Arm Exercises After Breast Surgery

These moves can help you recover arm/shoulder strength and flexibility

Woman stretching arms
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Women with breast cancer will often undergo breast surgery as part of their treatment and will need to do arm exercises to fully recover. Having any form of breast surgery can affect the mobility of your arm and shoulder and make it difficult to do daily tasks like brushing your hair, dressing, or reaching for an item on the shelf.

These include surgical procedures such as:

Even breast radiation therapy can cause muscle fibrosis (scarring) and impede upper body mobility unless you make an effort to exercise.

Without exercise, it is not uncommon for women to experience a decreased range of motion of the arm and shoulder, adhesive capsulitis (frozen shoulder), or arm or hand lymphedema (lymph node obstruction).

Furthermore, because surgical adhesions (tissues that stick together following surgery) can affect the elasticity of your chest muscles, you may also need to practice deep breathing exercises to restore flexibility to those tissues. This is especially true if you've had radiation, since the lungs and muscles used for breathing (including the internal intercostal muscles, pectoralis major, and pectoralis minor) may be directly affected.

Preparation

As much as you may want to speed through recovery, it is important to discuss your exercise plans with your doctor before starting. Based on your physical condition, fitness level, and exercise experience, your doctor may want you to first meet with a physical therapist who can show you how to exercise appropriately and safely.

You should also consider physical therapy if you don't have full use of your arm and shoulder within three to four weeks of surgery.

As a rule of thumb, wait until your surgical drains are out before you even think about exercising. Starting prematurely can place undue pressure on your stitches, causing tears, bleeding, or the puckering of the incision.

Once the drains are gone and the holding stitches have been removed, you can start exercising gradually. The aim is to gently stretch the retracted tissues and release the adhesions without causing damage or tears.

Compression sleeves may also be used if you develop lymphedema. Wearing them can help relieve the build-up of fluid and may even help prevent lymphedema following mastectomy, lymph node dissection, or a sentinel node biopsy.

Exercise Tips

Whatever the aims of your exercise program, it is important to follow the same rules that apply to any workout. This includes warming up properly rather than jumping into a routine. You will also need to approach exercises correctly, neither overextending a joint nor engaging in more exercise than is appropriate.

Here are a few tips that can help:

  • Wear loose, comfortable clothing, rather than spandex.
  • Try taking a warm shower or bath before exercising to relax your muscles. A warm compress may also help.
  • If you have pain, you can take an ibuprofen 30 minutes before exercising.
  • To warm up, walk for 10 to 15 minutes to get your heart pumping. This improves your circulation and helps clear excess fluid from tissues.
  • Exercise slowly, maintaining control of your movements from start to finish. Never swing your arm or drop it at the end of an exertion. If you find your arm quivering or suddenly giving out, you are pushing too hard.
  • Be conscious of your breathing, keeping it steady. Avoid holding your breath.
  • After each exercise session, cool down by walking for five or 10 minutes and gently stretching all of the major muscle groups.
  • Keep to a routine, setting aside at least two exercise sessions per day. Deep breathing exercises should be performed six times daily.

It is perfectly normal to feel tightness in your chest and armpit after breast surgery. There may also numbness where nerves have been severed. Don't let this get you down. With slow, steady, and consistent exercise, you can continue to improve even months after your surgery.

Never exercise to the point of pain. If you feel pain, stop immediately. If the pain is serious or persists for more than an hour, call your doctor.

Basic Arm Exercise Routine

You don't need much to get started on an arm exercise program. Find a room in your house large enough to lie down. If it is not carpeted, you can soften the floor with an area rug or a yoga mat. You will also need a bath towel, a straight-back chair, and a broom handle or cane.

The Wand Lift

The wand lift involves a broom handle, cane, or similar dowel-shaped item (your "wand"). For this exercise, find a comfortable place to lie down.

To do the wand lift:

  1. Lie on your back, keeping your back and neck in a straight line.
  2. Bend the knees to keep your lower back flat. Keep your feet flat on the floor, about a shoulder's width apart.
  3. Keeping your upper arms on the floor and grab the wand with your hands a shoulder's width apart.
  4. Keeping your arms straight, raise the wand over your head as far as you can without pain. Keep your arms parallel, and do not lift the shoulder blades or shift your position.
  5. Hold for 5 seconds. Lower and rest.
  6. Repeat 5 to 7 times.

Don't worry if you are unable to lift the wand all the way up. As you progress, you will gradually be able to increase your range of motion and overall flexibility.

Elbow Winging

Do this exercise while lying on the floor. This will help keep your shoulder blades stable as your shoulders rotate.

To do this exercise:

  1. Lie with your knees bent and your hands clasped behind your neck. Keep your back and neck in a straight line.
  2. Without lifting your head, press your elbows toward the floor as far you can and hold for 3 to 5 seconds. Be sure your shoulder blades are level and avoid cocking the head.
  3. Repeat 5 to 7 times.

The Chest Stretch

You can do this exercise on the floor or on your bed. If you choose the latter, be sure to position the shoulder of your affected arm as close to the edge of the bed as possible. This will give you the greatest range of motion.

To do the chest stretch:

  1. Lie on your back with your knees either up or down.
  2. Raise your affected arm until it is perpendicular to your body.
  3. Next, open your arm to the side of your body as far as you can without pain.
  4. Hold for 30 seconds, then bring your arm back to your side.
  5. Repeat 3 to 5 times.

In time, you can use a light weight (of hold a hardcover book) to assist with the chest stretch as long as there is no pain.

The Shoulder Blade Squeeze

Do this exercise while seated on a stool, the edge of a chair, or the edge of your bed. You need enough space behind you to rest your hands and rotate your elbows.

To do the shoulder blade squeeze:

  1. Sit up straight, keeping your spine and neck in a straight line.
  2. Bring your hands behind your back and clasp them together. Your shoulders and arms should be relaxed.
  3. Keeping your hands clasped, pull your shoulders down and back while rotating your elbows inward. You should be able to feel your shoulder blades moving toward your spine and your chest widening. Try to maintain symmetry on both sides of your body, neither tilting nor twisting in either direction.
  4. Hold for 3 to 5 seconds and release.
  5. Repeat 5 to 7 times.

The Side Stretch

The aim of the side stretch is to gently extend your chest wall muscles, trunk, spine, neck, shoulders, and arms. To do so:

  1. Sit in a straight-back chair with your back and neck straight. You can keep your knees together or position your feet a shoulder's width apart.
  2. Clasping your hands together, raise your arms over your head as far as you can without pain.
  3. Slowly bend to one side, feeling a good stretch along your arms and sides. Try to keep your hands overhead and not in front of you.
  4. Hold for 3 seconds and return to an upright position.
  5. Bend to the other side, holding for 3 seconds.
  6. Repeat 5 to 7 times.

The Front-Facing Wall Climb

The aim of the front-facing wall climb is to use the wall to support your arms as you lift them overhead next to your ears (rather than in front of your face, as is prone to happen after a mastectomy).

To do the front-facing wall climb:

  1. Stand facing the wall with your toes 8 to 10 inches from the baseboard.
  2. Place your hands on the wall at eye level.
  3. Walk your fingers up the wall, climbing as high as you can without veering off at an angle. You should feel your shoulder joints and arm muscles working together.
  4. Hold at the highest point for 15 seconds.
  5. Relax and slide your hands back to eye level.
  6. Repeat 3 to 5 times.

The Side-Facing Wall Climb

This variation of the wall climb stretches the latissimus dorsi muscle and helps release stiffness in the shoulder and rotator cuff.

To do the side-facing wall climb:

  1. Stand with your affected arm to the wall with your feet positioned 8 or 10 inches from the baseboard.
  2. Place your hand on the wall above your shoulder at a 30-degree angle (roughly the same level as the top of your head).
  3. Walk your fingers up the wall, keeping your elbow straight. Climb as high as you can without pain. You should feel your shoulder joint rotating and upper arm muscles stretching.
  4. Hold at the highest point for 15 seconds.
  5. Relax your arm and slide it back to the starting position.
  6. Repeat 3 to 5 times.

Standing Corner Push-Ups

If you can't find a corner of a room with enough space to work in, find an open doorway instead. The idea is to use your body's own weight to passively exercise your chest muscles.

To do the corner push-up:

  1. Facing the corner of your room, rest your forearms on the wall with your upper arms level to the ground.
  2. Take a half a step backward so that you are in a slightly tilted position. This is your starting position.
  3. With your back straight, feet flat, and forearms steady, gently lean into the corner until you feel a good stretch. You should feel your shoulder blades moving toward your spine.
  4. Hold for 30 seconds and return to the starting position.
  5. Repeat 3 times.

The Towel Stretch

For the towel stretch, you will need a long, soft bath towel. For this exercise, you will use one arm to passively exercise the other. The goal is to loosen your affected shoulder so that you can reach the middle of your upper back.

To do the towel stretch:

  1. Stand straight with the towel draped over your right shoulder. Hold the front of the towel with your right hand and the back of the towel with your left hand, pivoting your arm backward.
  2. Gently pull the towel with the right hand. This will stretch your left arm and cause the shoulder to rotate.
  3. Hold for 30 seconds and relax.
  4. Switch arms and repeat the first three steps.
  5. Repeat the entire sequence 3 times.

Deep Breathing

Deep breathing can be performed on its own or be incorporated into your exercise routine. The aim is to strengthen both the diaphragm (the muscle that separates the abdominal cavity from the chest cavity) and intercostal muscles by actively engaging both simultaneously.

To do deep breathing:

  1. Lie on your back with our legs straight and arms relaxed.
  2. Inhale with a slow, deep breath, fully expanding your chest while pushing your belly button away from the spine. (This is not the same thing as belly breathing, in which you would press the belly button toward the spine.)
  3. Hold for 3 to 5 seconds and exhale.
  4. Repeat 5 to 7 times.

In time, you can increase the holding of your breath as long as you don't feel dizziness, lightheadedness, or pain.

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