Post-operative breast cancer rehabilitation exercises

by Specialist

I. Post-breast cancer rehabilitation exercises – breathing exercises

Patients after breast cancer surgery should recognize the importance of rehabilitation as early as possible and actively engage in rehabilitation exercises. The correct rehabilitation exercises can prevent patients from forming abnormal postures, gradually expand joint mobility, promote edema reduction and prevent the occurrence of delayed lymphedema, restore the ability of daily life movements, and improve the quality of daily life (QOL). The methods and focus of postoperative rehabilitation exercises are different at different stages. Breathing exercises are one of the simple and effective self-exercises that patients can perform early after surgery. This video is suitable for patients from the perioperative period to the recovery period, and respiratory exercises can be performed in the supine position in the early postoperative period. It is important that the breathing exercises are not painful and that they are performed within the limits of a mild thoracic tugging sensation.

Exercises for post-breast cancer rehabilitation – breathing exercises

Deep Breathing Exercises

    Essentials: Place your hands lightly under your collarbone and relax on deep inhalation; on deep exhalation, press lightly along the descending rib cage to promote deep exhalation

  1. Cautions: Pay attention to maintaining a slight tuck in the abdomen when standing, neutral pelvic position, and do not bend the lumbar spine too far forward, causing discomfort such as lumbar pain, either in the standing or seated position.

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  2. Frequency: 3-5 times/group; 2 groups per day.

  3. Starting period: 1 week after surgery.

  4. Contraindications: Reduce the amplitude of movement or discontinue the breathing exercise when the wound is painful during deep breathing and when there is significant discomfort in the thorax.

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Torso rotation breathing

    Essentials: Place the ipsilateral hand lightly under the affected clavicle and relax with deep inspiration during contralateral rotation; exhale deeply during ipsilateral rotation and press lightly in the direction of descending ribs to promote deep exhalation.

  1. Cautions: Pay attention to maintaining a slight abdominal tuck when standing, neutral pelvic position, and do not bend the lumbar spine too far forward, causing discomfort such as lumbar pain, which can be implemented in either a standing or sitting position.

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  2. Frequency: 3-5 times/group; 2 groups per day.

  3. Starting period: 1 week after surgery.

  4. Contraindications: Reduce the amplitude of movement or discontinue the breathing exercise when the wound is painful during deep breathing and when there is significant discomfort in the thorax.

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Hand over head (rotational) breathing

    Essentials: Fully abduct the arms, open the thorax when inhaling, and inhale deeply; when exhaling, hold the chest (do not bend over) with the elbow tips facing each other. Note: Pay attention to keep a slight abdominal tuck when standing, neutral pelvic position, lumbar vertebrae do not bend too far forward, causing discomfort such as lumbago, can be implemented in the standing or sitting position.

  1. Frequency: 3-5 times/group; 2 groups per day.

  2. Starting period: 4-6 weeks postoperatively and beyond.

  3. Contraindications: Active shoulder abduction angle on the operated side is less than 120 degrees, wound pain during deep breathing, and respiratory exercise should be reduced or discontinued when there is significant discomfort in the thorax.

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II. Postoperative breast cancer rehabilitation exercises – neck exercises

Neck exercises are one of the simple and effective self-exercises that patients can do early after surgery. It can relieve neck muscle stiffness and prevent postural abnormalities caused by changes in the position of the clavicle and scapula due to neck muscle tension, which can lead to limited joint mobility. This video is for patients who are 3 days postoperative. The caution when exercising is not to cause pain due to the exercise, but only to the extent that there is a mild pulling sensation in the thorax.

Recovery exercises after breast cancer – neck exercises

    Essentials: Stand with your feet shoulder-width apart, probe forward and down and then lower your head to the maximum range, hold for 3-5 seconds, raise your head slowly to the maximum range while maintaining the probe to the front, hold for 3-5 seconds; look at the toes of one side and repeat the above actions diagonally, pay attention to keep your head in a straight line during the exercise to avoid excessive neck rotation.

  1. Caution: Pay attention to keep a slight abdominal tuck when standing, neutral pelvic position, lumbar vertebrae do not bend too far forward, causing discomfort such as lumbar pain, and can be implemented in a standing or sitting position.

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  2. Frequency: 3-5 times per movement/group; 2 groups per day.

  3. Starting period: 3 days after surgery.

  4. Contraindications: The exercise should be discontinued when neck activity is accompanied by dizziness and other discomfort.

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Three: Shoulder exercises for postoperative breast cancer rehabilitation

Shoulder exercises are different exercises that patients choose according to their recovery status after surgery. Shoulder exercise is a very important self-exercise. Early and correct self-exercise can effectively expand shoulder joint mobility, promote edema reduction, and improve the quality of daily life. This video is suitable for 6 weeks postoperatively. It includes active, active-assisted, stretching and resistance exercises for the shoulder joint; promotes muscle strength around the shoulder, stretches the muscles on the operated side that are prone to tension, and improves soft tissue extensibility.

Exercises for post-breast cancer rehabilitation – shoulder exercises

    Caution: Try to face the mirror during the activity while confirming the movement. Do not cause pain during exercise, keep the trunk symmetrical, and do not shrug your shoulders to compensate during arm raising or abduction on the operated side. The amount of exercise should be moderate and should not cause excessive fatigue. Be careful to maintain a slight abdominal retraction and neutral pelvic position when standing, and do not bend the lumbar spine too far forward, which may cause discomfort such as lumbar pain, or in a sitting position. If you have severe limitation of shoulder joint movement, please seek medical attention and professional rehabilitation treatment.

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  1. Frequency: 1-2 times a day; adjust the amount according to your condition.

  2. Initiation period: 6 weeks postoperatively, patients who are basically free of mobility problems and need to consolidate and strengthen the function of the operated arm.

  3. Contraindications: Significant mobility impairment on the operated side and suspension of exercise if there is intense pain during exercise.

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IV. Postoperative exercises for breast cancer rehabilitation – proprioceptive training

Ontogenic sensory exercises are exercises for patients to restore shoulder function after surgery and prevent the development of sports injuries and edema. There are many core stability exercises and periacetabular proprioceptive promotion exercises that need to be selected and exercised under the guidance of a professional rehabilitation therapist. This video is suitable for 6 weeks post-operative, peri-articular functional and overall strengthening exercises.

Post-breast cancer rehabilitation exercises – proprioceptive training

    Caution: Selection and exercise must be done under the guidance of a professional rehabilitation therapist.

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  1. Frequency: 1-2 times daily; adjust according to your condition.

  2. Initiation period: 6 weeks post-operatively, patients who are basically free of mobility impairment and need consolidation, strengthening and prevention of arm motion injury.

  3. Contraindications: Significant mobility impairment on the operative side and suspension of exercise for those with intense pain during exercise.

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    V. Postoperative exercises for breast cancer rehabilitation – physical training

    Physical exercise is an important exercise for patients to improve physical fitness and relieve cancer-caused fatigue during and after chemotherapy. A professional rehabilitation therapist is needed to develop a reasonable exercise prescription based on the patient’s condition. According to research literature, aerobic exercise (running platform or power bicycle) with intensity of 60%-80% of maximum heart rate and duration from 15-45 minutes 3 times a week for 12 weeks during chemotherapy after breast cancer surgery is effective in reducing body fat rate and improving burnout. This video is suitable for physical exercise during chemotherapy.

    Exercise for post-breast cancer rehabilitation – physical training

      Frequency: 3 times per week for 12 weeks.

    1. Initiation period: Patients during chemotherapy and with high burnout.

    2. Cautions: Exercise prescription by professional rehabilitation therapist is required. Patients with severe cardiorespiratory disease, hypertension and other underlying diseases need to exercise under medical supervision.

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