Exercises after mastectomy or breast conserving surgery

After breast cancer surgery you might develop a stiff shoulder or arm. Your nurse or a physiotherapist will ask you to do regular exercises after surgery to help you recover. They should give you a leaflet which explains the exercises. 

Simple arm exercises can help to:

  • keep your movement full in your arm and shoulder
  • relieve pain and stiffness
  • reduce swelling

Exercise after a breast reconstruction

If you have had breast reconstruction, the exercises you need to do are different and depend on the type of reconstruction you have had.

When to start

You start the exercises the day after surgery if possible. You should aim to do the exercises 2 or 3 times a day. The goal is to get your arm and shoulder moving as well as it did before the surgery.

What exercises to do

Begin each session by circling your shoulders to get the muscles moving.

Other early exercises are:

  • brushing or combing your hair
  • slowly reaching up behind your back to touch just under the shoulder blades

Once your drains and stitches are out, and as you get stronger and more confident you can do more of the exercises and increase the range of movements.

These exercises shouldn’t be painful, but you may feel a stretching sensation in your armpit or along your arm. It can help to take painkillers before you start. It will become easier and more comfortable the more you do the exercises.

Below is a short video showing you how to do exercises after breast cancer surgery.

Any problems

Talk to your surgeon or breast care nurse if you have ongoing problems with arm or shoulder pain, stiffness or swelling.

Sometimes fluid collects near the wound, this is called a seroma. Sometimes the fluid needs to be drained and it may affect the movement in your arm. Speak with your doctor if this happens to you. 

You must also contact your nurse or doctor if your wound looks red or inflamed or is painful. In any of these situations, they may need to see you in the clinic. They may also suggest that you stop the exercises for a short time.

If you haven’t seen a physiotherapist already and you are struggling with pain or lack of movement speak to your doctor or breast nurse. They can arrange for you to see one. The physiotherapist can give you more exercises to do and offer advice on physical activity.

Scar tissue in the armpit (cording)

Some women develop scar tissue in the armpit after lymph node removal. The connective tissues in the armpit get inflamed, which forms one or more tight bands. This usually happens within the first few weeks or months after the operation.

The scar tissue is called cording or banding or axillary web syndrome. It can feel something like a guitar string. It can extend down the arm past the elbow, possibly as far as the wrist or thumb.

Cording is harmless but can be painful and can limit your arm movement. Massaging the area regularly can help. Tell your breast care nurse if you develop cording. They can refer you to a physiotherapist. They can show you how to massage the area and teach you stretching exercises. It usually gets better within a few months. Taking anti inflammatory painkillers may also help. Speak to your nurse or doctor about taking these. 

Picture showing cording in the armpit

It is important to massage the scar area to keep the skin as supple as possible. This can be done with a gentle moisturiser. If you are having radiotherapy, check with your specialist which moisturiser is suitable. 

How long should I exercise for?

You should continue your arm exercises until you get back to the range of arm movements before you had surgery, and without any discomfort. This can take a few weeks or months.

You should carry on with these exercises during radiotherapy treatment. This helps to stop your arm and shoulder from becoming stiff during your treatment.

Speak to your nurse or physiotherapist if you have any concerns about the exercises.

Davina's story

Davina had a lumpectomy and lymph nodes removed. This is her story about her treatment, challenges and how she coped. 

“I’m getting stronger every day by doing the exercises I was shown at the hospital.”

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