After surgery, the goal is to regain full range of motion in your shoulder – aka, the ability to move your arm and shoulder the way you did BEFORE surgery.
There’s work involved.
In the form of EXERCISE.
How that lands with you depends on where you are in your breast cancer experience. If you’re recently post-surgery, any type of physical activity likely doesn’t sound appealing.
Even before your surgery, I imagine you had strong opinions about EXERCISE. Everyone has a unique “relationship” with moving their body for health.
Some love it. Some hate it. Some are meh.
For many women, activity, exercise and fitness all mean the same thing, even though there are significant differences between them. (1)
Maybe they all make you think of running, jumping, pounding hearts, breathlessness and sweat. In my opinion, this is where much of the apprehension regarding post-surgery exercise stems from.
Below I offer inspiration, information and guidelines to help you SAFELY get your movement back after surgery, but first, let’s explore what activity is and isn’t.
DEFINING ACTIVITY, EXERCISE, AND FITNESS
Physical Activity: Bodily movement produced by muscles that results in calorie burning. Physical activity in daily life can be any of the following – occupational (standing/walking at your job), sports (tennis, volleyball), physical conditioning (swimming, walking), household activity (cleaning, washing windows), other activities (gardening, mowing the lawn).
Exercise: Exercise is a subset of physical activity that’s planned, structured, and repetitive and has an objective of the improvement or maintenance of physical fitness. Examples: weight lifting to get stronger and more toned, walk-to-run training for a race, or a regular, structured exercise program that keeps you strong, flexible and aerobically fit.
Physical Fitness: A set of attributes that are either health- or skill-related. The degree to which people have these attributes can be measured with specific tests. Examples are cardiovascular endurance, muscle strength and endurance, flexibility, and/or body composition (i.e. body fat to muscle ratio).
The exercises you’ll do after surgery aren’t geared toward physical fitness, nor are they considered physical conditioning. Rather, you’ll execute planned, structured, repetitive exercises designed to help you regain full range of motion.
Although it may seem daunting now, I encourage you to try them. These exercises are designed to be done gently, while keeping you on a rehabilitation schedule that’s safely within your individual ability.
I won’t lie. These aren’t body-punishing exercises, but they’re tough!
Doing the exercises requires effort and commitment. You’ll never again take for granted the ability to effortlessly raise your arm over your head.
You’ll experience a certain degree of discomfort as you work to regain the ability to scratch your back, put on your sports bra, or hold a blow dryer – it’s worth the effort!
WHAT’S YOUR RELATIONSHIP WITH EXERCISE?
One of the most helpful things you can do in regaining full range of motion and the use of your arm, is to get your mindset in the right place.
If you weren’t big on exercise before your diagnosis, you still may not be an avid fan. Is it possible to view exercise as a gateway to doing all the things you enjoy with the people you love?
If you received no information from your healthcare team on how to physically recover from surgery, you may not realize there’s a timeline for getting started and progressing, along with targeted exercises designed to help.
By the way, I received NO information on this topic from my healthcare team.
Given my training and experience as a personal fitness trainer, you’d think I’d have a sense of what to do, or at least some idea of what exercises were safe and recommended.
Even though I got moving the day after surgery (I had no drains and did nothing intense), because I don’t work with a cancer population, I had no idea that a specific protocol existed.
I was simply moving on instinct.
It’s critical that all breast cancer patients receive rehabilitation information, as well as the option and referral to work with a physical therapist specializing in post-breast cancer surgery rehabilitation.
Whether your surgery was a lumpectomy or partial/full mastectomy, a qualified oncologic physical therapist can address weight restrictions, issues around scar tissue, and satisfy potential lymphedema and cording concerns with trustworthy information, resources and exercises.
If you haven’t received guidance from your healthcare team, ASK FOR IT (take them a copy of this post!), and click here to learn about this unique physical therapy discipline.
THESE EXERCISES HELP IMPROVE RANGE OF MOTION (ROM)
I’ve had a number of women ask me what exercises are safe and appropriate to do at the time of diagnosis, following surgery, and even well beyond surgery. I did some research and offer you the following.
Please know this. You’ll feel hesitant about moving the part of your body affected by surgery.
It will feel weird. It may feel tight or stretchy. Or tingly. It may hurt a bit, or feel completely numb at or near the area where you had surgery. It may be ALL of these at once!
This is normal.
While everyone has a different experience with recovery, over time, most women experience improvement in range of motion, a decrease in pain and tingling (it likely will completely disappear), and elimination of or reduction in the feeling of numbness (although, sometimes numbness lingers).
I had a lumpectomy and skin graft in 2014; I STILL have tightness in the area where lymph nodes were removed, but no pain, numbness or tingling when stretching or exercising.
The way to maintain the “gains” you make in your recovery is to NEVER STOP doing the stretching and exercises.
I still work to reduce the tightness in my chest every, single day. It keeps me mobile.
There are three phases to post-surgery exercise:
- First week after surgery
- Second week after surgery or after drains are removed
- Six weeks and beyond
Post-surgery exercises also vary depending on whether or not you’ve had breast reconstruction, with range of motion guidelines, restrictions and the number of repetitions recommended accordingly.
CAUTION!!!
- DO NOT start any exercise before your doctor approves activity
- If you have drains placed, there are very clear guidelines for activity BEFORE and AFTER removal
- If you don’t have drains, you may have a bit more leeway regarding timeline for starting, and what you can/can’t do. Bottom line, follow your doctor’s recommendations for WHEN and IF it’s safe to begin
- Use guidelines for your individual situation
- This refers to the type of surgery you had, and whether or not you had reconstruction
- Guidelines vary based on whether you had surgery on one or both sides.
- The side(s) where surgery occurred is called the “affected side”. This is important to be aware of as you hear or read exercise cues indicating how to involve each side in the recommended exercise
- Perform all exercises slowly and gently
- All the while taking deep, calming breaths
- It’s important to keep moving
- If you feel some (slight) pain or numbness; these should both lessen with time. However, if you feel the pain and/or numbness prevents you from performing your activities of daily living (ADL’s), or doesn’t improve with time, contact your doctor, nurse navigator or physical therapist
- Some swelling or puffiness on the affected side is normal
- Ask your doctor or physical therapist for guidance on what to do to help reduce swelling
- It’s never too late to begin
- If you didn’t do exercises following surgery and are living with physical limitations, you can still use these guidelines.
ARE YOU INSPIRED AND READY TO START?
Breast cancer surgery rehab isn’t my area of expertise; I’m acting as the messenger.
Below are a couple of trusted resources to get you started and keep you going:
- Memorial Sloan Kettering Cancer Center: Shares eight targeted exercises. Also touches on scar massage and swelling. Click here —> Exercises After Breast Surgery
- Exercise supports healthy survivorship and potentially helps reduce risk of recurrence: Click here —> Reduce Your Risk of Breast Cancer with Physical Activity
If you found this post helpful, please share with friends, family and colleagues who would benefit.
Please leave a comment below! I’d love to know. . .did you or did you not have formal rehab after your breast surgery?
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Thanks for reading my blog post!
I help post-treatment survivors of hormone-positive breast cancer end food fear, confusion and overwhelm, eat without stress and guilt, and rebuild their health so they can do the things they enjoy with the people they love.
I’m a registered dietitian, personal trainer, nutrition therapist and coach, speaker, and survivor of hormone-positive breast cancer.
Ready for professional support to rebuild your health and gain peace of mind?
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This information is for educational purposes only and is not intended as medical advice. Please consult your dietitian or doctor for guidance specific to your needs.
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