1. Stand up straight with your head high and your arms at your sides.
2. Place your feet hip width apart for balance. You will have better balance if you do your exercises barefoot or in low-heeled shoes.
3. Flatten your abdomen to avoid a hollow back.
4. Try to make all movements from your shoulder.
5. If possible, exercise in front of a mirror to ensure even posture and correct movement.
6. Breathe deeply before, during and after each exercise.
7. Your ultimate goal is to reach as high as possible and to regain your normal range of shoulder movement.

Click to enlarge

BALL/SPONGE SQUEEZING – prevents or reduces temporary swelling that may occur in the affected arm

1. Lie in bed, holding a rubber ball or sponge in your hand.
2. Lift your arm straight up and alternately squeeze the ball / sponge and relax.
3. Do this exercise as often as recommended by your surgeon.
4. If you can’t hold your arm straight up, support it
with several pillows.

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BACK SCRATCHER – allows you to reach the middle of your back with your hand

1. Start in the standard position.
2. Place the hand of your unoperated side on your hip for balance.
3. Bend the other arm at the elbow, placing the back of the hand on the small of your back.
4. Gradually work your hand up your back until your fingers reach the opposite shoulder blade.
5. Slowly lower your arm and return to the standard position. Rest and repeat.

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ELBOW PULL-IN – increases the rotation of the shoulder in both directions

1. Start in the standard position.
2. Extend your arms sideways and lift to shoulder level.
3. Bend your arms, clasping your fingers at the back of your neck.
4. Pull your elbows in toward each other until they touch.
5. Return to position 3.
6. Unclasp your fingers and extend your arms sideways at shoulder level.
7. Return to the standard position. Rest and repeat.

HOW TO HELP YOURSELF

Please do:

1. See your surgeon for regular follow-up visits.
2. Exercise regularly. If your surgeon agrees, you can do these exercises at least three times a day.
3. Keep busy. Take up your normal activities as soon as possible.
4. Get all the rest you need.

Please do not:

1. Get overtired.
2. Lift heavy objects.
3. Become discouraged. A happy outlook and confidence in your surgeon will help you recover.
4. Expect family and friends to continue to wait on you. Try to help yourself as soon as you are able.