PhysicalTherapy.com Phone: 866-782-6258


Exercising after Mastectomy

Andrea Branas, PT, MSE, MPT, CLT

April 23, 2014

Share:

Question

How quickly can a client begin exercising a shoulder after a mastectomy?  Are there specific exercises to perform with the upper extremity to minimize scarring?  How often should the exercises be performed?

Answer

If you are seeing patients post-surgically, you will want to talk to the surgeon.  After a mastectomy, you also want to think about other surgical procedures the patient may be having or may have had.  Some women will have a mastectomy without concurrent surgeries; however, a lot of women are now getting reconstruction at the time of surgery or getting spacers in planning for implants.  The short answer is that you want to wait until after the drains are removed.  You want to see that the patient is starting to get healing of their tissues. 

As far as specific exercises to perform with the upper extremity to minimize scarring, there is no research on specific guidelines that you can follow.  Most surgeons have some recommendations.  What we have done is give our surgeons the exercises and general range of motion activities that we recommend.  We do not want the patients doing anything that is going to cause impingement of the shoulders.  Our surgeons, at one point, were giving out shoulder abduction, but we got rid of that and gave them a more appropriate shoulder flexion exercise.  We have found that, in general, wall walking is not a good exercise post mastectomy.  If a patient does not have good range of motion, as they walk their arm up the wall, they will just elevate their shoulder girdle and will end up with an impingement.  I would stay away from wall walking.  Sometimes sitting in a chair and doing trunk forward flexion and walking the arm forward on the table will actually give great shoulder flexion and allows the scapula to separate from the shoulder flexion movement.  


andrea branas

Andrea Branas, PT, MSE, MPT, CLT

Andrea Branas is a lead physical therapist at Good Shepherd Penn Partners in Philadelphia, PA.  Andrea works in the Abramson Cancer Center at the University of Pennsylvania Health System providing patient care, education, leadership and training in the area of cancer rehabilitation.  Andrea’s areas of clinical expertise include lymphedema, pelvic floor rehabilitation, breast cancer rehabilitation and exercise for cancer related fatigue. In her current role, Andrea uses her expertise to help cancer survivors reach their physical potential by promoting rehabilitation starting at the time of cancer diagnosis.  She is currently a collaborator on an NIH Funded Dissemination grant to look at strength training for survivors of breast cancer.   Andrea has served as a guest lecturer for women’s health and cancer content at Arcadia and Widener Universities and the University of Medicine and Dentistry in New Jersey DPT programs. Andrea received her Masters degree in Physical Therapy from the University of the Sciences in Philadelphia in 1998 and her Master’s of Science in Engineering degree from the University of Pennsylvania in 1991.  She is currently working towards her transition DPT at Arcadia University. 


Related Courses

Mindfulness: Beyond Guided Meditation
Presented by Jennifer Stone, PT, DPT, OCS, PHC
Recorded Webinar

Presenter

Jennifer Stone, PT, DPT, OCS, PHC
Course: #3902Level: Intermediate2 Hours
  'Great way to approach a topic many know nothing about'   Read Reviews
Mindfulness can be a really powerful cognitive-behavioral tool and has many relevant applications when treating patients with pain, especially chronic pain. Many courses for rehabilitation professionals teach guided meditation, which is an amazing tool. However, mindfulness has many other applications and opportunities for use in the treatment of patients with pain. This session discusses the history and science behind mindfulness, as well as provides a variety of practical mindfulness tools for the everyday practitioner. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT/PTA.

Cultivating a Sustainable Core, Part II: Therapeutic Interventions from Yoga, Physical Therapy, and Sports Medicine in Rehabilitation
Presented by Liz Gillem Duncanson, PT, MPT, ATC, CSCS, PYT, RYT-200, C-IAYT
Recorded Webinar

Presenter

Liz Gillem Duncanson, PT, MPT, ATC, CSCS, PYT, RYT-200, C-IAYT
Course: #3332Level: Intermediate2 Hours
  'breaks down breathing and core activation in a way to utilize it in the clinical setting'   Read Reviews
This course is a continuation of the course titled, "Yoga Therapeutics to Cultivate A Sustainable Core" We build on the evidence-based and anatomical foundation of the dynamic core and apply the clinical reasoning of progressing patients and athletes through therapeutic exercises. This course is directly related to the practice of physical therapy and athletic training and is appropriate for the PT,PTA and AT.

Cancer Related Comorbidities and Adverse Treatment Effects
Presented by Stephen Morris, PT, PhD, FACSM
Recorded Webinar

Presenter

Stephen Morris, PT, PhD, FACSM
Course: #3592Level: Intermediate2 Hours
  'Many patients have a history or co-morbidity of cancer to be aware of in treatment plans'   Read Reviews
Cancer and its treatment are known to cause survivors to experience a number of comorbidities and adverse effects. Because physical therapy management of the cancer survivor must either focus on these comorbidities/adverse effects or treat them, physical therapists must have a fundamental understanding of the most common of conditions. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT/PTA.

Physical Mobility in Women With Chronic Physical Disabilities who are Pregnant or Parenting
Presented by Susan N. Smith, PT, DPT, PCS, Amy Wagner, PT, DPT, GCS
Recorded Webinar

Presenters

Susan N. Smith, PT, DPT, PCSAmy Wagner, PT, DPT, GCS
Course: #2581Level: Introductory2 Hours
  'the video was very good'   Read Reviews
As advances in medical care continue to increase the survival of premature infants and infants, more women with chronic physical disabilities such as cerebral palsy and spina bifida are reaching their reproductive years. These women face unique challenges including access to reproductive health care, decreased mobility, and obstacles in caring for their infants. This course will explore the basic physical therapist management of women with chronic physical disability who are pregnant or parenting. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT and PTA.

Physical Therapy Treatment Of Abdominal Scars, Adhesions, and Abdominal Cutaneous Nerve Entrapments.
Presented by Cynthia Neville, PT, DPT, WCS, BCB-PMD
Recorded Webinar

Presenter

Cynthia Neville, PT, DPT, WCS, BCB-PMD
Course: #2850Level: Advanced2 Hours
  'example of how to test and videos; extra handout/table on nerve entrapment'   Read Reviews
Abdominal scars, adhesions, and nerve entrapments are a source of abdominal and pelvic musculoskeletal pain symptoms. This course will examine and discuss physical therapist examination and treatment of musculoskeletal symptoms that may be caused by or associated with abdominal scars, adhesions, and abdominal cutaneous nerve entrapments. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT and PTA.