Breast cancer treatments can reduce mobility and cause pain.
For the more than 300,000 people who are diagnosed with breast cancer each year, therapies such as chemotherapy, radiation, lumpectomies and mastectomies can be lifesaving. But they can also be tough on the body.
Common side effects of treatments, even nonsurgical ones, include nerve damage, muscle loss and thickening of connective tissue throughout the chest and shoulders, says Leslie J. Waltke, physical therapist and founder of the Waltke Cancer Rehabilitation Academy, which trains oncological healthcare providers.
Meanwhile, surgery can sometimes involve cutting or removing parts of the pectoralis major muscle, which spans the chest and connects to the shoulder. Scar tissue and tightness in this area can negatively affect posture and result in frozen shoulder syndrome, a condition marked by aching pain and a limited range of motion that affects daily function, explains Ashley Adamczyk, a physical therapist who specializes in oncological rehabilitation at Rush University Medical Center in Chicago.
Restriction through the torso can also limit the ability of the ribs to move and the diaphragm to properly expand and contract for optimal breathing, Waltke says.
Experts share seven stretching and strengthening exercises that can help ease tightness, increase mobility and improve recovery in the chest and shoulders. For the best results, talk to your oncologist or physical therapist before beginning these or any other exercises that involve your upper body, especially if you are recovering from a lumpectomy or mastectomy. While helpful, any upper-body exercises should be properly timed and are generally discouraged in the first weeks after surgery.
Lying overhead reach
Breast cancer treatments can reduce overhead shoulder mobility, the ease at which you can raise your arms overhead, Waltke says. Ease into this stretch to help regain healthy movement. You should feel a gentle stretch in the front of you shoulders as well as your shoulder blades.
Instructions: Lie flat on your back with your feet on the floor, core braced and arms extended toward the ceiling. Lower your arms over the crown of your head toward the floor until they touch or nearly touch the floor. Hold for five seconds, breathing deeply throughout and not letting your back arch. Work up to 30 seconds.
This gentle stretch focuses on the sides of your chest where your pectoralis connects to your shoulder, Waltke says. It also engages the muscles surrounding your shoulder blades to encourage pain-free posture.
Instructions: Lie flat on your back with your feet on the floor, core braced, hands behind your head and elbows pointed toward the ceiling. Without allowing your back to arch, lower your elbows straight to the sides of your head until they touch or nearly touch the floor. Hold this position as long as it feels comfortable, starting with five seconds and working up to 30 seconds. Taking long, full breaths, allowing your abdomen and chest to inflate, will deepen the stretch.
This mobility drill lengthens the muscles of the core, sides and the spine, Waltke says. If you’ve spent a lot of time lying or sitting throughout treatment, the rotations will feel especially good.
Instructions: Lie flat on your back with your knees bent, shins parallel to the floor, core braced and arms straight out to your sides on the floor. Lower your knees straight to your side until they touch the floor. Try to keep both shoulders flat on the floor. Hold this position as long as it feels comfortable, starting with five seconds and working up to 30 seconds. Repeat on the opposite side. Breathe deeply, in through your nose and out through your mouth.
This stretch directly targets the chest, with the most intense sensation where the chest connects to the shoulder. This is an easy exercise to get carried away with, so focus on only moving as far as is comfortable, Adamczyk advises. Do not push to the point of pain.
Instructions: Standing next to a wall, extend your nearest arm behind you and place your palm on the wall. You may already feel a slight stretch in your chest and the front of your shoulder. Step forward with one foot to deepen the stretch. Hold. Start with five seconds and gradually increase to 30 seconds. Resist the urge to hold your breath.
Cross-body overhead stretch
Stretching the tissues through the sides of your torso and ribs (which are often restricted following surgery) encourages proper breathing mechanics, helping you take in more air with each breath, Adamczyk says. Better breathing can help both healing and energy levels.
Instructions: Standing or sitting, wrap one arm around your waist and raise the other above your head. Slowly reach the raised arm across your body toward your opposite shoulder. Focus on maintaining an upright posture and not just bending at the waist, but also actively reaching with your arm. Hold for five seconds and work up to 30 seconds. As you inhale, try to inflate your abdomen into your hand. Repeat on the opposite side.
Engaging and strengthening the upper back and rear deltoid muscles, this simple exercise helps prevent the hunched-over posture that can occur with tight chest muscles, Adamczyk says. If you don’t have a resistance band, you can still perform this exercise without gear. The key is to concentrate on squeezing your shoulder blades together as tight as possible as you move your arms to your sides.
Instructions: Stand tall and hold the ends of a light resistance band in front of you, elbows straight but not locked out. The band should be taut. Without allowing your back to arch or shoulders to lean back for momentum, squeeze your shoulder blades together to draw your arms out straight to your sides, stretching the band to match your arm span. Pause, then slowly return your arms in front of you. Start with one set of five reps and work up to three sets of 10 to 15. Exhale as you stretch the band, and inhale as you return your arms in front of you.
Some shoulder exercises, while being beneficial for strength, can contribute to wear and tear through the joint. This shoulder-raise variation is incredibly effective and carries a low risk of discomfort, Adamczyk says. No dumbbells? Two cans of food, or even filled water bottles, work just as well.
Instructions: Stand tall and hold a pair of light weights at your sides with your palms facing in. Without allowing your back to arch or shoulders to lean back for momentum, raise both arms diagonally in front of your body until they reach shoulder height, she says. Maintain a neutral “handshake” grip at all times. Pause, then slowly lower the weights. Start with one set of five reps and work up to three sets of 10 to 15. Exhale through your mouth as your raise the weights, then inhale through your nose as you lower them.
7 physical therapy exercises for better healing following breast cancer treatment:
1. Lying overhead reach.
2. Butterfly stretch.
3. Trunk rotation.
4. Chest stretch.
5. Cross-body overhead stretch.
6. Band pull-apart.
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