Physical activity and rest are both important after a mastectomy or breast reconstruction surgery. Your body is recovering from a serious procedure that requires time, patience, and the right exercise program tailored to your specific needs in order to heal and feel better.
Performing specific exercises after a mastectomy or breast reconstruction can help keep the range of motion in your shoulder and arm, relieve stiffness and pain, and reduce swelling.
Even something as simple as combing or brushing your hair or reaching behind your back to touch under the shoulder blades is considered critical exercise after a surgical procedure.
The important thing is to ease back into exercise gradually to avoid overloading the system. Here, we go over exercise considerations, physical activity in the first week, cardio exercise, and strength training after a mastectomy or breast reconstruction surgery.
Exercising after a mastectomy or breast reconstruction often depends on any restrictions put in place by the surgeon, says Diana Garrett, D.P.T., O.C.S., C.L.T., C.S.C.S. at Saint John’s Cancer Institute.
“Some surgeons prefer only light activity after surgery for two to three weeks, so it’s essential to get clearance from your physician about what you can and cannot do,” she says.
Physical activity also depends on the type of surgery and your overall health. In general, it’s best to avoid vigorous exercises and heavy lifting so that your wounds have a chance to heal, says Constance M. Chen, MD, a board-certified plastic surgeon and breast reconstruction specialist.
“In a healthy person, it takes six to eight weeks for full wound healing to occur,” Dr. Chen says.
Overall, the American Cancer Society recommends starting slowly and only progressing when you are ready (
An important note
Both experts interviewed for this article stress the importance of working with a physical therapist and your surgeon to develop an exercise routine tailored to individual needs.
Because your specific needs will vary based on the type of surgery you have, it’s best to speak to a PT who can give you customized recommendations for your recovery.
In the first week after mastectomy (with or without breast reconstruction), Dr. Chen says it’s important to walk so that you can move your muscles and get your lungs and legs working again. However, you should avoid vigorous, repetitive movements that prevent wound healing.
Because breast surgery is linked to shoulder and scapular dysfunction, Garrett says it’s essential to regain full mobility after surgery. Some of the top exercises Garrett does with patients the week after mastectomy or reconstruction are:
- Diaphragmatic breathing (belly breathing): You can practice this several times a day in a seated or prone position. Begin by taking a deep breath while expanding your chest and belly. Relax and then blow it out. Do this about four to six times, several times a day.
- Shoulder blade pinches: In a seated position, place your arms at your sides with elbows bent. Squeeze your shoulder blades together to bring your elbows behind you. Hold for a few seconds and then return to the starting position. Repeat five times.
- Arm-assisted raises: Use the non-involved arm to raise the surgical-side arm overhead until a stretch is felt. You can do this several times a day.
- Elbow openers or elbow winging: You can do this lying on the floor or in bed. Place your hands behind your head. Your elbows will point toward the ceiling. Move the elbows apart and down toward the floor. Do this five to seven times.
In addition to the movements above, the American Cancer Society recommends lying down and raising the surgery-side arm above heart level for 45 minutes to help ease swelling. Aim to do this two to three times a day. You can also open and close your hand 15 to 20 times and bend and straighten the elbow to help ease swelling (
Gentle stretching, arm circles, seated side bends, and shoulder rolls are other exercises you can perform in the week after surgery.
All exercises should be pain-free. Garrett says you should feel a stretch, but if there is any pain, do not go as far into the stretch. Aim to do these exercises each day.
Because of suture healing, Garrett says you will likely delay cardiovascular exercise until the surgeon clears you.
According to Chen, if you are healthy and healing well, you should be able to return to cardio exercises two months after surgery. However, you should consult with your surgeon to make sure that this is appropriate for your specific situation.
Walking is an excellent activity to incorporate during the first few months until your doctor gives you the okay to move on to more vigorous cardiovascular exercises.
Cardio exercise guidelines for breast reconstruction are similar to mastectomy. That said, since there is more than one type of breast reconstruction surgery, the exercises you perform will depend on the type of surgery you had. Your surgeon will give you recommendations based on your procedure.
The American Cancer Society recommends adding strength training exercises to your routine about four to six weeks after surgery (
After your doctor gives you the okay to add strength training exercises to your routine, you’ll want to aim for two days a week, as recommended by the American Cancer Society and the American College of Sports Medicine.
Many times after surgery, Garrett says the pectoral muscles tend to be shortened and tight. While stretching the chest muscles will help, she says it’s also beneficial to strengthen the back muscles and the area between the scapulae.
“Strengthening these muscles will help to improve overall posture and upper body strength,” Garrett says. She recommends using an assortment of resistance bands and dumbbell exercises to target specific muscles such as the rhomboids, latissimus, lower and middle trapezius, and the rotator cuff muscles.
Additionally, Garrett suggests incorporating core strengthening to improve overall postural control.
Strength exercise guidelines for breast reconstruction are similar to mastectomy. However, as mentioned earlier, there is more than one type of breast reconstruction surgery, and the exercises you perform will depend on the type. Your surgeon will give you recommendations based on your procedure.
When performing exercises in the weeks after mastectomy and breast reconstruction surgery, you should only do what’s comfortable for you. This may take some trial and error to determine your pain threshold, but when in doubt, stop if you feel any discomfort.
It’s normal to experience some tightness in your chest and armpit, but the American Cancer Society says this should decrease as you do your exercises (
Also, try to perform exercises when your body is warm — like after showering — and make sure to wear loose-fitting clothing that is comfortable.
If you’re exercising on your own and experience any one of the following symptoms, stop what you’re doing and contact your doctor (
- pain that gets worse
- feeling like you are getting weaker
- a loss of balance or falling
- having a new heaviness or aching sensation in your arm
- unusual swelling that gets worse, or headaches, dizziness, tingling, or blurred vision
Exercising after breast surgery is a critical step in recovery. Make sure to go slow and only do movements that feel comfortable.
Your doctor should provide you with a treatment plan that includes specific exercises to perform immediately and for the first few weeks after surgery.
If possible, ask about working with a physical therapist trained in post-surgery rehab. They can assist you with the exercises, make sure you are doing the moves correctly, and design a long-term fitness routine that supports your recovery. Soon, you’ll be on the path to regain strength and cardiovascular health.