Exercises After Your Mastectomy Without Breast Reconstruction or With Breast Reconstruction Using a Tissue Expander

In this video, we'll show you how to do arm and shoulder exercises after your mastectomy without breast reconstruction or mastectomy with breast reconstruction using a tissue expander.

Do each exercise five times a day until you can move your affected arms the way you did before surgery. After that, keep doing them once a day, especially if you still feel some tightness in your chest, shoulder, or under your arm.

Deep Breathing.

Deep breathing can help you relax and ease discomfort and tightness around your incision. It's also a good way to relieve stress during the day.

Sit comfortably in a chair and take a slow, deep breath in through your nose, letting your chest and belly expand. Then breathe out slowly through your mouth. Repeat this as many times as needed.

Shoulder Rolls.

Stand or sit comfortably with your arms relaxed at your sides. Start with backward shoulder rolls. In a circular motion, bring your shoulders forward, up, backward, and down.

Try to make the circle as big as you can and move both shoulders at the same time. If you feel tightness across your incision or chest, start with smaller circles and make them bigger as the tightness lessens.

Backward shoulder rolls might feel a little tighter than forward shoulder rolls. This will get better with practice. Do 10 backward shoulder rolls. Then switch to forward shoulder rolls. Bring your shoulders backward, up, forward, and down.

If you feel tightness across your incision or chest, start with smaller circles and make them bigger as the tightness lessens. Do 10 forward shoulder rolls.

Shoulder Wings.

Stand or sit comfortably and place your hands on your chest or collarbone. Raise your elbows out to the sides, up to shoulder level, then slowly lower your elbows.

If you feel discomfort, hold your position and do the deep breathing exercise. If the discomfort passes, raise your elbows a little higher within your range of motion restriction. If it doesn't, don't raise them any higher.

Finish the exercise raising your elbows only high enough to feel a gentle stretch and no discomfort. Repeat this movement 10 times, then slowly lower your hands.

Arm Circles.

If you had surgery on both breasts, do this exercise with one arm at a time. Doing it with both arms at once will put too much pressure on your chest.

Stand with your feet slightly apart and raise your affected arm out to the side. If you had immediate lymphatic reconstruction, also called ILR, don't raise your arm higher than 90 degrees, shoulder level. If you didn't have ILR, raise your arm as high as you can.

Start making slow backward circles in the air with your arm. Make sure you're moving your arm from your shoulder, not your elbow. Keep your elbow straight. Make each circle larger until they're as big as you can comfortably make them.

This is what backward arm circles look like with a 90-degree range of motion restriction. This is what they look like with no range of motion restriction. If you feel any aching or your arm is tired, take a break and keep going when you feel better.

Do 10 backward arm circles, then slowly lower your arm to the side. Rest your arm for a moment.

When you're ready, raise your affected arm out to the side and start making slow forward circles. Remember to keep your elbow straight. Make each circle larger until they're as big as you can comfortably make them.

This is what forward arm circles look like with a 90-degree range of motion restriction. This is what they look like with no range of motion restriction. If you feel any aching or your arm is tired, take a break and keep going when you feel better.

Do 10 forward arm circles, then slowly lower your arm to the side. Do 10 forward arm circles, then slowly lower your arm to the side. Do 10 forward arm circles, then slowly lower your arm to the side. Do 10 forward arm circles, then slowly lower your arm to the side.

W Exercise.

Stand or sit comfortably and form a W with your arms out to the side and palms facing forward. Try to bring your hands up so they are even with your face.

If you can't raise your arms that high, bring them to the highest comfortable position. Make sure not to lift your elbows past your range of motion restriction.

Pinch your shoulder blades together and downward, as if you're squeezing a pencil between them.

If you feel discomfort, stop at that position and do the deep breathing exercise. If the discomfort passes, try to bring your arms back a little further. If it doesn't, don't reach any further.

Hold the furthest position that doesn't cause discomfort and keep squeezing your shoulder blades together and downward for five seconds. Then slowly bring your arms back to the starting position. Repeat this movement 10 times.

Back Climb.

You'll need a timer, stopwatch, or watch with a second hand for this stretch.

Stand or sit comfortably. Place your hands behind your back and hold the wrist on your affected side with your other hand. If you had surgery on both breasts, use the arm that moves most easily to hold the other. Slowly slide your hands up the center of your back as far as you can.

If you feel tightness near your incision, stop at that position and do the deep breathing exercise. If the tightness lessens, try to slide your hands up a little further. If it doesn't, leave your hands where they are.

Hold the highest position you can for one minute. Use the stopwatch or timer to keep track. You should feel a gentle stretch in your shoulder area. Remember to breathe normally. After one minute, slowly lower your hands.

If you had an ILR procedure, don't do the last three exercises during the first two weeks after your surgery. You can start doing them two weeks after your surgery, when your care team tells you it's safe to raise your arm more than 90 degrees.

If you didn't have ILR, you can continue with the next three exercises.

Hands Behind the Neck.

You'll also use the timer, stopwatch, or watch with a second hand for this stretch.The first few days you do this stretch, do it lying comfortably on your back on your bed with a pillow under your head. It may be helpful to roll up a small or medium towel and place it under the middle of your back along your spine. This will help open up the front of your chest.

Put your hands together in front of you. Slowly raise them toward your head, keeping your elbows together in front of you, not out to the sides. Don't bend your neck or head upward. Keep your shoulder blades squeezed together the whole time. Slide your hands over your head until you reach the back of your neck, then spread your elbows out to the sides.

If you feel tightness across your incision or chest, hold your position and do the deep breathing exercise. If the tightness lessens, continue with the movement. If it doesn't, reach up and stretch your elbows back as best as you can without causing discomfort.

Hold this position for one minute. Use a stopwatch or timer to keep track. Remember to breathe normally.

After one minute, slowly bring your elbows back together. Slide your hands over your head and lower your arms. Once you're comfortable doing this stretch while lying on your back, you can do it while sitting or standing. It's okay to rest your hands on your head if you need to. This is what the hands behind neck stretch looks like sitting or standing.

Side Wall Crawls.

Before you start, gather four pieces of dark tape. You'll use them to mark your progress with the next two exercises.

If you had surgery on just one breast, stand with your unaffected side closest to the wall, about one foot or 30.5 centimeters away 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, you don't need to do this.

Turn your body so your affected side is now closest to the wall. If you had surgery on both breasts, you can start with either side closest to the wall.

Crawl your fingers up the wall as far as you can. Be careful not to turn your body. Make sure only the side of your body faces the wall.

When you get to the point where you feel a good stretch but not pain, do the deep breathing exercise. Then crawl your fingers back down the wall to the starting position.

Do 10 side wall crawls. Try to crawl a little higher each time. You shouldn't feel pain while doing this exercise, but it's normal to feel some tightness or pulling across the side of your chest. Focus on your breathing until the tightness lessens. Don't hold your breath.

On your 10th crawl, use a piece of tape to mark the highest point you reached with your affected arm. This will let you see your progress each time you do the exercise. If you had surgery on both breasts, repeat this exercise with your other arm.

Forward Wall Crawls.

You'll also need two pieces of tape for this exercise. Stand facing a wall with your toes about 6 inches or 15 centimeters 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 comfortable height. Crawl your fingers up the wall as high as you can, keeping your hands even with each other. 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. Then crawl your fingers back down the wall to the starting position. Do 10 forward wall crawls. Try to go a little higher each time.

On the 10th crawl, use the other piece of tape to mark the highest point you reached with your affected arm. This will let you see your progress each time you do this exercise.

As you become more flexible, you may need to move closer to the wall so you can reach a little higher.

If you are a patient at MSK and have any questions, call your healthcare provider. You can also find information on our website, www.mskcc.org/pe.