3.2 Physical Activity & Exercise

3.2.1 Exercise Guidelines

As you gradually increase your daily activities, it is important that exercising is one of them (Lymphedema Working Group, 2012). Only do activities you are comfortable with. If you are unsure what you can and cannot do, do not hesitate to consult your healthcare team.

Before exercising, you can take your pain medication around 15 to 30 minutes before you begin to promote increased movement and decreased pain (Lymphedema Working Group, 2012). Going for walks can be a good form of exercise while you are recovering from surgery. For example, you could walk for 20 minutes 5 times a week. Overall, doing multiple small exercise sessions every day can be the most beneficial. For example, you can do a 10-minute workout in the morning, afternoon, and evening.

3.2.2 Exercises with the Drain

If your drain is still in place, you should still do the exercises recommended to you by your healthcare team (Lymphedema Working Group, 2012). However, do not push yourself if you start feeling excessive amounts of pain or discomfort while exercising; stop doing those exercises until your pain has completely gone away.

Here are some common exercise recommendations:

Deep Breathing

1. Sit upright in a comfortable position.
2. Inhale deeply through your nose while expanding your stomach and chest.
3. Relax your neck and shoulders while slowly releasing the breath. (Boudarra et al., 2020)

Arm Elevation

1. Start with your arms resting at your sides.
2. Raise both of your arms to shoulder level while keeping them straight.
3. Make sure that you do not raise your arms any higher to prevent the development of unwanted side effects, such as lymphedema.
4. Slowly lower your arms again. (Boudarra et al., 2020)

Posture Control

1. While standing upright, push your chest forward while moving your shoulders backwards.
2. Lightly squeeze your shoulders while turning your thumbs outwards. (Boudarra et al., 2020)

Shoulder Circles

1. Lift your shoulders like you are shrugging.
2. Slowly rotate your shoulders forward, backward, and down to make a circle.
3. Alternate which direction you are rotating your shoulders. (Boudarra et al., 2020)

3.2.3 Exercises After Drain Removal

After your drain removal and more than one week has passed since your surgery, you can start doing more exercises as instructed by your healthcare team (Boudarra et al., 2020). The recommended exercises depend on whether you have reached the 6-week mark post-surgery.

Up to 6 Weeks After

Wall Climbing

1. While standing, face a wall about 1 foot away from you.
2. Walk your fingers on both hands up the wall.
3. When you feel a stretch, walk your fingers back down the wall.
4. As you do this exercise more often, you will gradually be able to move your fingers higher up the wall. (Boudarra et al., 2020)

Side Wall Climbing

1. Similar to wall climbing, stand 1 foot away from the wall with the side you had surgery on facing the wall.
2. Walk the fingers of your affected arm up the wall.
3. When you feel a stretch, walk your fingers back down the wall. (Boudarra et al., 2020)

More Than 6 Weeks After

Six weeks after your surgery, you can usually start doing your normal exercises from before your surgery (Boudarra et al., 2020). However, do these exercises in moderation and monitor how your body feels during them. Talk to your healthcare team first to ensure that you are exercising safely.

You may begin to rely more on the arm you did not have surgery on, but you must keep your affected arm moving just as much as the other one (Boudarra et al., 2020).

Since you are doing more exercises, you might feel more pain or even see some swelling (Boudarra et al., 2020). You can take pain medication as needed, but keep an eye on any swelling that is not going away. This swelling could be lymphedema and will require treatment as soon as possible.

BC Cancer provides a helpful handout for exercising with breast cancer, which you can refer to. You can find this handout below.

If you would like a walkthrough of what exercises you can do while recovering from breast cancer surgery, check out Video 14 (BC Cancer, 2021b) and Video 15 (BC Cancer, 2021c).

3.2.4 Questions to Ask About Exercise

1. When can I start exercising after my surgery?
2. Can I exercise while receiving treatment for breast cancer?
3. What negative effects should I look for while exercising?
4. Can someone help me create an exercise plan to optimize my health?
5. What exercises are best for someone with breast cancer?
6. When can I resume playing and participating in intense sports, such as cardiovascular conditioning, pickleball, soccer, or volleyball? (Lymphedema Working Group, 2012)