Patients with breast cancer can prevent edema, promote wound healing, and restore upper extremity function by promoting blood and lymphatic fluid return with specific arm exercises after surgery.
For better recovery, postoperative exercise should be gradual and avoid excessive exercise. Three months after surgery, it is recommended to exercise three times a day for 10-15 minutes each time, with both arms moving simultaneously or sequentially to ensure symmetrical and coordinated movements.
Postoperative rehabilitation exercises can be divided into three sets: morning, midday and evening according to the postoperative time.
Early rehabilitation exercises
Application time: 24 hours to 1 month postoperatively.
Objective of the exercise: to promote blood and lymphatic fluid return, prevent lymphedema, and promote wound healing.
Caution: Gradually increase the amount of exercise, and you can do all movements after 2 weeks.
1. Fist clenching exercise
Stretch out your arms, make a natural fist with both hands, and repeat the “open palm – make a fist – open palm” movement, which can be started 24 hours after surgery.
2. Wrist exercises
Relax the wrist by raising the forearm and repeating “move the wrist up and down – rotate inward twice – relax the wrist – rotate outward twice”, which can be started 48 hours after surgery.
3. Forearm exercises
Clamp the upper arm and move the lower arm up and down; this exercise can be started on postoperative day 3.
4. Elbow exercises
Put your elbow on the same side of your waist and repeat “raise your arm to the opposite side of your chest – touch your hand to the opposite shoulder as much as possible – lower your arm”.
5. Elbow cradle exercise
The affected arm is placed in front of the chest, and the healthy hand holds the affected elbow joint, helping to raise the affected arm and then lower it, alternating between the two arms, which can be started on the 7th postoperative day.
6. Shoulder shrugging exercise
Repeat the “shoulder rotation forward – chest in – shoulder rotation back – chest up” movement, which can be started on postoperative day 9.
7. Upper arm exercises
Repeat the “arm straight up-as parallel to the floor as possible-lower down” movement, which can be started on postoperative day 10.
8. Neck exercises
Repeat the “forward-backward-left-forward-backward-right” rotation of the head and neck with arms crossed.
9. Stretching exercises
The arms are stretched out to the sides, naturally raised at an angle to the body (about 45 degrees), with the affected arm raised forward onto the opposite shoulder and the other arm back, maintaining the angle between the arm and the body.
10. Shoulder lift exercise
Hold the wrist of the affected side in the healthy hand to the abdomen, raise the affected arm to the chest, keeping it horizontal and reaching forward as far as possible, then lower it and repeat the movement with the affected hand helping the healthy hand, alternating between the two arms, which can be started on postoperative day 14.
Intermediate recovery exercises
Applicable from 1 month post-op to 3 months post-op.
Objective of the exercise: to fully exercise the shoulder muscle groups, prevent scar adhesions and improve joint mobility by pulling the muscles around the wound.
1. Stretching exercise
Stand with your feet shoulder-width apart, stretch your arms out to the sides at an angle of about 45° to your body – move your hands to the middle to cross over your abdomen and lower your head – move your hands to the sides to resume stretching and raise your head, and repeat again.
2. Side thrusters
Stand with your feet shoulder-width apart, hold the affected wrist in your healthy hand and raise it to your chest, keeping it horizontal, push to the affected side, pull to the healthy side, and then restore, then repeat once more.
3. Hand shake exercise
Hook your arms forward and flat, palms forward, swing your arms down and back, then swing your arms forward and up to the back of your head, then back to forward and flat. Repeat the movement once.
4. Chest expansion exercise
Standing with your feet shoulder-width apart, raise your arms flat in front of your chest, then spread them out to the sides and keep them horizontal, then retract them to flat in front of your chest. Repeat the movement once.
5. Side raises
Standing with your feet shoulder-width apart, spread your arms out to your sides and raise them flat, bend your elbows up, and then return to raising them flat to your sides. Repeat the movement once.
6. Supination exercise
Standing with your feet shoulder-width apart, hold the affected wrist in your healthy hand, hold it flat in front of your chest, then raise it up over your head, then return to a flat chest position. Repeat the movement once.
7. Wrap-around movement
Standing with your feet shoulder-width apart, hold the wrist of the affected side in your healthy hand and wrap it around from the affected side up through your chest to the top of your head, and then wrap it back down from your healthy side. Repeat the movement once.
8. Abdominal exercises
Stand with your feet shoulder-width apart, put your hands on your shoulders, raise them up over your head, bend over in a lunge, drop your hands straight down, and then return to a standing position. Repeat the movement once.
9. Turning exercise
Raise your hands upward, lift your head and chest, cross your arms with one hand and hold the other hand forward, then rotate backward, restore, and repeat the movement once.
10. Finishing Exercises
Step in place and swing your hands naturally forward and back.
Late recovery exercises
Application time: 3 months post-op.
Purpose of exercise: consolidation exercise.
Precautions: Exercise 1 time daily.
1. Warm-up exercise
Stand with your feet shoulder-width apart, hold your hands flat to your sides, and move your arms up and down in a circular motion with your breathing.
2. Head shaking exercise
Fold your arms and shake your head from side to side, moving as far as you feel the tug on your neck.
3. Head Lifting Exercise
Stretch your hands up to your chest, bring your feet together, hold your hands together and raise them above your head, while landing on your left foot back on your toes, and then resume the initial movement.
4. Arm extension exercise
Hold your hands up, bend to the left, and stretch your right hand behind your head, then resume the upward motion, bend to the right, and stretch your left hand behind your head.
5. Waist exercise
Raise one arm, bend to the opposite side, then wrap it forward until the arm is down, lower your head with your chest, and wrap it backward around your shoulder. Then switch to the opposite side.
6. Turning waist movement
With your body weight to the right, turn your waist at the same time, bend your arms and raise your upper arms as high as possible perpendicular to your body, then retract your arms, return your body to square, and repeat the movement to the left.
7. Wrap-around exercise
Cross your arms in front of your belly and do a big wrap-around motion upward.
8. Finishing exercises
Step in place and bend your hands to swing them forward and back.
