After a breast reconstruction surgery, physical activity and rest are important. Your body is healing from a serious procedure that requires time, patience, and the right exercise program tailored to your specific needs in order to heal and feel better.

Specific exercises can help keep the range of motion in your shoulder and arm, relieve pain, and reduce swelling after a breast reconstruction.

Critical exercise after a surgical procedure is anything but simple, and includes things like combing or brushing your hair or touching your shoulder blades.

To avoid overloading the system, it is important to ease back into exercise gradually. We discuss exercise considerations, physical activity in the first week, cardio exercise, and strength training after a breast reconstruction surgery.

Exercising after a mastectomy or breast reconstruction often depends on any restrictions put in place by the surgeon, says Diana Garrett, D.P.T., O.C.S., C.L.T., C.S.C.S. at Saint John’s Cancer Institute.

She says that it is important to get clearance from your physician about what you can and cannot do after surgery.

Physical activity also depends on the type of surgery and your overall health. In general, it’s best to avoid vigorous exercises and heavy lifting so that your wounds have a chance to heal, says Constance M. Chen, MD, a board-certified plastic surgeon and breast reconstruction specialist.

It takes a healthy person six to eight weeks to heal a wound.

Overall, the American Cancer Society recommends starting slowly and only progressing when you are ready (1). They also suggest working with a cancer exercise specialist or physical therapist to make sure you’re doing the exercises properly.

An important note

The experts interviewed for this article stress the importance of working with a physical therapist and your surgeon to develop an exercise routine tailored to your needs.

If you have a surgery that requires a specific type of treatment, it is best to speak to a doctor who can give you recommendations for your recovery.

In the first week after mastectomy (with or without breast reconstruction), Dr. Chen says it’s important to walk so that you can move your muscles and get your lungs and legs working again. However, you should avoid vigorous, repetitive movements that prevent wound healing.

Breast surgery is linked to shoulder and scapular problems, so it is important to regain full mobility after the surgery. Some of the top exercises that are done with patients the week after a surgery are:

  • Diaphragmatic breathing (belly breathing): You can practice this several times a day in a seated or prone position. Begin by taking a deep breath while expanding your chest and belly. Relax and then blow it out. Do this about four to six times, several times a day.
  • Shoulder blade pinches: In a seated position, place your arms at your sides with elbows bent. Squeeze your shoulder blades together to bring your elbows behind you. Hold for a few seconds and then return to the starting position. Repeat five times.
  • Arm-assisted raises: Use the non-involved arm to raise the surgical-side arm overhead until a stretch is felt. You can do this several times a day.
  • Elbow openers or elbow winging: You can do this lying on the floor or in bed. Place your hands behind your head. Your elbows will point toward the ceiling. Move the elbows apart and down toward the floor. Do this five to seven times.

In addition to the movements above, the American Cancer Society recommends lying down and raising the surgery-side arm above heart level for 45 minutes to help ease swelling. Aim to do this two to three times a day. You can also open and close your hand 15 to 20 times and bend and straighten the elbow to help ease swelling (1).

You can do some exercises in the week after surgery.

All exercises should be pain-free. If there is any pain, do not go as far into the stretch as if you were a doctor. Aim to do these exercises every day.

Because of the healing process, you will likely delay cardiovascular exercise.

If you are healthy and healing well, you should be able to return to exercising two months after surgery. You should consult with your surgeon to make sure that this is appropriate for your situation.

Walking is an excellent activity to incorporate during the first few months until your doctor gives you the okay to move on to more vigorous cardiovascular exercises.

Guidelines for breast reconstruction are similar to those for mastectomy. Since there are more than one type of breast reconstruction surgery, the exercises you perform will depend on the type of surgery you had. The surgeon will give you recommendations.

The American Cancer Society recommends adding strength training exercises to your routine about four to six weeks after surgery (1). You can perform exercises with a small set of hand weights or resistance bands.

The American Cancer Society and the American College of Sports Medicine recommend that you aim for two days a week of strength training after your doctor gives you the okay.

Many times after surgery, Garrett says the pectoral muscles tend to be shortened and tight. While stretching the chest muscles will help, she says it’s also beneficial to strengthen the back muscles and the area between the scapulae.

“Strengthening these muscles will help to improve overall posture and upper body strength,” Garrett says. She recommends using an assortment of resistance bands and dumbbell exercises to target specific muscles such as the rhomboids, latissimus, lower and middle trapezius, and the rotator cuff muscles.

Core strengthening is suggested to improve overall control.

Guidelines for strength exercise are similar to those for mastectomy. There are more than one type of breast reconstruction surgery, and the exercises you perform will depend on the type. The surgeon will give you recommendations.

When performing exercises in the weeks after mastectomy and breast reconstruction surgery, you should only do what’s comfortable for you. This may take some trial and error to determine your pain threshold, but when in doubt, stop if you feel any discomfort.

It’s normal to experience some tightness in your chest and armpit, but the American Cancer Society says this should decrease as you do your exercises (1).

Try to perform exercises when your body is warm and wear clothes that are comfortable.

If you’re exercising on your own and experience any one of the following symptoms, stop what you’re doing and contact your doctor (1).

  • That pain gets worse.
  • You are getting weaker.
  • A loss of balance.
  • There is a new sensation in your arm.
  • It can be swelling, headaches, dizziness, or blurred vision.

Exercising after breast surgery is important for recovery. Make sure you do movements that are comfortable.

Your doctor should give you a treatment plan that includes exercises to perform immediately after surgery.

Ask about working with a physical therapist who is trained in post-surgery rehabilitation. They can help you with the exercises, make sure you are doing the moves correctly, and design a long-term fitness routine that supports your recovery. You will be on the path to regain strength and cardiovascular health soon.