Breast cancer is a common malignant tumor in women, and the main treatment method at present is modified radical surgery plus comprehensive treatment. Due to the large surgical invasion, it often damages blood vessels, nerves and muscles, causing some patients to suffer from complications such as shoulder stiffness, atrophy, muscle adhesions and limited upper limb function. Inadequate postoperative limb function exercise may increase the local blood circulation and increase the burden of blood and lymphatic reflux, leading to edema and inducing other complications. Functional exercise of the limbs after breast cancer surgery can improve the function of the upper limbs, promote blood and lymphatic reflux, reduce the swelling of the limbs caused by surgical trauma and poor reflux, reduce subcutaneous blood and fluid accumulation and flap necrosis, and promote wound healing. Therefore, it is important to learn the functional exercise of the affected limb after breast cancer surgery to reduce the edema of the affected upper limb and restore the superficial skin sensation of the operated area, restore the shoulder joint movement and maximize the recovery of self-care ability. I. Significance of postoperative rehabilitation exercises Postoperative rehabilitation exercises for breast cancer are very important to prevent postoperative dysfunction and improve patients’ quality of life. It is generally believed that the myogenic fibers will be shortened to varying degrees 5-7 days after surgery, and over 3 weeks, the loose connective tissue around muscles and joints will become dense connective tissue, which will easily lead to joint contracture and weakening or loss of muscle strength. Therefore, systematic functional exercise in the early postoperative period can prevent scar contracture, muscle atrophy and joint ankylosis around the axilla, as well as prevent the contracted scar tissue from compressing the axillary vein, reduce the obstruction of axillary venous return, and at the same time promote blood circulation and lymphatic reflux, effectively reduce the occurrence of edema and the degree of edema. Position and time of rehabilitation exercise 1.Position: After the patient’s blood pressure stabilized 6 hours after surgery, he/she should be in semi-recumbent position with the head of the bed raised 30-40°, the elbow joint mildly bent and the upper limb on the affected side padded with a soft pillow; he/she can change the position in bed 7 days after surgery. The postural measures to prevent edema of the affected upper limb are to stuff ordinary soft pillows or clothes or quilts under the upper limb, and to make the elbow joint higher than the shoulder, the wrist higher than the elbow joint, and the affected upper limb at 30° to the bed, which can effectively reduce the edema of the affected limb after surgery. 2. Time: For the time to start exercise, the traditional view is that the affected limb should be braked within 2 days after breast cancer surgery so as not to affect the adhesion of the incision flap and cause bleeding and fluid accumulation under the flap. However, recent clinical studies have shown that as long as the shoulder joint is not abducted, flexed and extended in the early postoperative period (within 1 week), and the amplitude of movement is not too large, and the affected limb is not supported to get up, the functional exercise of the affected limb should be carried out as early as possible. You can do finger exercises on the day of surgery, and hand, wrist, and elbow exercises 1 to 3 days after surgery, because the range and amount of activities are not large, it will not aggravate the wound pain and bleeding. The time to start shoulder exercises should be 7 to 10 days after surgery. It is generally believed that the anterior and posterior shoulder exercises are feasible 7 days after surgery, and after 10 days, the flap is firmly attached to the chest wall, so the shoulder abduction and rotation exercises can be started to restore the shoulder joint function to the preoperative level as much as possible. Postoperative rehabilitation exercises 1. Phase I: The time range is about 0-7 days after surgery. During this stage, finger joint and metacarpophalangeal joint functional training is the main focus. During training, attention should be paid to shoulder joint braking and prevention of postoperative subcutaneous bleeding to avoid wound recovery and other adverse effects. (1) Finger stretching exercise: alternate with children’s game “rock, paper, scissors, cloth”, alternate finger flexion exercise on the affected side one by one, suitable for 1-2 days after surgery. (2) Ball grip and ball squeezing exercise: the affected side of the hand holds an elastic ball or metal ball, and the affected side of the thumb and index finger squeeze the elastic ball or metal ball, which is suitable for 3-4 days after surgery. (3) Fingertip kneading exercise: hold several sheets of paper into a mass one by one, and knead the surface of the paper mass with the fingertips on the affected side, kneading clockwise and then counterclockwise, repeatedly for several times, suitable for about 5 days after surgery. Practicing the above movements helps to ensure normal function of the metacarpal and finger joints, and also promotes peripheral circulation of the affected upper limb, which helps to relieve edema caused by surgical trauma, for about 10 minutes each time, 4-5 times a day, and can also be increased or decreased appropriately according to the patient’s postoperative physical condition. 2. Phase 2: The time range is about 7-14 days after surgery. This stage is based on shoulder joint inversion, forward flexion, back extension and abduction exercises, the angle of action is 30-45, the angle size depends on the actual situation, but it is appropriate to elevate the shoulder joint no more than 90°, so as not to overstretch the wound and affect the normal recovery. (1) Ball throwing exercise: The affected hand throws the elastic ball and then retrieves it by means of a leather band to catch it, repeatedly. Especially suitable for patients with limited anterior flexion function. (2) Combing exercise: alternate the comb with the hand on the healthy side and the hand on the affected side to comb the hair, and repeat several times. Pay attention to the exercise to keep the head in a neutral position as far as possible, do not deviate or turn to the left or right. It is especially suitable for patients with limited internal and external functions, and also for patients with limited supination functions. (3) Pendulum movement: in an upright position, arms straight and abducted, then inward and crossed, repeated several times, such as pendulum movement; or upright and upper body leaning forward, hands swinging back and forth, slightly wider than shoulder width. This is especially suitable for patients with limited internal and external functions, and also helpful for patients with limited posterior extension functions. (4) Shoulder shrugging exercise: Patients shrug their shoulders and move their shoulders in a circle for many times, which is helpful to relax the local muscles of the shoulder joint. (5) Wall climbing gymnastics: Use the hand on the healthy side to reach upward along the wall to the highest point, use this as the target exercise for the affected limb, first face the wall, touch the wall with both toes, start climbing upward along the wall with both hands from the shoulder, gradually raise the touching point of the upper limb on the affected side; then turn sideways to the wall, perpendicular to the wall, start climbing upward along the wall with the upper limb on the affected side from the shoulder, gradually raise the touching point of the upper limb on the affected side. Note that after climbing to the highest point, stay for a moment so that the adherent soft tissues can be fully separated, and then slowly climb down from the highest point, which can avoid the severe pain when putting down quickly. When climbing the wall sideways, always keep the body upright and do not turn the upper body. It is especially suitable for patients with limited forward flexion and abduction, and also for patients with limited supination. The above movements are designed to prevent and treat shoulder joint dysfunction on the affected side, loosen adhesions, promote blood circulation in the affected upper limb and shoulder, and prevent edema. Each time for 20 minutes, 4-5 times a day. If the dysfunction is obvious, you can focus on doing the corresponding training. 3. Phase 3: From about 15 days after surgery onwards, all belong to this phase. The rehabilitation training in this stage can extend the movements of the second stage, but the amplitude of the movements should be increased so that the activities of the shoulder joint can be restored to normal as much as possible, and the following movements can be applied to strengthen the functional training of the shoulder joint. (1) Thoracic expansion exercise: bend both elbows, clench both hands in front of the chest and brace the chest backward; abduct both upper arms and brace the chest backward with force, repeatedly and alternately, to help patients with limited posterior extension function. (2) Upper arm exercise: both upper arms are stretched forward, gradually dropping to the sides of the body, and then both upper arms are abducted and straightened upward, repeatedly in this order, which helps patients with limited forward flexion, abduction and supination. (3) Rotation of the arms: Abduction of both upper arms and rotation outward and backward as much as possible with the shoulder level as the center, which helps patients with abduction and posterior extension dysfunction. (4) Over-the-top ear touching exercise: the upper limb on the healthy side goes around the top of the head to touch the ear, and the upper limb on the affected side goes around the top of the head to touch the ear, repeatedly and alternately, to help patients with abduction and supination dysfunction. (5) Posterior item tying skirt exercise: place both hands posteriorly on the item, back and waist, do necklace tying, skirt pants-like or close both fingers, which helps patients with supination and posterior extension dysfunction. This stage of rehabilitation training should be continued, should be consciously trained in daily work and household chores, the number of times and time to do not overwork the affected limb is appropriate, until the affected limb fully restored function. Fourth, postoperative rehabilitation exercise precautions 1, functional exercise is mainly independent exercise, the exercise time should be not less than 6 months. 2.Progressive, moderate, to not feel fatigue, especially the early postoperative exercise should be moderate, because the postoperative circulation of the affected limb has not been established before. Early excessive movement may increase the local blood circulation and increase the burden of blood and lymphatic reflux, leading to edema and other corresponding complications. Shoulder activity should be limited to not produce significant pain. 3. Develop an individualized exercise plan. Take individual counseling in the process of exercise to correct various deviations, such as postural deviations. 4.Combine with massage. The stimulation of the skin by massage can cause the release of histamine-like substances, which can dilate the capillaries and promote blood circulation. Help eliminate limb swelling, while massage has a sedative or stimulating effect on the nervous system. Facilitate the healing of the skin, reduce the growth of traces, and facilitate the recovery of muscle and nerve function. 5, combined with aerobic exercise. Early local functional exercise and combined with aerobic exercise can help to maintain and improve the motor function of the upper limbs by improving cardiopulmonary function, promoting local blood circulation, increasing the activity of enzymes, thickening muscle fibers, increasing synovial fluid secretion, preventing muscle atrophy and joint stiffness, maintaining the original motor reflexes and developing the body’s compensatory function, thus helping to maintain and improve the motor function of the upper limbs, so that the ability to perform daily activities can be restored and improved.