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Exercises after breast reconstruction using an implant

The exercises aim to help you get back to your normal activities and a full range of movement. Your specialist, nurse or physiotherapist will tell you which exercises to do and when you need to do them. You start by doing some gentle exercises and slowly build up to full movement over a number of weeks. This allows time for your body to heal. You can usually use your affected arm normally, up to shoulder height, for light activities from the day after your surgery. 

During the first 2 weeks after surgery try to maintain a good upright posture and do some gentle exercises, such as shoulder shrugs and shoulder rolls.Try to avoid lifting your arm above the height of your shoulder, stretching it behind your back, or lifting anything heavier than a bag of sugar.

From 3 to 4 weeks you can start lifting your arm above your head and moving it more. Exercises include walking your arm up a wall when standing next to it and when facing it. At this stage you can start to do housework and to drive, as long as you can do an emergency stop and manage the gear stick and hand brake.

At 6 weeks you should be able to do most normal activities. Heavy lifting may still be difficult. If you need to build up strength you can ask for some extra exercises from a physiotherapist. Try to build up your general fitness levels by walking and gradually increasing the distance and pace. Keep doing the arm exercises, even when you have full movement in your shoulder. This is especially important if you have had, or are going to have, radiotherapy. On some days your shoulder may feel stiffer than on others. This is quite normal and can last for between a year and 18 months.

When to ask for help

Contact a health professional if you have any swelling or a feeling of heat in the area of surgery. Or if you have pain or increasing difficulty doing any of the exercises.

 

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The exercises on this page

This page tells you about exercises to do after breast reconstruction surgery using a simple implant or a tissue expander implant. There is separate information about exercises after other types of breast reconstruction.

Always check with your specialist before doing these exercises. They may want you to do other exercises or use slightly different timescales.

 

Why you need to do exercises

The aim of exercising after breast reconstruction surgery is to help you get back to your normal activities and a full range of movement. It takes time to get over surgery and you are likely to feel tired at first. The exercises will help to keep you moving and stop your shoulder or scar getting too stiff or tight.

You start by doing some gentle exercises and slowly build up to full movement over a number of weeks. This allows time for your body to heal. You can usually use your affected arm normally, up to shoulder height, for light activities from the day after your surgery. Your doctor or nurse will let you know if there is any reason for you not to do this.

Below we have listed some movements you should not do in the first few weeks. Listen to your body. If you feel tired and achy you may need to slow down. Your shoulder and chest may feel tight and uncomfortable but you should not have uncontrollable pain. If you do have pain, stop and contact your specialist.

 

Things not to do in the first 2 weeks

There are some things you should try to avoid doing during the first 2 weeks after surgery. Your surgeon may suggest slightly different timings so check if you are unsure.

  • Don’t lift your arm above the height of your shoulder or stretch behind your back
  • Don’t lift anything heavier than a bag of sugar

You might not realise that some everyday things can strain your muscles. Avoid doing any of the following with your arm on the side of your surgery.

  • Pushing yourself up off the bed
  • Pushing doors open
  • Pulling washing out of the washing machine

Avoiding these things helps your muscles to slowly stretch and heal. The implant has been placed under the muscle at the front of your chest. It stretches the chest muscle more than usual. By avoiding the movements listed above, the implant won’t move and you won’t over stretch the muscle or the wound. So it can all heal and settle down.

When you are fastening your bra, do it up at the front, swivel it round, and put your arm on the side you had surgery in first. When you put your coat on, make sure you put the side you had surgery in the armhole first.

 

The first 2 weeks after surgery

During the first few weeks, maintaining a good posture and doing the exercises below will help to stop your shoulder and arm getting stiff. This will help you get back to normal activities. The time that is right for you to do these exercises varies. Always, check with your surgeon about when you can do these exercises.


Maintain a good posture

You should try to maintain a good posture when you are doing the exercises below. This helps to stop you becoming round shouldered, and helps to strengthen your muscles. You can do this by

  • Imagining you have a piece of string pulling you up tall from the ceiling
  • Thinking ‘tall and straight’
  • Lifting your chest up

Exercises

The exercises below help to stop you developing stiffness in your arm and shoulder in the first 1 to 2 weeks. They also help get you back to moving your arm normally while giving you time to heal.

  • Shoulder shrugs – Relax your shoulders. Lift your shoulders up towards your ears slowly and gently. Then slowly relax them back down.

Diagram showing how to do shoulder shrugs after breast reconstruction surgery

Start with 5 of these every hour and gradually build up to 10 every hour over the first three weeks.

  • Shoulder rolls – Relax your shoulders. Roll your shoulders forwards and then slowly backwards. When you roll them backwards, squeeze the shoulder blades together at the back. Take a deep breath as you do each exercise.

Diagram showing how to do shoulder rolls after breast reconstruction surgery

Start with doing 5 of these every hour and gradually build up to 10. Repeat every hour over the first 3 weeks.

  • Shoulder raise – Place your fingertips onto your shoulders. Slowly raise the elbow up to the side, then move it clockwise or forwards, gently circling your arm. You are aiming to get your elbow level with your shoulder. You may not be able to do this at first but don’t worry. Try to increase the height each time you do the exercises until you get level with your shoulder. Then repeat it the other way.

Diagram showing how to do shoulder raises after breast reconstruction surgery

Start with 5 and build up to 10 in each direction. Repeat every 2 or 3 hours over the course of the next 3 weeks.

  • Arm swings – With your arm hanging down slightly in front of you or to the side, slowly draw imaginary circles and lines on the floor. Start with small circles and increase the size as it feels comfortable to do so. This keeps the armpit area moving.

Diagram showing how to do arm swings after breast reconstruction surgery

Start with 5 and build up to 10 in each direction over the next 3 weeks. Repeat every 2 or 3 hours.

  • Body turns (rotations) – Cross your arms across your body so that your hands are placed lightly on your shoulders. Slowly turn to look to the left and then to the right.

Diagram showing how to do body turn exercises after breast reconstruction surgery

Start with 5 and build up to 10 in each direction over the course of 3 weeks. Repeat every 2 or 3 hours.

Returning to normal activities

In the first 1 to 2 weeks, you can use your arm normally up to shoulder height for light activities, such as face washing, hair brushing, eating etc. But avoid lifting your arm above the height of your shoulder. Don’t lift anything heavy but you can use your arm to lift a cup of tea.

It is good to get moving about as soon as possible. Gentle walking can help to maintain your fitness, will help you to heal, and make you feel better.

When you are sitting, try to change position regularly. This can help to stop you stiffening up.

You can have sex but don’t lift your arms above your shoulder.

 

From 3 to 4 weeks after surgery

Check with your surgeon about when you can start these exercises. They may want you to follow slightly different timescales.

You should continue with the exercises you have been doing. And you can now start the following exercises to help you get back to a full range of movement in your shoulder. It is normal to feel tight and bruised across your chest wall. This will improve as you continue with the exercises and start on the ones below.

For the exercises below, start with doing 5 of each every 2 to 3 hours. Work up to 10 of each of them over the next two weeks. You will need to start gradually and slowly so that you don’t strain your arm.

  • Lifting your arm above your head – Lie on your back and hold your arm on the side you had the operation with your other hand. Gently lift your arms as far as you can above your head. When you can do this easily, do it sitting in a chair.

Diagram showing how to lift your arm over your head after breast reconstruction surgery
 

  • Walking your fingers up the wall – Stand facing a wall and walk your fingers up it slowly. You may feel tightness, but it should not be painful. If it is very painful, tell your specialist physiotherapist or breast care nurse.

Diagram showing how to do a walk your fingers up the wall exercise after breast reconstruction surgery

If you find this exercise difficult, stand with the side you had your operation next to a worktop. Standing still, put your hand on the worktop and slowly walk your body backwards keeping your hand where it is.

Diagram showing a shoulder stretch exercise after breast reconstruction surgery

  • Walk your fingers up the wall sideways – Stand with the side you had the operation next to the wall. Walk your fingers up the wall so that the palm of your hand is facing the wall.

Diagram showing how to walk your arm up the wall sideways after breast reconstruction surgery

  • Beach pose – Lie on your back. Put your fingers lightly on your ears, with your elbows pointing up towards the ceiling. Slowly let your elbows fall back so that you end up with your head on your arms – a bit like when you are lying on a beach.

Diagram showing how to do a beach pose exercise after breast reconstruction surgery

  • Chest stretch – Stand up, keeping your arms relaxed and straight by your side. Then slowly take your arms behind you, as if you are trying to touch your hands together at the back.

Diagram showing how to do a chest stretch exercise after breast reconstruction surgery

You can now start to do normal things such as housework, gradually building up the amount you do. You can usually start to drive, as long as you can do an emergency stop and manage the gear stick and handbrake. Always check with your insurance company before driving.

 

At 6 weeks

After 6 weeks you should be able to do most normal activities. Heavy lifting may still be difficult. If you are struggling to build up strength you may need some extra exercises from a specialist physiotherapist. If you don’t have a specialist physiotherapist, you can ask to be referred to your local physiotherapy outpatient department for advice and guidance.

Keep trying to maintain and build up your general fitness levels. Keep walking and start to increase the distance and pace gradually. The amount you will be able to do will depend on your fitness levels before your surgery.

Keep doing the exercises, even when you have full movement in your shoulder. This is especially important if you have had, or are going to have, radiotherapy. On some days your shoulder may feel stiffer than on others. This is quite normal and can last for between a year and 18 months. Rarely it can last for longer.

 

When to ask for help

You should contact your specialist, breast care nurse, or physiotherapist if you have any of the following at any point

  • Any redness or heat in your breast
  • Swelling
  • Severe pain
  • Worsening movement of your arm
  • Difficulty doing the exercises
  • Change in shape of  the new breast
  • Increasing tightness across your shoulder
  • Shortness of breath that is not resolving
  • Any redness, pain, heat or swelling in the calf or thigh

Fluid can build up around your breast or under your arm. This is called a seroma. It can be uncomfortable and may need draining. Contact your breast care nurse or specialist if you think you are developing a seroma.

If you have any of the signs above, you may need to reduce the amount of exercises that you are doing or find a different way of doing them. If you are worried please speak to your breast care nurse, consultant, GP or physiotherapist (if you have access to one).

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Updated: 17 October 2012