According to the Canadian Cancer Society on average, 429 Canadian women will be diagnosed with breast cancer every week. Almost all of these women will undergo some form of breast surgery. Research about exercise and its relationship to cancer is generally favorable, showing such benefits as increased sense of well-being and strength and endurance, all of which cancer and its treatments can diminish. Exercise can also reduce daily fatigue in women with breast cancer receiving chemotherapy (Schwartz et al. 2003) decrease psychological distress, fatigue, weight gain, premature menopause and changes to body image (Maruyama 2001) and benefit postmasectomy patients in regaining their function and range of shoulder motion (Na et al. 2005).

The surgeon’s approval is required before a postoperative woman can begin an exercise program. Once approval is granted the following sample exercise program which is divided into three main phases can be started.

The main purpose of phase I is relaxation. Deep breathing can help decrease pain caused by the surgery. For example, breathe in through the nose and out through the mouth, taking twice as long to exhale as the inhale. Other exercises that can be performed during phase I are pullovers, wall climbs, and a butterfly stretch.

Pull-Over: Lying on the back with knees bent and feet flat on the floor (crunch position), hold a rod in both hands, resting over the hips. Slowly lift arms until the rod is directly over the face, keeping the elbows straight. Take a deep breath in and while exhaling, slowly lift the rod overhead, until the rod is resting on the floor. Wall Climb: Facing a wall, stand about six inches away. Place palms on wall, just above head. Walk the fingers of the un-operated side up the wall first until full extension is reached do the same on the operated side. Butterfly Stretch Lying in the crunch position with hands clasped behind the head, push elbows down towards the floor. To release, lift the elbows back up towards the face.

Phase II can be performed four to six weeks post surgery. Continue the phase I exercises and add more conditioning exercises such as wall push-ups, bicep curls, tricep extensions, basic abdominal crunches and shoulder retractions. Cardiovascular activity may also be performed at this time. Depending on fitness levels, begin with just one to five minutes, two to four times a day, working up to 15 continuous minutes. Follow with a full body stretch.

For Phase III, continue with Phase II exercises and consider adding some ball work to restore balance and work on core stability. Also, begin adding exercises to work the entire body, such as seated rows, push-ups, leg extensions, leg curls, squats, alternating opposite arm/leg lifts on all fours, and oblique work. Progressively increase cardiovascular activity to thirty minutes. This should be followed by a full body stretch.

It’s important to remember that initially, the goal for women who have had breast surgery is to restore function fitness comes later. A certified personal trainer with postmasectomy training can help restore the bodies, minds and spirits of individuals who have undergone breast surgery. By learning all we can about breast cancer and by networking with medical and fitness professionals, the road to full recovery is a road within reach.

Adapted from Na, Y.M., et al. 2005. Early rehabilitation program in postmasectomy patients

Stumm, D. 2003. Recovering from Breast Surgery Exercises to Strengthen Your Body and Relieve Pain.

Jenn Naiman, Group Fitness Director