This information describes how you can perform arm and shoulder exercises, a breathing exercise, and scar massage after your mastectomy.
Starting the Exercises
Ask your surgeon when it’s safe for you to start doing these exercises. Although most men can start the exercises on the first day after their surgery, speak with your surgeon before you begin.Back to top
Videos Showing the Exercises
A video demonstrating how to perform exercises after your mastectomy can be found on Memorial Sloan Kettering’s (MSK) website at www.mskcc.org/pe/exercises_without_reconstruction. The exercises are the same for both women and men.Back to top
Deep Breathing Exercise
Exaggerated deep breathing can help you relax and ease discomfort and tightness around your incision (surgical cut). This is also a very good exercise to relieve tension during the day.
To do this exercise, sit comfortably in a chair and take a slow, deep breath through your nose. Let your chest and belly expand. Now, exhale slowly through your mouth. You can repeat this several times.
Arm and Shoulder Exercises
Doing arm and shoulder exercises will help you regain full range of motion on the side where you had your surgery, which is called the affected side. With full range of motion, you will be able to:
- Move your arm over your head and out to the side.
- Move your arm behind your neck.
- Move your arm to the middle of your back.
Do 10 repetitions of each exercise below 5 times a day until you have regained full range of motion and can use your arm as you did before surgery in all of your normal activities. This includes activities at work, at home, and in recreation or sports. If you had limited movement in your arm before surgery, your goal will be to regain as much movement as you had before.
If you quickly regain full range of motion, continue doing these exercises once a day. This is especially true if you feel any tightness in your chest, shoulder, or under your affected arm. These exercises can help prevent scar tissue from forming in your armpit and shoulder. Scar tissue can limit your arm movements later.
If you continue to have difficulty moving your shoulder 4 weeks after your surgery, tell your surgeon. They will determine if you need further rehabilitation, such as physical or occupational therapy.
Before you begin, gather the following supplies:
- 4 pieces of tape (to mark your progress on a wall)
- A stopwatch, timer, or watch with a second hand. You will need to hold some of the exercises for a full minute.
The shoulder roll is a good beginning exercise, since it provides a gentle stretch to your chest and shoulder muscles.
- Stand or sit comfortably with your arms relaxed at your sides (see Figure 1).
- In a circular motion, bring your shoulders forward, up, backward, and down. Try to make the circle as large as you can and get both of your shoulders to move at the same time.
- If you have some tightness across your incision or chest, begin with smaller circles, but increase the size as the tightness lessens. You may find that the backward direction is a little tighter across your chest than the forward direction, which you’ll perform next. This will get better with practice.
- Now, switch directions and do 10 shoulder rolls in the forward direction. Bring your shoulders backward, up, forward, and down.
The shoulder wings exercise will help you regain outward movement of your shoulder. You can do this exercise while sitting or standing.
- Place your hands on your chest or collarbone.
- Raise your elbows out to the side (see Figure 2), limiting your range of motion as instructed by your healthcare team.
- Slowly lower your elbows.
- After 10 repetitions, slowly lower your hands back down to your lap.
If you experience discomfort while doing this exercise, hold your position and do the deep breathing exercise. If the discomfort doesn’t go away, do not raise your elbows any higher.
If you had surgery on both of your breasts, do this exercise with both arms, one arm at a time. Do not do this exercise with both arms at the same time. This will put too much pressure on your chest.
- Stand with your feet slightly apart for balance. Raise your affected arm out to the side as high as you can (see Figure 3). Begin making slow, backward circles in the air with your arm. Be sure the movement is occurring at your shoulder and not at your elbow. Keep your elbow straight.
- Increase the size of the circles until they are as large as you can comfortably make them, limiting your range of motion as instructed by your healthcare team. Be sure to complete at least 10 full backward circles. If you feel any aching or if your arm is tired, take a break. Continue doing the exercise when you feel better.
- Slowly lower your arm to your side. Rest your arm for a moment.
- To perform the second part of the exercise, raise your affected arm out to the side as high as you can. Begin making slow, forward circles.
- Increase the size of the circles until they are as large as you can comfortably make them. Be sure to complete at least 10 full forward circles. If you feel any aching or if your arm is tired, stop before 10 circles.
- Lower your arm to your side.
The W exercise can be done standing, sitting, or lying on your back. Doing this exercise with your back against the wall may help you position yourself properly.
- Form a “W” with your arms out to the side and palms facing forward (see Figure 4). Try to bring your hands up so that they are even with your face, limiting your range of motion as instructed by your healthcare team. If you can’t raise your arms that high, bring them to the highest comfortable position.
- Pinch your shoulder blades together and downward, as if you are squeezing a pencil between your shoulder blades.
- If you feel discomfort in the area near your incision, stop at that position and do the deep breathing exercise. If the discomfort passes, try to bring your arms back a little further. If the discomfort doesn’t pass, do not reach any further. Hold the furthest position you can and squeeze your shoulder blades together for 5 seconds.
- Slowly bring your arms back down to the starting position. Repeat this exercise 10 times.
You can do the back climb in a sitting or standing position.
- Place your hands behind your back and grasp the hand on your affected side with your other hand (see Figure 5). If you had surgery on both breasts, use whichever arm moves most easily to help the other. Perform this stretch for one arm at a time only; do not perform the stretch with both arms at the same time.
- Slowly slide your hands up the center of your back as far as possible. Hold the highest position for 1 minute.
- If you feel pulling or stretching near your incision, stop at that position and do the deep breathing exercise. If the tightness goes away, try to slide your hands up a little further. If it’s still there, do not slide your hands up any further.
- Hold the highest position you can for 1 minute. You should feel a gentle stretch in your shoulder area.
- After 1 minute, slowly lower your hands.
- If you had surgery on both breasts, repeat the exercise using your other arm.
You can do the hands behind neck exercise in a sitting or standing position.
- Stand or sit comfortably with your feet on the floor. Clasp your hands together on your lap. Slowly raise your hands toward your head, keeping your elbows together in front of you and not out to the sides (see Figure 6). Keep your head level; do not bend your neck or head forward.
- Slide your hands over your head until you reach the back of your neck. When you get to this point, spread your elbows out to the side. Hold this position for 1 minute. If you are not able to get into this position, reach up and stretch your elbows back as best you can. Breathe normally. Do not hold your breath as you stretch your body.
- If you have some tightness across your incision or chest, hold your position and do the deep breathing exercise. If the tightness decreases, continue with the movement. If the tightness stays the same, hold the position you’re most comfortable in for 1 minute.
- Slowly come out of the stretch by bringing your elbows back in front of you and sliding your hands over your head. Then, slowly lower your arms to your lap.
You will need 2 pieces of tape for the forward wall crawl exercise.
- Stand facing a wall. Your toes should be about 6 inches from the wall.
- Reach as high as you can with your unaffected arm and mark that point with a piece of tape. This will be the goal for your affected arm. If you had surgery on both breasts, set your goal using the arm that moves most comfortably.
- Place both hands against the wall at a level that’s comfortable. Crawl your fingers up the wall as far as possible, keeping them even with each other (see Figure 7). Try not to look up toward your hands or arch your back.
- When you get to the point where you feel a good stretch, but not pain, do the deep breathing exercise.
- Return to the starting position by crawling your fingers back down the wall.
- Repeat the wall crawl 10 times. Each time you raise your hands, try to crawl a little bit higher
- On the tenth crawl, use the other piece of tape to mark the highest point you reached with your affected arm. This will allow you to see your progress each time you do this exercise.
As you become more flexible while doing this exercise, you may need to take a step closer to the wall so that you can reach a little higher.
You will also need 2 pieces of tape for the side wall crawl exercise.
You should not feel pain while doing this exercise. It is normal to feel some tightness or pulling across the side of your chest. Focus on your breathing until the tightness decreases. You should breathe normally throughout this exercise. Do not hold your breath.
Also, be careful not to turn your body toward the wall while doing this exercise. Keep your body at a 90-degree angle to the wall.
- Stand with your unaffected side facing the wall, about a foot away from the wall.
- Reach as high as you can with your unaffected arm and mark that point with a piece of tape (see Figure 8). As with the forward wall crawl, this will be the goal for your affected arm. If you’ve had surgery on both breasts, set your goal using the arm that moves most comfortably.
- Turn your body so that your affected side is now facing the wall. Crawl your fingers up the wall as far as possible. When you get to the point where you feel a good stretch, but not pain, do the deep breathing exercise. Return to the starting position by crawling your fingers back down the wall.
- Repeat this exercise 10 times.
- On your tenth crawl, use the other piece of tape to mark the highest point you reached with your affected arm. This will allow you to see your progress each time you do the exercise.
- If you had surgery on both breasts, repeat the exercise with your other arm.
You may feel uncomfortable touching your skin in the area of the scar. It’s very important that you become comfortable moving the skin over this area. Moving the skin will help improve the circulation and soften the tissue.
Don’t start doing the massage until your incision has fully healed and your nurse tells you it’s safe. There should be no open wounds or scabbed areas. The area of the scar may be numb or extra sensitive at first. Both of these feelings are normal after surgery.
To do the massage, place 2 or 3 fingers over the scar and gently move the skin in all directions. Pick up your fingers and move them an inch or 2 over, and then repeat the massage.
Do this massage once a day for 5 to 10 minutes.Back to top
After your surgery, you may have some swelling or puffiness in your hand or arm on your affected side. This is normal and will usually go away on its own.
If you notice swelling in your hand or arm, raise your arm above your head several times a day and do hand pumps. To do hand pumps, slowly open and close your fist 10 times. Elevating your arm and pumping your muscles helps to drain the fluid out of your arm.
You may also elevate your arm a few times a day for about 20 minutes at a time. To elevate your arm while sitting or while lying on your back, rest your arm on a few pillows next to you. Your arm should be raised above the level of your heart. Do not hold your arm over your head for more than a few minutes. This can cause the muscles of the arm to get tired.
If you’re able to sleep on your unaffected side (the side on which you didn’t have surgery), you may place 1 or 2 pillows in front of you and rest your arm on them. If the swelling does not go down within 4 to 6 weeks, call your doctor or nurse.Back to top
If you have any questions about the exercises or any other information presented here, call the Rehabilitation Service at 212-639-7833.Back to top