After having treatment for breast cancer, you might experience pain in your arms and shoulders, mostly on the same side of your body as the treatment. It’s also common to have stiffness, swelling, and a reduced range of motion in your arms and shoulders. Sometimes, it can take months for these complications to appear.
Pain like this can occur for various reasons. For example:
- Surgery can cause swelling. It can also require you to take new medication, and it can cause scar tissue to form that’s less flexible than the original tissue.
- New cells that form after radiation therapy can be more fibrous and less able to contract and expand.
- Some breast cancer treatments, like aromatase inhibitors, can cause joint pain or increase your risk of osteoporosis. Drugs called taxanes can cause numbness, tingling, and pain.
Fortunately, there are simple exercises you can start within days after surgery and continue during radiation or chemotherapy. You may find it helpful to consult a physical or occupational therapist before you begin. Many rehab therapists have special training in oncology rehab and lymphedema treatment. Your oncologist may be able to refer you. Don’t hesitate to ask for a therapist with specialist training.
It can be hard to get motivated when you’re tired and sore, but it’s good to remember that simple exercises done well are very effective and may lower your risk of future symptoms. They don’t take long to do. Wear comfortable, loose clothing, and don’t start exercises when you’re hungry or thirsty. Plan to do the exercise at a time of day that works best for you. If any exercise increases your pain, stop doing it, take a break, and move on to the next one. Take your time, and remember to breathe.
Step One: Your First Few Exercises
Here are some exercises you can do sitting down. They‘re usually safe to do within a few days of surgery or if you have lymphedema, but be sure to check with your doctor before doing any exercises.
You can sit on the edge of a bed, on a bench, or on an armless chair. Repeat each of these once or twice per day. But don’t worry if that seems like it’s too much. Even if you do them every other day, they’ll still help. Aim for five reps per exercise, and then slowly increase to 10. Do each repetition slowly and methodically. Doing any exercise too quickly can cause pain or muscle spasms. Slowing down can make them easier and more effective.
1. Shoulder Shrugs
Let your arms hang down by your sides, and raise the tops of your shoulders toward your ears. Hold this position for a few seconds, and then lower your shoulders completely.
2. Shoulder Blade Squeezes
Let your arms relax and squeeze your shoulder blades together across your upper back. Keep your shoulders relaxed and away from your ears. Hold this position for a few seconds, and then relax.
3. Arm Raises
Clasp your hands together and raise your arms up to the level of your chest. If one arm is weaker or tighter than the other, the “good” arm can help the weaker one. Lift your arm slowly, and then lower it gently. Don’t go past the point of pain. After you’ve done these for a few days or weeks and when you begin to feel looser, you can try raising your arms higher than chest height and aim to get them above your head.
4. Elbow Bends
Start with your arms by your side, with your palms facing forward. Bend your elbows until you touch your shoulders. Try to raise your elbows until they’re chest height. Then, allow your elbows to straighten and lower your arms by your side.
Step Two: Now Add These Exercises
After you’ve done the above exercises for about a week, you can add these:
1. Arms Sideways
Start with your arms at your side. Turn your palms so they’re facing forward. Keeping your thumbs up, raise your arms straight out to your sides to about shoulder height and no higher. Then, lower gently.
2. Touch Your Head
Do the above exercise, but before you lower your arms, bend your elbows and see if you can touch your neck or head. Then, straighten your elbows and lower your arms gently.
3. Arms Back and Forth
You may do this on a bench or armless chair, or standing up. Let your arms hang by your sides with your palms facing your body. Swing your arms back as far as they can comfortably go. Then, swing them forward to about chest height. Don’t create so much momentum that you swing your arms too much in either direction. Repeat.
4. Hands Behind Back
Clasp your hands behind you and try to slide them up your back toward your shoulder blades. Hold this position for a few seconds, and then lower them.
Remember to stop or slow down if any exercise increases your pain. After you finish, rest and have something to drink. It’s normal to have a little soreness or stiffness the day after you begin any new exercise. This kind of soreness feels different from regular pain, and a hot shower will often relieve it. Remember to continue to do the exercises each day. If you find that exercising causes increased pain that doesn’t go away, see your doctor or talk to a rehab therapist.
While starting exercises soon after breast cancer treatment and keeping up with them can prevent further problems, some arm and shoulder issues can occur no matter what you do. See your oncologist if you continue to have symptoms in spite of exercise or if you get new or worsening symptoms.
You may find you need to see an orthopedist or another specialist. You may also need X-rays or an MRI so that your doctor can diagnose you and recommend treatments. Your doctor may recommend that you see a physical or occupational therapist. If you’re already seeing a rehab therapist, be sure to tell them if anything new occurs or if your symptoms worsen.