Targeted Exercises for Breast Cancer Patients
Post-op / Recovery Period
Traditionally, exercises are prescribed after surgery while the patient is at home recovering from surgery. The importance of recovery should not be underestimated. Even the most brilliant operation will fail if patient care in the recovery period is not done right. Unlike surgery, where the patient is a passive recipient, once she is discharged home, the patient almost always assumes complete responsibility for her recovery process. Adequate rest, a healthy diet, proper wound care, and gentle, targeted exercise are integral to a successful recovery.
Benefits of targeted post-op exercise:
1. Surgery performed on the breast affects the function, such as range of motion and strength of adjacent parts of the body. Exercise helps maintain the natural movement of the neck, shoulders, and elbows and preserves strength in the arms.
2. Exercising early in the recovery period helps prevent scar tissue from becoming adherent or stuck to nearby structures such as muscle. It is almost impossible to have an excellent cosmetic outcome when adhesive scar tissue forms. In addition, adhesive scar tissue is often painful and may require injections or more surgery.
3. Exercise releases organic, natural endorphins, providing an overall sense of well-being.
4. Gentle, moderate exercise encourages the development of new lymphatic channels and promotes lymphatic flow and drainage.
WARNING: Vigorous exercise, especially weight-bearing exercise, can place a lot of stress on sutures, overwhelm the lymphatic system and promote excess fluid formation leading to an overproduction of seroma fluid and increased JP drain output. Do not engage in strenuous activity, and do not lift, push, pull, or carry anything more than 10 pounds until you are cleared to do so by your surgeon.
General Considerations:
1. The exercises described here are suitable for pretty much every patient who undergoes breast surgery, regardless of the type of breast surgery or reconstruction performed. However, it’s a good idea to check with your breast oncology surgeon and plastic surgeon if you have any questions or concerns.
2. The exercises can also be done during other cancer treatments, such as radiation therapy or chemotherapy.
3. If you are in the post-op phase, start the exercises the morning after returning from the hospital. At first, do them twice a day. After a few days, you can move up to three times a day if you feel good. Continue to exercise two or three times a day until your postop doctor’s visit.
4. Wear loose, comfortable clothing and find a private space with enough room to move. Clear away any tripping hazard, such as loose rugs or objects on the ground.
5. The exercises can be done standing or sitting. If necessary, most of them can even be done in bed. I recommend you start out sitting at first and see how things go. Once you feel confident sitting, you can do the exercises in the standing position. If standing, have a chair or something nearby to sit on if you feel faint or light-headed.
6. If you have a JP drain, make sure it is pinned to your clothing.
7. If a particular movement causes pain, do not push through the pain. Pain is a warning telling you to stop or at least slowdown. Do as much exercise as possible without pain, then move on to the next one. Try the movement or exercise again on your next session but listen to your body and stop if you have pain or discomfort. Be sure to tell your doctor about the exercises/movements that resulted in pain.
TARGETED EXERCISE CONTRIBUTES TO A SUCCESSFUL POST-PERATIVE RECOVERY
Exercises for breast surgery patients
Do these exercises slowly and deliberately.
1. Bend your neck down and touch your chin to your chest (hold 10 seconds). Bring your head back to the neutral position (hold 10 seconds). Do this ten times.
2. Turn your head slowly over your right shoulder (hold 10 seconds), bring it to the midline (hold 10 seconds), turn your head slowly over your left shoulder (hold 10 seconds) and bring it back to the midline (hold 10 seconds). Do this ten times.
3. Slowly shrug your shoulders up (hold 10 seconds), shrug down (hold 10 seconds), and shrug backward (hold 10 seconds). Do this ten times.
4. Bring your arms out at a 90-degree angle to your body. Bend your right elbow and touch the right shoulder (hold 10 seconds), then straighten out the elbow all the way (hold 10 seconds). Do the same exercise with the left arm touching the left shoulder. Do this ten times.
5. Bring your arms out at a 90-degree angle to your body. Bend your right elbow and touch the left shoulder (hold 10 seconds), then straighten out the elbow all the way (hold 10 seconds). Do the same exercise with the left arm, touching the right shoulder. Do this ten times.
6. Clasp your hands behind your head and place your elbows in front of your face. Then spread both elbows out to the side (hold seconds). Do this ten times.
7. Start with your arms straight in front of you. Bring both arms behind your back simultaneously to the level you would be when fastening your bra and touch your fingertips together (hold for 10 seconds).
8. Bring both arms out in front of you. Slowly open and close your hands at the same time. Do this ten times.
9. Bring both arms out at your sides at a 90-degree angle to your body. Slowly open and close your hands at the same time. Do this ten times.
10. Bring both arms straight up over your head. Slowly open and close your hands at the same time. Do this ten times.
11. Sit up straight, take a deep breath in and hold it for 10 seconds, then exhale. Do this ten times.
Additional exercises for patients who have had a sentinel lymph node biopsy or axillary lymph node dissection.
12. Face the corner of a wall. Stand up straight with your feet about one foot-length apart. Place your palm and forearm against each wall at a 90-degree angle at shoulder height. Then gently lean your chest toward the wall (hold for 10 seconds). Do this ten times.
13. This is a very popular exercise in my practice. We call it the Itsy Bitsy Spider. Face a wall. Stand up straight with your feet about a foot-length apart and a foot-length away from the wall. Place your fingertips against the wall at shoulder height. Gently crawl your fingers up the wall as your feet shuffle toward the wall. Do this until you feel the stretch in your shoulders, and you can’t go any higher. Then hold for 10 seconds. Do this ten times.