Physiotherapist guidance for arm activity following breast surgery

Check with your doctor about relative restrictions on exercises following surgery, although most exercises can start on the day after surgery.  Your surgeon may request a physiotherapist to help you with some of the exercises initially.  It may take two to three months for you to recover full use of your arm.  If you are having specific problems with moving your shoulder, ask your doctor regarding a referral to a physiotherapist.

Shoulders are made to have full movement and your arm will feel best when this is achieved.  You are encouraged to use your elbow and hand as much as possible, within the limits of your pain, from as soon as you can after surgery.

For the first few days following surgery, deep breathing exercises are advised.  Lie on your back and breathe in until your lower chest expands, then exhale and relax.  Repeat three or four times to help you relax and also gently expand your chest on the operated side.

“Normal” shoulder movement implies that you have the ability to reach across the top of your head to touch the opposite ear without a stretchy feeling in you armpit (axilla).  Use this as a guide to measure your progress.  Shoulders are made to have full range of movement, and you will probably only feel comfortable once you have reached your normal.

Generally, it is okay to stretch your shoulder until you feel a mild pull, but no pain. Stretches should always be done slowly and smoothly.  You can stretch up to three times a day.  Consult your doctor or physiotherapist if you are unsure.

The stiffness and tightness in your chest after surgery and radiation therapy will come and go for a while.  

Start with activities that will assist your normal day-to-day activities: reach into cupboards, wash and dry your hair, fasten your bra.

After the stitches have been removed and the wound has healed fully, you may start massaging the scar for approximately 10 minutes after a warm bath or shower.  Use circular movements to cover the scar and surrounding areas, to ensure optimal flexibility of the scar tissue.

If swelling persists after surgery, elevate the arm at a 45º angle on pillows.   Apply heat packs (warm, not hot) to the limb, and do pumping exercises with the hand