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Exercises after Breast and Axillary Surgery (7823)

Exercises after Breast and Axillary Surgery (7823) - Clinical Hub, Patient Education, Health and Nutrition Facts For You, Cancer, BMT, Hematology


Exercises after Breast and Axillary Surgery
There are many types of surgeries for the treatment of breast cancer or cancers involving axillary
(underarm) lymph nodes:
ξ Lumpectomy, also known as Partial Mastectomy or Breast Conservation Surgery
ξ Mastectomy
ξ Breast Reconstruction
ξ Sentinel Lymph Node Biopsy
ξ Axillary Lymph Node Dissection

No matter what type of surgery, it is important for you to do specific exercises afterward to get your arm
and shoulder moving again.
The first exercise set (Initial Exercises) may be started the day after surgery. The second exercise set
(Advanced Exercises) may begin about a week after surgery or when drains have been removed.

Initial Exercises
Caution: While performing your initial exercise program, avoid sharp pain, incision stretch, or pull on
your drains. Move into each stretch to the point of tension, but not sharp pain. You should be able to take
a deep breath comfortably while stretching.
Perform these exercises for about 1 week. Then progress to the advanced exercise program.
ξ Exercise daily after surgery until you have full movement of your arm.
ξ Continue with any of the initial exercises that provide a good stretch.
ξ Start with 3 repetitions of each exercise twice a day. Slowly increase to 10 repetitions each by the
end of the first week.
ξ Exercise so you feel a good stretch under your arm and hold at that point for a slow count of 5-10.

Warm Up:
1. Do these exercises with your arm elevated above the heart on pillows (the first few days after
ξ Fist squeeze, wrist circles, elbow bends 15-20 times each.
ξ This will help move lymph fluid out of your arm.

Lying on Back
2. Forward arm lifts:
ξ Lie on your back with your arm at your side.
ξ Lift it forward and up, keeping your elbow straight until
your hand is over your head.
ξ Return slowly to your side.

3. Sideways arm lifts:
ξ Lie on your back with your arm at your side.
ξ With elbow straight and palm up, raise arm sideways keeping arm in
contact with the bed.
ξ Return slowly to your side.

4. Windshield wipers:
ξ Lie on your back with your arm straight out from your side
(shoulder level).
ξ Bend your elbow and point fingers toward the ceiling.
ξ Roll your arm forward until your palm rests on the bed.
ξ Roll your arm back attempting to rest the back of your hand on
the bed beside your head.

5. Shoulder shrugs:
ξ Sit up and straight
ξ Squeeze shoulders upward toward your ears.
ξ Hold for a few seconds, and then relax.

6. Shoulder blade stretch. This exercise helps to move your
shoulder blade.
ξ Sit in a chair very close to a table with your back
against the back of the chair.
ξ Place the unaffected arm on the table with your elbow
bent and palm down. Do not move this arm during the
ξ Place the affected arm on the table, palm down, with
your elbow straight.
ξ Without moving your trunk, slide the affected arm
forward, across the table. You should feel your shoulder
blade move as you do this.
ξ Relax your arm and repeat 5 to 7 times.

7. Shoulder blade squeeze. This exercise also helps to move your shoulder blade.
ξ Facing straight ahead, sit in a chair in front of a mirror. Do not rest
against the back of the chair.
ξ Your arms should be at your sides with your elbows bent.
ξ Squeeze your shoulder blades together, bringing your elbows behind
you. Keep your shoulders level. Do not lift your shoulders up toward
your ears.
ξ Return to the starting position and repeat 5 to 7 times.

Chest Wall Stretches
8. Deep breathing:
ξ Sit up straight with your hands on your stomach.
ξ Take a slow deep breath, inhaling through your nose.
ξ Allow your stomach to rise and breath out through your mouth.
ξ Try to expand your chest and rib cage as you inhale (exaggerate
the motion).
ξ Complete 3 times.

9. Neck and shoulder stretch:
ξ Turn your head to look over your shoulder.
ξ Rotate your head and shoulders.
ξ Complete on both sides.
ξ Complete 3 times in each direction.

10. Trunk Side Bend:
ξ Stand with legs apart, hands resting at side.
ξ Tighten belly muscles.
ξ Slide hand along outside of thigh towards knee on affected
ξ Return to stand up straight.
ξ Repeat on other side.
ξ Complete 5 times.

Advanced Exercises:
Caution: Progress to these exercises after about a week or after your drains
are removed.
1. Apron Strings:
ξ Sit up straight.
ξ Clasp your hands together behind your back as though you
were tying apron strings.
ξ Slowly lift your hands toward your shoulder blades.
ξ Pull your shoulders back to feel chest stretch.

2. Forward Arm Lifts:
ξ Sit up straight.
ξ Raise both arms forward and overhead, reaching toward the
ξ Lower your arms and relax them at your sides.

3. Sideways Arm Lifts:
ξ Sit up straight.
ξ Raise both arms out sideways to shoulder level.
ξ Turn palms up and raise arms further to touch your ears
with your upper arms.
ξ Keep your head straight.
ξ Lower your arms and relax them at your sides.

4. Tree Sway:
ξ Stand up straight.
ξ Clasp your hands together and watch your hands as you
stretch your arms above your head.
ξ Lean towards your affected side, getting an underarm stretch.
ξ Hold for 2-3 seconds and return to the starting position.
ξ Repeat this exercise, but lean towards the unaffected side.

5. Wall Forward Stretch:
Part 1:
ξ Facing the wall, stand
with your feet a
comfortable distance from
the wall.
ξ Place your palms on the
wall at shoulder level.
ξ Gently pushing into wall,
slowly walk your hand up
the wall until you feel a
good stretch, hold for 10
Part 2:
ξ Then with your hand in
place on the wall, turn
your body away from the
wall opening your chest
into a stretch.
ξ Only move until you feel
a stretch, not into pa.

General Exercise Guidelines:
1. Follow lifting instructions from your surgeon. Avoid heavy lifting such as furniture or
luggage. Avoid vacuuming for several weeks. Lifting light objects in your daily routine
can help you to regain strength.
2. When you have full movement of your shoulder, and you can tolerate 10 repetitions
easily of the advanced exercises, you may begin to add light resistance exercises.
a. You may choose to continue with the prescribed exercises, adding a one pound
weight. When you can easily complete 3 sets of 10 repetitions, you may increase
the weight slowly.
b. If you continue to have tightness in your chest wall or under arm area, you should
do the shoulder and chest wall stretches to prevent further stiffness or tightening
of your tissue.
3. If you will have radiation, keep stretching daily to maintain your range of motion for up
to 18 months.

If you need a referral, here is a list of the clinics with therapists who are trained to help with your
recovery after breast and/or underarm surgery:
UW Health UW Health
University Hospital Hand Clinic
600 Highland Ave., E3/211 1 South Park Street
Madison, WI 53792 Madison, WI 53715
(608) 263-8060 Phone (608) 890-6170 Phone
(608) 262-7679 Fax (608) 890-6718 Fax

UW Health UW Health
Yahara Rehabilitation Clinic The American Center
1050 East Broadway 4602 Eastpark Blvd.
Monona WI, 53716 Madison, WI 53718
608-890-6110 clinic scheduler (608) 263-7540
608-221-6250 fax
608-221-6253 voice mail

Your health care team may have given you this information as part of your care. If so, please use it and call if you
have any questions. If this information was not given to you as part of your care, please check with your doctor. This
is not medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because each
person’s health needs are different, you should talk with your doctor or others on your health care team when using
this information. If you have an emergency, please call 911. Copyright © 10/2016 University of Wisconsin Hospitals
and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#7823