Benefits of Exercise After Mastectomy

Introduction

A surgical procedure called a mastectomy removes all or part of the breast. Although it is frequently done to treat breast cancer, it can also be done for other purposes, such as gender transition in transgender individuals. A mastectomy's two main objectives are removing the malignant tissue and lowering the recurrence likelihood. A mastectomy may involve removing the entire breast or just the damaged breast tissue, depending on the kind and stage of the cancer. The lymph nodes in the armpit may also be removed in specific circumstances. Therefore, following the procedure, various breast exercises or physical workouts of the affected side play an important role in helping improve chest tightness after mastectomy, physical function, and discomfort, which are discussed in detail in the article.

What Are the Recommended Exercises After a Breast Reconstruction?

The following post-mastectomy exercises are usually recommended:

• Arm and Shoulder Exercise - This exercise helps to get back the full range of motion on the affected side of the body. The full range of motion includes moving the arm over the head and out to the side, behind the neck, and to the middle of the back.

• Deep Breathing Exercise - This exercise helps to ease tightness and discomfort around the incision and helps one relax by relieving stress. Deep breathing exercises can be done by sitting comfortably on a chair, taking a slow but deep breath, and letting the belly and chest expand. Then, breathe out slowly through the mouth.

• Wand Exercise - The exercise helps to move the shoulder forward with the help of a yardstick or broom handle to be used as a wand in this exercise. A person needs to lay their back down on the floor or bed, keeping their knees bent and feet flat, holding the wand across the belly with palms facing upwards. Then, lift the wand over the head as much as one can, taking help from the unaffected arm until the affected arm can be stretched well. Hold in position for at least five seconds, and repeat for 6 to 7 times.

• Elbow Winging - This exercise helps to increase the movement in front of the chest and shoulder. Lie down on the floor or bed, the same as in the wand exercise, and clasp the hand behind the neck with elbows facing towards the ceiling. Now move the elbows apart and down towards the floor, and repeat five to seven times.

• Shoulder Blade Squeeze - This exercise improves the movement of the shoulder blade by increasing it. Sit on the chair placed in front of a mirror, without resting on the back of the chair, face straight ahead. Place arms bent at the sides, squeezing the elbow blades, and bringing the elbows towards the spine. Move the elbows, but do not force the motion, and also do not lift the shoulders towards the ears. Exercise should be repeated 5 to 7 times.

• Side Bends - These help to improve trunk and body movement. A person should sit on the chair and clasp their hands together in front of them, lifting them slowly over the head, raised. With arms over the head, bend the trunk to the left side, keeping arms over the head, return to the position, and then repeat on the right side. Do the same exercise 5 to 7 times.

• Chest Wall Stretch - It helps stretch the chest. One should stand in the corner of the room, keeping their feet 8 to 10 inches away from the corner. Put the forearms on the walls by bending the elbows on each side of the corner and close to shoulder height. Now move the chest towards the corner. Stretch can be felt across the shoulder and chest. Repeat the same 5 to 7 times.

• Shoulder Stretch - This helps improve shoulder movement. Face the wall and keep your toes a few inches away from the wall. Now, put the hands on the wall with fingers trying to climb the wal,l reaching the maximum possible height unless a stretch can be felt. Repeat the exercise for 5 to 7 times.

What Are the Guidelines for Exercises After Mastectomy?

Exercises after mastectomy or reconstructionare recommended by the doctor as per the patient’s condition. They usually advise for exercises a week or more after the procedure. Therefore, the following are some of the general guidelines that one should keep in mind while doing these exercises:

• After mastectomy, there is some discomfort and tightness in the chest and arm that usually goes away with exercises. However, if it persists, one should see a doctor.

• There is soreness, itching, burning sensation, and tingling in the region after surgery as some nerves might get irritated during the procedure. One should keep doing the exercises unless they experience some unusual inflammation or swelling, which needs to be reported to the doctor.

• Always wear loose-fitting and comfortable clothes while exercising.

• Try doing exercises after taking a warm shower because it helps relax the muscles.

• Deep breathing should be done for a while after every set of exercises.

• Exercises should be done twice a day to get back to the normal stretch in the affected side of the body.

• Do not make any jerking movement or bounce after each exercise because one should not feel the pain while doing these exercises.

• All the exercises should be done slowly and gently, and each stretch should be held at the end of the motion to count to 5. Also, do each exercise correctly, and repeat each one at least 5 to 7 times.

Which Physiotherapy Exercises After Mastectomy Should Be Done?

Physiotherapy exercises can be beneficial for a mastectomy patient to improve range of motion, reduce stiffness, and prevent lymphedema. Here are some recommended physiotherapy exercises that a mastectomy patient can perform:

• Shoulder Rolls: Arms are at the sides, either on the seat or on the stand. Roll the shoulders slowly in a forward and backward motion.

• Wall Climbing: Stand facing a wall and place your hands on the wall at shoulder height. Lean forward and then push back, using the arms to climb up the wall. Repeat 10 times.

• Arm Circles: Stand with the arms at the sides. Slowly raise the arms to the sides and then circle them forward and backward. Repeat 10 times.

• Pendulum Swings: Lean forward and support the body with the unaffected arm on a table or chair. Let the affected arm hang down and gently swing it back and forth and then side to side. Repeat 10 times.

• Elbow Flexion: Sit or stand with the arms at the sides. Bend the affected elbow and bring the hand up towards the shoulder. Slowly straighten the arm back down. Repeat 10 times.

• Scapular Retraction: Arms are at the sides, either on the seat or on the stand. The shoulder blades should be squeezed together. Hold the contraction for a few seconds, then let go. Repeat 10 times.

It is important to perform these exercises gently and gradually and increase the intensity as tolerated. Also, one should seek advice from their doctor or physiotherapist before starting any exercise or physical activity after a mastectomy.

When Should One Start the Exercises After Mastectomy?

The timing of when to start exercising after mastectomy surgery can vary depending on the individual, the type of surgery, and the healthcare provider's advice. Usually, within a day or two after surgery, patients are advised to start a range of motion exercises gently. However, consulting with a healthcare provider or physiotherapist before starting any exercise program is important.

Moreover, the duration of the exercise program can also vary depending on the patient and the type of surgery they have undergone. Generally, patients are advised to continue exercising for at least 6 to 8 weeks after surgery or until their strength and range of motion are back.

The number of sets per day can also vary depending on the individual and the type of surgery. Generally, patients are advised to start with 2 to 3 sets of each exercise per day and gradually increase as tolerated. It is vital to pay attention to the body and refrain from overexerting the self because doing so can result in issues like lymphedema or damage.

It is necessary to pay attention to the physiotherapist or medical professional's recommendations regarding the timing and frequency of exercise after mastectomy surgery. Healthcare professionals can suggest personalized exercise programs to a person based on their individual needs and goals.

How Long Should One Exercise After Mastectomy?

One should continue their arm exercises until they get back to their normal range of arm movements before they have a mastectomy or breast surgery and without any stiffness or discomfort. One can get back to normal motion in about a week to months.

Also, one should know that these exercises should not be done during radiotherapy treatment because this helps the affected side to not become stiff during the treatment.

How Scar Tissue in the Armpit Affects Movement After Mastectomy?

Scar tissue in the armpit (cording) develops after the lymph node removal, causing inflammation of the connective tissues in the armpits, forming tight bands. This usually feels like a guitar string, and the scar tissue is called cording, banding, or axillary web syndrome. The cording after mastectomy can extend downwards to the arm via the elbow, maybe up to the wrist or thumb, thus causing pain and affecting arm movement.

Scar tissues after mastectomy can be prevented by regularly massaging the affected region.

What Are the Things to Keep In Mind After Mastectomy?

After breast surgery, one should keep doing exercises and breast workouts as much as they can to keep muscles strong and active. However, to be on the safer side, one should stop exercising in case they:

• Start losing balance, feel weak, or start falling.

• Have worsening pain.

• Experience aching, heaviness, or chest tightness after mastectomy.

• Develop unusual swelling or worsening swelling.

• Experience dizziness, headaches, blurred vision, tingling, or new numbness in the arms or chest.

Conclusion

Recovery from a mastectomy includes regular exercise. Exercise helps lessen tiredness and depression while also enhancing physical performance and quality of life. Patients must also understand the importance of gradual improvement and must also be aware of any potential activity restrictions after mastectomy. Exercises that require pushing or pulling heavy objects, as well as those that are painful or uncomfortable, should be avoided by patients. Always pay attention to the body's cues and quit if any pain or discomfort is experienced.