Exercises after surgery for breast cancer - transcript

Physiotherapist: These exercises should help you regain your arm and shoulder movement following breast cancer surgery. They may not be suitable if you have had a reconstruction. If you are unable to do these exercises please contact your health carers.

Knock at the door

Woman: Come in

Physiotherapist: Hello there

Woman: Hello

Physiotherapist: Hello, hi, my name is Nicola, I am one of the physiotherapists. Do you mind if I come round and go through your exercises with you?

Woman: Oh no of course not

Physiotherapist: Thank you very much

Woman: I have been expecting you

Physiotherapist: Have you, oh OK. Well what we would like to do now is just try and get this arm moving OK. I am going to go through some exercises for your arm and for your shoulder, OK. Unfortunately it can be a little bit uncomfortable in the armpit and across the chest when you have this type of surgery. So some people are quite reluctant to get that arm moving but obviously it is really important that we get you to have full range of movement as soon as possible and also get you back to all the activities that you were doing before

Woman: OK

Physiotherapist: OK and back to your housework as well

Woman: Oh well I am not so keen

Physiotherapist: Not so keen, OK. It is also really important that we get your arm moving well so you can have your radiotherapy. Sometimes for having radiotherapy you need to have your arm up over your head. So that’s quite a stretch that you may need to build on

Woman: Right

Physiotherapist: OK and it is also really important that you do these exercises for the next couple of months especially after your radiotherapy because problems can sometimes occur a little bit further down the line

Woman: Right

Physiotherapist: OK, what we are going to do now is we’re going to go through the exercises. So if I just take this pillow away, OK. It’s really important that you try and use this arm as normally as you possibly can over the next couple of weeks. These exercises are perfectly safe to do in the first couple of weeks after your surgery. And obviously at the moment you’ve got your drain in, be aware of it but you can still do these basic exercises. What we don’t want you to do is lift your arm above shoulder level if you can help it.

Woman: Right

Physiotherapist: OK, when I say shoulder level, it is where your elbow is in relation to your shoulder. So you can think about having your arm up, only until your arm is level with your shoulder. OK and you can do that out to the side. So you should still be able to do your hair, or put a hat on or anything like that. OK but we don’t want you taking your arm up higher than that at the moment. OK, can you do that in both directions, for me?
Physiotherapist: That’s it. Good

Woman: Enough?

Physiotherapist: Yep, and then come back down. And then come out to the side. This can be the one that pulls a little bit in the armpit, don’t be afraid of it. That’s it, good, well done, and then come back down again. OK, that just shows you what you can do with that arm. And now the exercises. The first exercise – the shoulder shrugs. So just relax the shoulders first, to begin with

Woman: OK

Physiotherapist: These exercises can be done either in the bed, or sat in the chair or standing it doesn’t matter. I want you to bring your shoulders up towards your ears, and then relax them down, OK. Come up again, and then relax down. Good once more, and relax. OK you going to that 10 times and maybe try and do it 3 to 5 times during the day, OK

Woman: Right

Physiotherapist: OK, the next exercise is very similar, it’s shoulder circles. So now with the shoulders relaxed, take your shoulders up and then roll them back and down, good and again. That’s it, once more. Good and now can you change direction so you are coming forwards first so you are rolling them up and forwards. Once more and then relax. OK, if you can do that 10 times in each direction and again try and do it 3 to 5 times a day, OK.

Voiceover: Try to repeat these shoulder shrugs and circles throughout the day. Think about doing them whilst you are doing other things such as watching the television or when you are waiting for the kettle to boil.

Physiotherapist: At the start of the second week following your surgery you should try and push that arm a little bit further. You should try to continue with the shoulder shrugs and the shoulder circles that you were doing in the first week but now also try this next set of exercises to lift your arm above your shoulder

Voiceover: Lean with your back up against a wall. Gently lift your arms up over your head. You should be aware of a gentle stretching sensation in your armpit and across your chest wall. Now bring your arm back down to your side. And repeat this 10 times.

Stay in the same position but now take your arm up and out to the side, it is normal to feel a stretching sensation. Again repeat this 10 times and do both sets of exercises 3 to 5 times a day.

Now lie on your back on a firm surface. You may have a folded towel or cushion underneath your head. Place both hand behind your head so that your elbows are pointing up towards the ceiling. Slowly let your elbows fall gently out to the side. Repeat this movement 10 times and on the last movement hold for a slow, deep breath in and out. Try to repeat this exercise 3 to 5 times a day. You can carry doing these exercises during your course of radiotherapy.