Written By Anthony Lombardo, PT, DPT, USA-W, USA-PL, CPT, Pn.1
October is Breast Cancer Awareness month and it’s important to know that those recovering from cancer need to tackle recovery with the same strength as they battled cancer. After surgery, exercise and physical therapy can make a big difference.
After breast cancer surgery, a patient can experience loss of both mobility and strength in their upper body. Your range of motion will be compromised, which is how much you can safely move a part of your body. And depending on the type of surgery you had, you may need to limit your range of motion for a little while after surgery.
Here are exercises you can try to give the tissue in your shoulder, armpit, and breast time to heal and help you get back to the activities you love.
Deep Breathing Exercise
Deep breathing can help you relax and ease discomfort and tightness around your incision (surgical cut). It’s also a very good way to relieve stress during the day.
- Sit comfortably in a chair.
- Take a slow, deep breath through your nose. Let your chest and belly expand.
- Breathe out slowly through your mouth.
Repeat as many times as needed.
The shoulder roll is a good exercise to start with because it gently stretches your chest and shoulder muscles.
- Stand or sit comfortably with your arms relaxed at your sides.
- Start with backward shoulder rolls. In a circular motion, bring your shoulders forward, up, backward, and down. Do this 10 times.
- Switch directions and do 10 forward shoulder rolls. Bring your shoulders backward, up, forward, and down. Do this 10 times.
Try to make the circles as big as you can and move both shoulders at the same time. If you have some tightness across your incision or chest, start with smaller circles and make them bigger as the tightness decreases. The backward direction might feel a little tighter across your chest than the forward direction. This will get better with practice.
The shoulder wings exercise will help you get back outward movement of your shoulder. You can do this exercise while sitting or standing.
- Place your hands on your chest or collarbone.
- Raise your elbows out to the side limiting your range of motion as instructed by your healthcare team.
- Slowly lower your elbows.
- Do this 10 times. Then, slowly lower your hands.
If you feel discomfort while doing this exercise, hold your position and do the deep breathing exercise. If the discomfort passes, raise your elbows a little higher. If it doesn’t pass, don’t raise your elbows any higher. Finish the exercise raising your elbows only high enough to feel a gentle stretch and no discomfort.
If you had surgery on both breasts, do this exercise with both arms, 1 arm at a time. Don’t do this exercise with both arms at the same time. This will put too much pressure on your chest.
- Stand with your feet slightly apart for balance. Raise your affected arm out to the side as high as you can, limiting your range of movement as instructed by your healthcare team.
- Start moving slow, backward circles in the air with your arm. Make sure you’re moving your arm from your shoulder, not your elbow. Keep your elbow straight.
- Increase the size of circles until they’re as big as you can comfortably make them, limiting your range of motion as instructed by your healthcare team.
- If you feel any aching or if your arm is tired, take a break. Keep doing the exercise when you feel better.
- Do 10 full backward circles. Then, slowly lower your arm to your side. Rest your arm for a moment.
- Follow steps 1 to 4 again, but this time make slow, forward circles.
You can do the W exercise while sitting or standing.
- Form a “W” with your arms out to the side and palms facing forward. Try to bring your hands up so they’re even with your face. If you can’t raise your arms that high, bring them to the highest comfortable position. Make sure to limit your range of motion as instructed by your healthcare team.
- Pinch your shoulder blades together and downward, as if you’re squeezing a pencil between them.
- If you feel discomfort, stop at that position and do the deep breathing exercise. If the discomfort passes, try to bring your arms back a little further. If it doesn’t pass, don’t reach any further.
- Hold the furthest position that doesn’t cause discomfort. Squeeze your shoulder blades together and downward for 5 seconds.
- Slowly bring your arms back down to the starting position. Repeat this movement 10 times.
You can do the back climb stretch while sitting or standing. You’ll need a timer or stopwatch.
- Place your hands behind your back. Hold the hand on your affected side with your other hand. If you had surgery on both breasts, use the arm that moves most easily to hold the other.
- Slowly slide your hands up the center of your back as far as you can.
- If you feel tightness near your incision, stop at that position and do the deep breathing exercise. If the tightness decreases, try to slide your hands up a little further. If it doesn’t decrease, don’t slide your hands up any further.
- Hold the highest position you can for 1 minute. Use your stopwatch or timer to keep track. You should feel a gentle stretch in your shoulder area.
- After 1 minute, slowly lower your hands.
Hands behind Neck
You can do the hands behind neck stretch while sitting or standing. You’ll need a timer or stopwatch.
- Clasp your hands together on your lap or in front of you.
- Slowly raise your hands toward your head, keeping your elbows together in front of you, not out to the sides. Keep your head level. Don’t bend your neck or head forward.
- Slide your hands over your head until you reach the back of your neck. When you get to this point, spread your elbows out to the sides. Hold this position for 1 minute. Use your stopwatch or timer to keep track.
- Breathe normally. Don’t hold your breath as you stretch your body.
- If you have some tightness across your incision or chest, hold your position and do the deep breathing exercise. If the tightness decreases, continue with the movement. If the tightness stays the same, reach up and stretch your elbows back as best as you can without causing discomfort. Hold the position you’re most comfortable in for 1 minute.
- Slowly come out of the stretch by bringing your elbows together and sliding your hands over your head. Then, slowly lower your arms.
Forward Wall Crawls
You’ll need 2 pieces of tape for the forward wall crawl exercise.
- Stand facing a wall. Your toes should be about 6 inches (15 centimeters) from the wall.
- Reach as high as you can with your unaffected arm. Mark that point with a piece of tape. This will be the goal for your affected arm. If you had surgery on both breasts, set your goal using the arm that moves most comfortably.
- Place both hands against the wall at a level that’s comfortable. Crawl your fingers up the wall as far as you can, keeping them even with each other. Try not to look up toward your hands or arch your back.
- When you get to the point where you feel a good stretch, but not pain, do the deep breathing exercise.
- Return to the starting position by crawling your fingers back down the wall.
- Repeat the wall crawl 10 times. Each time you raise your hands, try to crawl a little bit higher.
- On the 10th crawl, use the other piece of tape to mark the highest point you reached with your affected arm. This will let you to see your progress each time you do this exercise.
As you become more flexible, you may need to take a step closer to the wall so you can reach a little higher.
If you are experiencing pain after breast cancer surgery, contact Professional Physical Therapy for an assessment and/or physical therapy evaluation, so you can get your life healthier and more comfortable today!