Your cancer care team may suggest doing arm and shoulder exercises after having your lumpectomy or axillary lymph node removal to restore range of movement that existed prior to surgery. These can help ensure you return to the level of mobility that was present prior to undergoing these surgeries.
Studies show that exercise helps move fluid through the lymph system and may reduce swelling. Therefore, it’s crucial to continue these exercises even during radiotherapy treatments.
Deep Breathing Exercises
Deep breathing (also called diaphragmatic or abdominal breathing) helps increase oxygen in your blood and lower your heart rate, providing a great tool for managing stress and pain management. Furthermore, deep breathing can be used as an effective relaxation strategy before sleep as it allows your mind to transition into a restful state more easily.
Strive to do this exercise for 10-20 minutes per day in a peaceful place that won’t disturb you for at least 10-20 minutes, several times each. Sit comfortably, inhaling through your nose for five counts before exhaling through your mouth again five counts later – gradually increase how long each breath in and out takes until eventually your ability increases to handle longer cycles of breathing in and out at once.
Keep a log or use an app to help track how many breaths and how long each takes; or as you progress further, consider including some advanced deep breathing exercises like box or 4-7-8 breathing into your routine.
Breathing techniques can be particularly beneficial if you’re experiencing anxiety before an event or appointment, like visiting the doctor or taking a test. Stress raises heart rate and blood pressure levels, leading to feelings of anxiety. Breathing exercises help calm your body down so that you remain focused and relaxed during stressful situations.
Exercise that strengthens your rib cage and chest wall muscles to make coughing less painful. You can do this exercise in bed, on a chair, sitting comfortably with back straightened and supported with pillows; simply breathe in through nose for four counts then exhale through mouth for eight counts (see image below) until repeated as many times as desired.
This easy, gentle movement promotes lymph drainage and can prevent stiffness in the operated arm. If your posture restricts lymph flow, performing this movement every 30 minutes is especially crucial.
Arm and Shoulder Exercises
Arm and shoulder exercises can help restore full range of motion in affected arms. You can do them lying down, sitting in a chair or standing up. For optimal results it is best done under supervision by a physiotherapist or exercise physiologist; to start these exercises safely speak to your cancer care team who will inform when it’s safe for you to start these exercises.
Exercise should be completed three times each day until your arm can move as it did prior to surgery, then once daily thereafter in order to reduce scarring from forming in your armpit and shoulder area which could impede later movement.
One study demonstrated that women able to do shoulder-arm exercises had significantly better quality-of-life measures compared to those who couldn’t, suggesting these exercises may help prevent lymphedema after breast cancer treatment.
Once your wound has healed and you can comfortably hold out both arms at your sides, begin doing these exercises. Sitting or standing is best so as not to place too much strain on the wound. Doing these exercises shouldn’t cause pain; although stretching sensations may occur.
Perform these exercises each week until they can be comfortably completed. You can begin these exercises in Week 1, provided your shoulder and arm move nearly as they did prior to surgery.
Start off lying on your back, with both hands at your sides, and move your shoulders slowly forward, up, backward, and downward in a circular fashion. Strive to create as large circles as possible but don’t push too hard; stop this exercise if any tightness arises in your chest or incision area.
Stand with your toes approximately six inches (15 centimeters) away from a wall and use your unaffected arm to reach up the wall as far as comfortably possible, marking that point with tape. Next, try reaching this height using only your affected arm – if this proves difficult gradually work up towards reaching this target height over time.
Chest Stretches
Your doctor, breast care nurse or physiotherapist should give you exercises to do after surgery in order to ease stiff shoulder and arm pain and restrict movement. This is particularly beneficial for women undergoing lumpectomy, partial mastectomy, sentinel node biopsy or complete mastectomy (with or without reconstruction). In addition, these exercises may also prevent scar tissue formation in your armpit or shoulder that might restrict arm movement.
Stand with your back against a wall at least 6 inches from it and position your palms on the frame of a door, elbows pointing slightly below shoulder height and fingers laid lightly across its frame. Step slowly upward until a gentle stretch appears across your chest – hold for 30-60 seconds then release. Repeat three times daily.
One study had participants repeat arm movements three times daily for three weeks after surgery and until their affected arm could move the same as before their procedure. They continued the exercises even during radiotherapy treatments.
After lymph node removal, some women experience tight bands of scar tissue in their armpit or chest that resemble guitar string or cord-like material. This could be caused by either surgery itself or radiation therapy treatments; according to research findings, early progressive arm movement prevented scar formation as well as reduced the risk of lymphedema compared with restricting activity in arms affected by surgery.
Once your arm movements are under your control, it’s advisable to continue them during radiotherapy treatment sessions as this will keep it moving as normally. Additionally, try other exercises during your time lying down for radiotherapy treatment.
Arm Lifts
After lumpectomy, lymph node removal or mastectomy, you’ll receive exercises from either a breast care nurse or physiotherapist that will help get your shoulder and arm moving again. As soon as you feel ready, begin these exercises immediately.
Avoid sharp pain by stretching or pulling on any drains (if applicable). Move slowly into each stretch until reaching a point of tension but no pain is felt. Additionally, continuing to exercise your shoulders and arms throughout your treatment can help reduce swelling while preventing stiffness from occurring.
Regaining your arm movements after breast surgery may be challenging, but these arm lifts and shoulder stretches may help restore mobility to both chest and arm muscles. If any discomfort arises during these exercises, please discontinue and seek advice from a breast care nurse or physiotherapist immediately.
Begin with your back up against a wall, lifting one arm up until it stretches before returning it down again and repeating 10 times. Finally do this same exercise with the opposite arm.
Once you are comfortable, try raising your arm overhead in a pain-free range. As this may be difficult to achieve, start slowly by starting from where you can reach before gradually increasing height as possible.
After having an armectomy or lymph node dissection, some women develop something known as cording or axillary web syndrome in their armpit, often felt as a string or tight band and sometimes reaching down into their elbow or wrist area. While this condition may be uncomfortable or even painful, over time it usually improves; massaging the area or taking anti-inflammatory painkillers may provide some relief.
Lying back with both arms supported on chairs (or not if you had a double mastectomy) and your surgical arm straight up in the air, gently rock backwards and forwards for one minute before proceeding with reconstruction and/or drains in place.
