A
Program after Breast Surgery
Exercises:
1. Pendulum
2.
Exaggerated Deep Breathing
3. Clasp-Lift-Stretch
4. Back
Climb
5. Pulley
6. Wall
Climbing
Introduction
The following exercise program is designed to help
you regain full range of motion in your affected shoulder after
breast surgery. This means you should be able to move your arm up
overhead out to the side, and to touch the back of your neck and
the middle of your back. These exercises will also enable you to
return, within six to twelve weeks, to the activities you were able
to do before surgery.
After
your operation, you may experience a variety of sensations on the
side of surgery. These sensation are divided into three categories
• Incisional sensations occur
in the area of the incision and may be described as feeling of pulling
or discomfort. These sensations will diminish in a matter of weeks,
as healing progresses. Once your surgeon tells you that your incision
is healed, it is helpful to fully stretch the incisional area by
moving your shoulder through its complete range of motion.
•
Referred sensations may be felt in the upper arm, forearm, hand,
shoulder blade or rib cage area on the side of surgery. These sensations
occur because the small nerves that go to the skin were affected
by the surgery. These feelings are described as heaviness, stiffness,
numbness, tingling, pins and needles, "water leaking down the
arm", or burning in the affected area. These sensations may
vary and may increase with fatigue, emotional changes or a change
in the weather. Referred sensations will gradually diminish, but
some may persist for weeks, months or even a year, because the nerves
that were cut during surgery grow back slowly.
•
Phantom sensations are feelings that the absent breast or nipple
is still present after surgery. These are normal and will go away
with time.
While
doing the exercises it is important to distinguish between incisional
discomfort and referred sensation. If you start to feel incisional
pulling or discomfort, do not continue with the exercise beyond
that point since doing so could delay your healing. If you feel
referred sensations, you may continue exercising - it may relieve
the sensations. If the referred sensations are so uncomfortable
that they make it hard to exercise, consider taking your pain medication
at least 45 minutes before you start.
EXERCISES
With
your surgeon's permission, the following exercises can be started
on the second day after surgery. If you follow these directions, exercising
will hasten your physical recovery and minimize your discomfort. These
exercises should be done three times a day: When you awaken in the
morning, at noon and in the evening. Some people find that including
a fourth exercise session reduces shoulder stiffness. Continue
the exercises daily until you are able to do everything you did prior
to surgery. This includes activities at work, at home, in recreation
and in sports.
1.
Pendulum
(Patients who have had surgery on both breasts should do this exercise
with each arm).
Purpose:
• To increase the range of motion
of the affected shoulder in four directions.
• To relax any feeling of tightness or stiffness in
the affected shoulder.
Directions:
While standing against a wall, lean forward at the waist and place
your unaffected arm on the back of a chair and rest your forehead
on that arm. Slowly allow your affected arm to hang loosely until
your elbow is straight and the whole arm and hand are limp.
•
Swing your arm like a pendulum from left to right within a comfortable
range, making sure the motion is in your shoulder and not your elbow.
Do this 10 times.
•
Swing the arm in large circles, again, making sure the motion is
in your shoulder. Do this 10 times.
•
Reverse the direction of the circles. Do this 10 times.
•
Swing the arm forward and backward, moving the shoulder only. Do
this 10 times.
DISCONTINUE
THIS EXERCISE ONE WEEK AFTER YOUR DRAIN IS REMOVED.
2.
Exaggerated Deep Breathing
(Doing this exercise by itself several times a during the day will
help you relax).
Purpose:
• To ease the feeling of tight
skin over the chest.
• To ease the sensation of pulling
and discomfort that may be experienced during Exercises 3, 4 and
5.
Directions:
While seated comfortable in a chair, place either hand over the
center of your chest.
•
Take a slow, deep breath through your nose and left your chest expand.
• Exhale completely through pursed lips and let your
chest and shoulders relax.
DO
THIS EXERCISE 5 TIMES.
3.
Clasp-Lift-Stretch
Purpose:
• To increase the range of motion
of the affected shoulder in three directions.;
Directions:
In this exercise, you should maintain your most advanced position
for at least three minutes. You may find that this exercise can
be done more comfortably while lying flat in bed.
•
Sit up straight with your feet on the floor. Clasp your hands together
on your lap.
• Slowly raised your hands toward your forehead with
fingers clasped together and elbows in. When you start to feel incisional
pulling or discomfort, STOP; with fingers clasped, rest your hands
on your head; and HOLD THAT POSITION. Inhale and exhale as described
in Exercise 2. If the sensation of pulling or discomfort DOES NOT
stop, remain in this position for at least three minutes, breathing
comfortably.
• If the sensation of pulling or discomfort DOES stop,
continue sliding your hands over your head until you reach the back
of your neck. Keep you head straight.
• Gradually stretch your elbows apart, remembering to
STOP and breathe deeply when pulling or discomfort occurs and to
hold your most advanced position.
• When you tire, reverse the steps until your hands
are back on your lap. It might take several sessions before you
can accomplish this exercise completely.
DO
THIS EXERCISE ONCE.
4.
Back Climb
Purpose:
• To allow you to reach the middle
of your back.
Directions:
In this exercise you should maintain your most advanced position
for at least three minutes.
•
While seated, lean forward slightly.
•
Place your hands behind your back. Grasp your unaffected hand and
slide your hands up the center of your back. When you start to feel
incisional pulling or discomfort, STOP AND HOLD THAT POSITION. Inhale
and exhale deeply as described in Exercise 2. If the sensation of
pulling or discomfort DOES NOT stop, remain in this position for
at least three minutes, breathing comfortably.
•
If the sensation of pulling or discomfort DOES stop, continue sliding
your hands up your back until you reach the middle of your back.
•
After holding your most advanced position, slide your hands back
down and place them on your lap.
DO
THIS EXERCISE ONCE.
5.
Pulley
(Patients who have had surgery on both breasts should do this exercise
once with each arm).
Purpose:
• To increase the range of motion
of the affected shoulder in the overhead direction.
Directions:
In this exercise, you should maintain your most advanced position
for at least three minutes.
•
Drape a rope over a peg or hook that is six feet above the floor.
Place the chair against the wall directly under the peg or hook.
• Sit up straight with your back to the wall and grasp
one handle with the hand on the unaffected side. Then grasp the
second handle on the other hand.
•
Slowly lower the unaffected arm while raising the affected one.
When you feel incisional pulling or discomfort, STOP AND HOLD THAT
POSITION. Inhale and exhale deeply as described in Exercise 2. If
the sensation of pulling or discomfort DOES NOT stop, remain in
this position at least three minutes, breathing comfortably.
•
If the sensation of pulling or discomfort DOES stop, continue lowering
your unaffected arm. STOP when there is incisional pulling or discomfort
and HOLD THAT POSITION for at least three minutes. Again, inhale
and exhale deeply.
•
When you tire, maintain your grasp on both handles and slowly bring
them to the starting position. Release the handles simultaneously
and place your hands on your lap.
DO
THIS EXERCISE ONCE.
6.
Wall Climbing
Purpose:
• To increase the range of motion
of the affected shoulder in the overhead position.
Directions:
• Stand with your toes touching the wall. Reach as high
as you can with your unaffected arm held close to your ear and make
a mark at that level (you can use a piece of tape). This will be the
goal for your affected arm. (Note: If you have had bilateral breast
surgery, you may set your goal using either the arm on the earlier
side of surgery or the arm that moves more comfortably).
•
To begin the exercise, face the wall standing about six inches away.
Bend you elbows and place your hands against the wall at shoulder
level.
•
Walk your fingers up the wall parallel to each other until incisional
pulling or discomfort occurs. Mark this level. Then work both hands
down to the starting position.
DO
THIS EXERCISE 5 TIMES.
|
