Exercises After Breast Cancer Surgery

October is Breast Cancer Awareness Month. Breast cancer is the second most common cancer diagnosis and is commonly treated with surgery, such as a total mastectomy or removal of axillary lymph nodes. These surgeries can affect your ability to move your shoulder and arm. It is essential to engage in gentle movement and exercise post-surgery once cleared by your doctor to regain full range of motion, function, and strength in the affected arm and shoulder. In the video below, Mangiarelli Rehabilitation physical therapy assistant and certified lymphedema therapist Sue demonstrates several exercises you can do after breast cancer surgery to restore shoulder and arm function.

Effects of Breast Cancer Surgery

Women with breast cancer can undergo various surgeries for treatment, including a surgical breast biopsy, axillary lymph node removal, breast-conserving surgery (lumpectomy), total mastectomy, and breast reconstruction. Any of these surgeries can affect a woman’s ability to move the shoulder and arm or engage in daily activities. It is common for women to experience pain and stiffness in the affected arm (where the surgery took place), which can limit movement and lead to weakness and stiffness. Some women have a drain put into the area of their surgical incision, which helps to stop fluid from collecting in the surgical area. The drain can stay in for at least five days and up to three weeks. Exercise is still possible post-surgery but may be more limited due to the presence of the drain which can constrain movement.

Women who have undergone breast cancer surgery can develop cording and lymphedema. Cording involves a feeling of thick cord-like ropes under the skin in your armpit that runs down into your arm. It can be tight and painful, making it hard to lift the arm or straighten the elbow. However, it can resolve with regular stretching and exercise.

Lymphedema is a buildup of fluid under the skin due to inadequate drainage of the lymphatic system that leads to swelling in the affected area. One in five breast cancer survivors is at risk of developing breast cancer-related lymphedema due to damage or removal of lymph nodes during the course of treatment via surgery or radiation. It normally manifests in swelling in the arm from which the lymph nodes were removed, but it can also occur in the breast and trunk. Complete decongestive therapy (CDT) can help to prevent and manage breast cancer-related lymphedema, provided by a certified lymphedema therapist.

Exercises To Do After Breast Cancer Surgery 

It is essential to engage in gentle movement and exercise post-breast cancer surgery (once cleared by your doctor) in order to regain full range of motion, function, and strength in the affected arm and shoulder and relieve stiffness, pain, and swelling.

Exercises to increase shoulder and arm motion can be started within a few days after surgery and over time, will progress to strengthening. However, any exercise program should be done only once cleared by your doctor and should not be painful. A physical therapist can work with women after breast cancer surgery to design a customized, supervised, and progressive exercise program.  

Avoid vigorous exercise and heavy lifting as it is necessary to give the wound a chance to heal over the next 6 to 8 weeks. Breast cancer survivors can begin with gentle exercises, starting with deep breathing, shoulder rolls, and variations of wand exercises. Deep breathing exercises help to relax and ease discomfort and tightness around the incision, while the shoulder rolls and wand exercises working the shoulder help get back full range of motion on the affected side where surgery occurred.

Mangiarelli Rehabilitation physical therapy assistant and certified lymphedema therapist Sue demonstrates several exercises you can do after breast cancer surgery to restore shoulder and arm function:

Walking is a great cardiovascular activity to do to improve strength and endurance after surgery and improve circulation to aid in healing without overtaxing the body. Strengthening exercises of the arm and shoulder can be begun about 6 to 8 weeks post-surgery, starting with small hand weights or resistance bands.

Research has shown that exercise is effective in restoring shoulder and arm function post-breast cancer surgery and in preventing and managing breast cancer-related lymphedema. A meta-analysis of 24 randomized control trials looked at the effect of exercise on upper limb dysfunction after breast cancer treatment. The study showed that exercise implemented early in the postoperative period (days 1-3) and structured physical therapy exercise improved shoulder function, flexion, and abduction range of motion.

Another study looking at breast cancer survivors experiencing axillary web syndrome (visible cording in the breast and arm) demonstrated that those patients who participated in physical therapy exercises experienced improvements in shoulder range of motion. A study focused on complete decongestive therapy (CDT) for those experiencing lymphedema after breast cancer surgery concluded that CDT not only reduced lymphedema volume but also reduced average pain significantly from the start of treatment to the end of treatment eight weeks later. CDT involves manual lymphatic drainage, compression bandaging, skincare, and therapeutic exercises. CDT has been shown to improve pain and heaviness in the lymphatic limbs with 60-80% of patients reporting improvement after rehabilitation.

Have you or someone you love undergone breast cancer surgery? With targeted exercise and physical therapy, we can help you regain function in your arm and shoulder post-surgery and prevent lymphedema!