The surgery that you have had for breast cancer (mastectomy or lumpectomy), usually includes the removal of the axillary (under armpit) lymph nodes. It is important to move the shoulder joint after this surgery to prevent the development of lymphoedema as well as to ensure that you do not develop a stiff joint with limited movements. You should start as soon as the pain from the operation has reduced (after three to four days).
All exercises and daily activities should be done within your tolerance level (if an activity or exercise makes your arm sore, then you have overdone it).
These exercises should be done three times and repeated three times each day. You should practice this daily until you have achieved full and normal movements of the shoulder. This takes approximately 4 to 5 weeks
1. Squeeze Ball
Hold a soft rubber ball (you will find one in the BCWA Comfy Kit) cupped in your hand, alternately squeeze and relax. You should feel the muscles tightening throughout your arm. This exercise can be done while still in hospital and when you return home.
2. Hair Brushing Sit beside your dressing table. In the beginning rest your elbow (on the operated side) on a few books. Comb and brush your hair, keeping your head erect.
One side will do to start. As you get stronger, release your arm from the resting position and work the brush around your head until you are covering the entire scalp.
Rest whenever you feel you need to, but keep trying.
3. Palm press
Sit comfortably at a table. Place both elbows on the table with your palms pressed together in front of you. Press your palms together as firmly as you can and hold for 5 seconds. Rest then repeat 3 times.mly as you can and hold for 5 seconds. Rest then repeat 3 times.
4. Shoulder Circling / Shrug Sit on a stool and place both feet firmly on the floor. Sit evenly, with back straight, head up and shoulders level. Bring your shoulders up towards your ears, pull your shoulders blades together at the back, and then drop your shoulders and relax.
5. Head Turn and Bend
Whilst sitting, stretch your neck as tall as possible, keeping your chin in. Turn your head from side to side, looking over your shoulder as far as possible.
Bend your head from one side to the other, bringing your ear as close to your shoulder as possible.
6. Arms Upward Lift
Stand with your feet slightly, apart, stomach in back straight, shoulders level, head up and chin in. Clasp both your hands in front of you and straighten your elbows. Then lift your arms as high as possible above your head, stretch and then lower slowly again.
7. Wall Climbing
Start in the standing position, facing the wall, with your toes a few inches from the wall.
Bend your elbows and place your palms against the wall at shoulder level.
‘Walk’ the fingers of both hands up the wall until you have climbed as far as you can. Hold them here for 5 seconds. Walk your fingers down to shoulder level again. Rest a moment and then repeat the exercise 3 times.
Each day try to climb up just a little higher. Soon your arms will be straight up over your head.
8. Elbow Circling
Place your hands on your shoulders, your elbows tucked in at your sides. Circle your elbows forward to the shoulder level, then upwards, then backwards and then down to your sides again. Repeat in the opposite direction and repeat each exercise 3 times.
9. Elbows Push-back
Then push your elbows backwards and then forwards again. Rest in the starting position for 5 seconds. Repeat the exercise 3 times.
10. Towel stretch
Get a light bath towel or sheet. Hold one end with the good hand over the top of the shoulder and the other end with the hand of the operated side at hip level behind your back. Now using a ‘pulley’ action, raise the towel as far as you can and then pull it down again diagonally across your back (as if you were towelling your back dry). Rest for 5 seconds then repeat.Some of these exercises have been adapted with permission from the Canadian Cancer society website.