Exercise Following Breast Cancer Surgery

Whether you have had a lumpectomy or mastectomy, exercising your arm(s) after your breast surgery is important; as it will help you regain or maintain your range of motion and reduce your risk for complications. Learn more about Phase 1, Phase 2 and Phase 3 exercises following your breast surgery.

Begin with Phase I exercises. Once you can complete Phase I exercises without difficulty, you may begin Phase II exercises. Once you can complete all Phase II exercises and can reach full range of motion without pain, you can begin Phase III exercises or strengthening exercises.

Exercise guidelines

• Complete exercises both slowly and gently.
• Perform while lying down on your back, seated, or in standing.
• Perform each exercise 2-3 times per day.
• Start with 5-10 repetitions of each exercise and gradually increase to 20 repetitions.
• During and/or after exercise, you can reduce your repetitions, decrease your range of motion, and then gradually increase as comfortable.
• After you complete your exercises, elevate your arm for about 10-15 minutes on a comfortable surface or pillow. Use 2-3 pillows to raise your surgical arm higher than your heart. Keep your hand(s) above your wrist(s), and your elbow at shoulder level.

Please notify your surgeon if any of the following occur:

• Fever greater than 100.5 °F.
• New or worsening pain that is not reduced with pain medication.
• Severe nausea or vomiting.
• Development of a rash around your surgical site.
• Any redness, swelling, and/or drainage from your incision.
• A strained feeling in the affected limb.
• If you do not have full range motion after 4 weeks of exercises, contact your surgeon. He or she may refer you to an occupational or physical therapist.

What’s Normal?

It is normal to feel tired, and your arm may ache while doing exercises or after.

After your surgery, it is normal to have mild pain, feel sore, or feel pulling when exercising. If you feel you are not able to complete exercises because of pain, try waiting 20-30 minutes after taking pain medicine.

What’s Abnormal?

If you feel moderate to severe pain-STOP.

It is abnormal to have sharp or shooting pains, prolonged pain, new or unusual swelling and increased numbness or tingling. If symptoms occur, please contact your surgeon.

Phase 1 Exercises

Deep Breathing

This exercise will help you expand your lungs and diaphragm.

• Take a slow deep breath in through your nose
• Feel your belly rise and expand
• Relax and breathe out slowly through pursed lips
• Repeat 4 or 5 times
• Complete this exercise at least 6 times a day

Ball Squeezes

• Open/Close your fist 15 times every hour
• Use a soft squeeze ball and squeeze (10-15 times)
• Hold each squeeze for 3 seconds

Shoulder Shrugs

• Raise your shoulders up to your ears
• Hold for 5 seconds
• Relax and lower your shoulders

Shoulder Rolls

• Gently roll your shoulders backward and then forward (10 each)
• Allow your upper back to relax as you complete

Elbow Flexion

• Keep your elbows by your side with your palms facing toward the ceiling
• Slowly bend your elbows to touch your shoulders, and then relax back down

Shoulder Wings

• Place your hands on your chest or collarbone
• Raise your elbows slowly out to the side, just below or at your shoulder height but no higher
• Slowly lower your elbows to your side

Pendulum Swings

• Bend over slightly and relax your arm so that it dangles out in front of you
• Rock your body back and forth so that your arm swings like a pendulum
• Complete 10 clockwise and then 10 counterclockwise

Front Arm Raise to 90°

• Keep your arms straight out in front of you with palms facing down
• Gently and slowly raise both your arms up to a height that is comfortable for you and then slowly lower back down
• Reach the height that is comfortable for you, and go no higher than shoulder height

Phase 2 Exercises

Arm Circles

Do not complete this exercise with both arms at the same time. Complete with one arm at a time.

• Stand with your feet shoulder width apart
• Raise your arm out to the side and at/or below shoulder height
• Make slow, backward circles in the air
• Keep your elbow straight and move at the shoulder
• Rest your arm
• Then, begin making slow, forward circles in the air

Elbow Push Back

• Sit upright with both feet on the ground
• Keep your head and neck straight and relaxed
• Place your fingers behind your head
• Spread your elbows out to the side so you feel a stretch but no pain
• Hold the stretch for 2-3 deep breaths

Back Climb

• Place your hands behind your low back and hold the hand of your surgical arm
• Slowly slide your hands up to the center of your back to a comfortable level
• Hold for 5-10 seconds and slowly lower your hand

Wall Shoulder Flexion

• Stand and face a wall
• Slide or walk your fingers up the wall as far as comfortable. Hold the stretch for 5-10 seconds
• Return to the start position by walking your fingers down the wall

Chest Wall Stretch

• Stand and face a corner of the wall with your toes about 10 inches from the corner
• Bend your elbows and place your forearms on the wall, one arm on each side of the corner
• Elbows should be as close to shoulder height as comfortable
• Keep your arms and feet in place and slowly move your chest toward the center
• Hold the stretch for 3-5 deep breaths

Phase 3 Exercises

Full Range of Motion: Shoulder Flexion

• In standing or sitting, keep your arms relaxed and by your sides with your thumb up- facing the ceiling.
• Slowly raise your arms straight up until you feel a gentle and comfortable stretch and then lower your arm.

Note: When you can complete this movement without pain, you are back to full range of motion. Once cleared by your surgeon, you may then begin strengthening exercises.

Strengthening

You should start strength training with the lowest weight you have access to such as a light water bottle, a can of soup or a 1-2 lbs. hand weight.

• Strength training should only be performed every other day. On opposite days, perform Phase 1 and/or Phase 2 range of motion exercises to prevent soreness.
• Start with a set of 5-10 repetitions for each exercise.
• As you get stronger you may increase the repetition to 20. Increase the repetitions before increasing the weight or resistance.