Bismillahirahmanirahim , For this week i have been appointed to be one of the instructor to conduct an exercise awareness after a breast cancer treatment , as a physiotherapist i feel want to share some of the information and also guideline for helping the people to achieve their goal of recovery by doing an exercise.
Exercise is an important part of breast
cancer treatment and recovery. Exercising the arm and shoulder after breast
cancer surgery helps:
•
improve muscle tone
•
regain and maintain movement and mobility in the arm and shoulder
•
regain the ability to do daily activities
•
lessen side effects of surgery, such as pain, joint stiffness and swelling
• improve well-being in daily life
Rehabilitation exercises are also important
after radiation therapy because this type of breast cancer treatment can
continue to affect the arm and shoulder for several months. Exercises can help
the arm stay flexible. It is beneficial to continue doing exercises for 2–3
months after finishing radiation treatment. Every woman is different and heals at her
own pace. Some exercises, such as those that increase arm and shoulder
movement, can be done soon – often a few days – after surgery. When the doctor
gives the go-ahead, other normal activities can be started again.
General tips for exercising
·
Wear comfortable, loose
clothing when exercising.
·
Try doing exercises after a
shower when muscles are warm and relaxed.
·
Take slow, deep breaths when
doing each exercise. Deep breathing helps fill the lungs completely and can
also improve relaxation. Breathe in as much air as possible while trying to
expand the chest and stomach like a balloon. Relax and breathe out slowly and
completely.
·
Do the exercises until you feel
a gentle stretch, but not to the point of pain.
·
Begin doing exercises and daily
activities slowly and gently.
·
Do not over-exercise. Increased
pain, discomfort and swelling are often signs of over-exercise.
·
Gradually increase the pace and
level of activity. Aim to restore pre-surgery function in the hand and arm.
·
Prop up the arm with a pillow
during or at the end of the day to help reduce swelling after surgery.
·
Report unexplained pain or
swelling in the hand or arm to your doctor or physiotherapist.
The time frames
mentioned below are only suggested guidelines. Always check with the
doctor or physiotherapist before beginning to exercise. They will usually
recommend when to start exercising and which exercises to do. The type of
exercises that may be done will depend on the type of surgery performed.
Exercise instructions can vary with the doctor, physiotherapist or hospital
First week after surgery
Typically, gentle range-of-motion exercises can
be done the first 3–10 days after surgery or while the drain is still in place.
Try to use the affected arm (the one on the same side as the area that was
operated on) for light daily activities, such as eating, washing and combing
your hair. Repeat these exercises 3–4 times a day. Do not make any sudden
movements until the incision has healed and the drain has been removed
If surgery irritates
nerve endings, there can be some soreness, numbness, tingling or a burning
feeling on the back of the arm or the chest wall. These feelings may increase a
few weeks after surgery, but you should try to keep doing the exercises unless
there is increased swelling or tenderness. If you have these symptoms, tell
your doctor. Sometimes gentle rubbing or stroking the area with a hand or a
soft cloth can help make it feel better
Hand and Finger Pump
This exercise helps reduce swelling after
surgery by using the muscles as a pump to improve the circulation in the
affected arm (on the same side as the surgery). This can be done lying or
sitting.
·
Lie on the unaffected side with
the affected arm straight out in front of you, above the level of the heart
(use pillows if needed). Alternatively, sit in a chair with good back support
with the affected arm supported by pillows.
·
Slowly open and close the hand.
Repeat 15–25 times.
·
Slowly bend and straighten the
elbow. Repeat 15–25 times.
Shoulder
shrugs and rotation
This exercise can be done sitting or
standing.
·
Lift both shoulders up toward
the ears. Hold for 5–10 seconds, then slowly drop them down and relax. Repeat
5–10 times.
·
Gently rotate both shoulders
forward and up, and then slowly back and down, making a circle. Switch
directions. Repeat 5–10 times in each direction.
This exercise can be done sitting or
standing.
·
Clasp hands together in front
of the chest. Extend the elbows so your arms are out in front of you, but your
elbows are not locked.
·
Slowly lift the arms upward
until a gentle stretch is felt. Hold for 1–2 seconds and then slowly return to
the start position.
·
Repeat 5–10 times.
scapular and shoulder squeeze
This exercise helps improve posture and
movement in the shoulder. It can be done sitting, without resting against the
back of the chair, or standing.
·
Place arms at your sides with
the elbows bent.
·
Gently squeeze the shoulder
blades together. Keep shoulders level and take care not to lift up or shrug the
shoulders. Hold for 5–10 seconds. Relax and return to the start position.
·
Repeat 5–10 times.
It is important to start working on getting
back full use of the shoulder as soon as possible. These exercises can be
started as soon as the doctor or physiotherapist gives the go-ahead. Most
women can start doing them about 3–6 weeks after surgery and after the drain is
removed.
Remember Do
not lift anything heavier than about 5 kg (10 lbs) during this stage.
wooden stick exercise (3 positions)
This exercise helps improve the forward
movement of the shoulder. You will need a “wand”, such as a broom handle, stick
or cane, to do this exercise. There should not be any pain or pinching during
these exercises – stop the movement if there is.
Position
1
·
Lie on your back with knees
bent. Hold the wand in both hands (palms facing down), with hands shoulder
width apart and elbows bent.
·
Straighten your arms and lift
the wand over the head until you feel the stretch. The unaffected arm helps
lift the wand. Hold for 1–2 seconds. Lower arms.
·
Repeat 5–10 times.
Position
2
·
Repeat with palms still facing
down, but with hands slightly wider apart than the hips or shoulders.
Position
3
·
Repeat with palms facing up
(under grip) and the hands hip width apart.
Scapular Winging
it
This exercise helps improve movement in the
front of the chest and shoulder. It may take several weeks of regular exercise
before you can get the elbows close to the floor. If there is pain or pinching
in the shoulder, place a small pillow behind the head, above the affected
shoulder.
·
Lie on the back with knees
bent. Clasp hands behind the neck with elbows pointed up to the ceiling. (If
putting hands behind the neck is too uncomfortable, place fingers on the
forehead with palms facing up.)
·
Move elbows apart and down
toward the floor. Hold for 1–2 seconds.
·
Repeat 5–10 times.
This exercise helps improve posture and
movement in the shoulder. It can be helpful to use a mirror to check your
movements. It can be done sitting, without resting against the back of the
chair, or standing.
·
Arms should be down at each
side with elbows straight and palms facing the body.
·
Open the chest, gently squeeze
the shoulder blades together and rotate thumbs so that the palms face forward.
Hold for 5–10 seconds. Relax and return to the start position.
·
Repeat 5–10 times.
Finger climbing Wall
This exercise helps increase shoulder
movement. Try to reach a little higher up on the wall each day.
·
Stand facing the wall, about 5
cm (2 inches) away. Place both hands on the wall at shoulder level.
·
Use the fingers to climb up, or
slide hands up, the wall until you feel the stretch.
·
Return to start position.
·
Repeat 5–10 times.
Shoulder Abduction
This can be done lying on the floor or on a
bed.
·
Lie on back and extend arms out
at the sides.
·
Move arms up to the head and
down to the thighs and repeat (like making an angel in the snow).
Repeat 5–10 times
More advanced exercises
Once there is good movement in the
shoulder, you can try more advanced stretches. By the end of this stage, there
should be full movement of the affected arm and shoulder. Continue doing all of
the exercises until both arms are equally strong and move easily. This may take
2–3 months.
Remember Do not lift anything heavier than about 5
kg (10 lbs) during this stage.
Alternate side
bends
This exercise helps improve movement on
both sides of the body.
·
Sit in a chair and clasp hands
together on the lap.
·
Slowly lift arms over the head,
keeping elbows bent slightly.
·
When arms are above the head,
bend at the waist and move the body to the right. Hold 1–2 seconds.
·
Return to the centre, and then
bend to the left. Hold for 1–2 seconds.
·
Repeat 5–10 times.
Doorway
stretch open
This exercise helps increase shoulder
movement.
·
Stand in a doorway and place
each hand lightly on either side of the doorframe.
·
Slide hands up until you feel
the stretch.
·
Return to start position.
·
Repeat 5–7 times.
Second stage of healing
Exercise during this stage (beginning about
6 weeks after surgery) includes gradually introducing strengthening and general
conditioning exercises. Day-to-day household and recreational activities can be
introduced gradually.
Talk to the doctor or healthcare team
before starting a specific strengthening program or trying aerobic exercise
(exercise that gets the heart and lungs working hard). Check whether there are
any special precautions that you need to take. Report any pain, shoulder
tightness or swelling in the affected hand or arm.
When to start Strengthening ?
Slowly getting back to household chores,
gardening or yard work are some of the ways a person can continue to build
their strength after breast cancer surgery.
·
About 4–6 weeks after surgery,
women can usually start strengthening exercises with light weights (500 g to 1
kg or 1–2 lbs).
·
An unopened soup can or a
plastic bottle filled with water can be used instead of free weights
(dumbbells).
·
Check with the doctor or
physiotherapist to decide what weight is best. They can also suggest suitable
strengthening exercises for the upper body.
General
conditioning effect after doing exercise
Regular aerobic exercise will improve a
person’s general physical condition. It can help with recovery and has many
health benefits. Aerobic exercise can help:
·
improve cardiovascular fitness,
which is how well the heart, lungs and blood vessels deliver oxygen to the
muscles
·
maintain a healthy body weight
·
reduce stress and anxiety
·
people cope with cancer
Brisk walking, swimming, running, cycling,
cross-country skiing and dancing are all examples of aerobic exercise.
Weight
training and sports guideline.
Consider wearing a compression sleeve on
the affected arm when doing heavy weight training (using more than 4.5 kg or 10
lbs) or strenuous upper body sports, such as tennis badminton and rowing
.So let exercise to help you regain back the function and also strength. Wallahuaklam.