Advice and arm exercises following breast surgery. Breast Care Team

Transcription

1 Advice and arm exercises following breast surgery Breast Care Team Leaflet Ref: Published: 10/15 Review: 10/18 Page 1

2 Introduction This leaflet includes advice and arm exercises following breast surgery. Why are arm exercises important? Following breast surgery, it is important to begin to move your arm and shoulder as soon as possible. This is to prevent the development of a stiff joint and to regain your normal range of movement as it was prior to surgery. Gentle movements help to improve the oxygen supply to the area being moved. This promotes tissue healing and reduces pain. Exercise enables the wound to heal with the skin stretched and as pliable as possible, so that the shoulder joint is not restricted. You may experience some discomfort and soreness at first, as the tight structures begin to stretch. So, exercise gently within these limits. Be persistent, but do not overstrain. Frequent short periods of exercise are most effective. Perhaps five minutes every couple of hours to begin with. Muscles seize up very quickly if they are not used, so it is important to carry on doing these exercises until you have full pain-free movement in your arm. If, after six weeks, you have still not gained full shoulder movement, contact your GP who will refer you to a physiotherapist for reassessment. When you go home, avoid any heavy lifting, pulling or pushing. You may swim once your scar is healed. If your arm swells at all, try to rest with your arm on a pile of cushions so that it is slightly higher than your elbow and shoulder. Leaflet Ref: Published: 10/15 Review: 10/18 Page 2

3 On the first day after your operation Do each of these exercise five to ten times to begin with, gradually increasing to 20 in the days following your operation. If pain occurs, stop and relax the shoulders, take some deep breaths through the nose, expanding the tummy, then breathe out through the mouth. Begin by brushing your hair and cleaning your teeth using the affected arm. Correct your posture in front of a mirror. Make sure your shoulders are level and held back. Warm up squeeze and relax your hand straighten your elbow fully shrug your shoulders up and down gently rotate your shoulders in a circular motion. Early exercises Arm swings Leaning forward in the chair, or while standing, let your arm fall forward and feel heavy. Swing your arm backwards and forwards. Be careful to move from the shoulder and not from the elbow. Gradually increase the size of the swing as the joint loosens and movement becomes easier. Leaflet Ref: Published: 10/15 Review: 10/18 Page 3

4 Swing your arm across your body and out to the side. Lift your arm up away from your body when you swing out. Stirring the pot Similar to the preceding exercise, but draw a circle with the affected arm. Do this clockwise and anti-clockwise. Increase the size of the circle each day. Back drying exercise With a towel, or similar item, use a gentle back-drying motion. Start with your unaffected arm at the top and draw the affected arm across your back. This will stretch the front of your shoulder. Then repeat starting with the affected arm at the top. Leaflet Ref: Published: 10/15 Review: 10/18 Page 4

5 Many women find it comfortable to sleep with their arm resting on a pillow. It is important to continue with the exercises, as they will help reduce the swelling. Shoulder rolling Place your hands on both your shoulders and circle your elbows. Increase the size of the circle each day. Make sure that you move both backwards and forwards. Shoulder lifting Use the non-affected arm to assist the movement of the affected arm and progress to lift over your head. You should feel a stretch around the shoulder. Begin gently, but try to progress quickly to a larger stretch, as you feel able to do so. You can first do this exercise lying on your bed. As the exercise gets easier, progress to clasping your outstretched hands together and lifting them above your head. Then try this exercise while sitting and then while standing. Leaflet Ref: Published: 10/15 Review: 10/18 Page 5

6 Hands behind your head Put both hands behind your head and brace your elbows back. Hands behind your back Put both hands behind your back, as if to fasten your bra. Later more complex exercises Wall reaching Stand, feet apart, facing a wall with your heels down. Stretch your unaffected arm up the wall as far as you can go. Mark the point you reached on the wall. Crawl the fingers of the affected arm up the wall, within the limits of any pain. Mark the point you reach and try to increase the height reached each day, until eventually your affected arm comes level with the unaffected one. Leaflet Ref: Published: 10/15 Review: 10/18 Page 6

7 Rope pulling Throw a rope or dressing gown cord over the top of an open door. Sit with the door between your legs. Hold one end of the rope in your affected hand and gently pull the other end of it with your unaffected hand. Raise your arm as high as possible each time until you attain full elevation. Rope string exercise Attach a length of rope or string to the doorknob or handle. Make small circles with it, moving the entire arm from the shoulder. Do this five times in one direction and five times in the other. Gradually increase the number and size of the circle by moving in closer. Special care of the arm Taking sensible care of your hand and arm on the side of your surgery may reduce the risk of swelling of the arm (lymphoedema). This may occur if you have had your lymph nodes surgically removed from under the arm (axilla) or have had a course of radiotherapy. Leaflet Ref: Published: 10/15 Review: 10/18 Page 7

8 It is very important to avoid cuts, scratches, burns and insect bites, as well as any trauma or injury to the affected arm. Protection against swelling of the arm Exercise and skin care can help to protect against swelling of the arm. Exercise Muscle activity will help stimulate lymphatic flow, so continuing the exercises and using your arm as normally as possible will help. Skin care Any break in the skin may become infected and increase the risk of swelling. Cuts and scratches must be well cleaned. Avoid having injections or acupuncture in the affected arm. Avoid having blood taken from the affected arm. Wear gloves when gardening, cleaning, using harsh chemicals or wire wool. Use an electric razor or depilatory cream for removing underarm hair. If any redness, swelling or warmth remains longer than 24 hours contact your GP. Leaflet Ref: Published: 10/15 Review: 10/18 Page 8

9 Useful information These can be obtained free of charge from various organisations, and include: Breast Cancer Care Freephone Macmillan Cancer Support Freephone am to 6pm, Mon to Fri or Further information and support If you would like further information or support, please do not hesitate to ask the doctors or contact the Breast Care Nurses: Nichola van der Ploeg Denise Hamer Victoria Adinkra Helen Smith or phone the hospital switchboard on and ask for the ward where you were staying. Leaflet Ref: Published: 10/15 Review: 10/18 Page 9

10 For further information on the references and sources used for this leaflet, please contact Comments, compliments or complaints We welcome any suggestions you have about the quality of our care and our services. Contact us: Freephone: Phone: Textphone: Customer Care, Reception, Macclesfield District General Hospital, Victoria Road, SK10 3BL For large print, audio, Braille version or translation, contact Communications and Engagement on East Cheshire NHS Trust operates a smoke-free policy (including e-cigarettes) For advice on stopping smoking please contact our Stop Smoking Service on East Cheshire NHS Trust does not tolerate any form of discrimination, harassment, bullying or abuse and is committed to ensuring that patients, staff and the public are treated fairly, with dignity and respect. We welcome user reviews of our leaflets. Please share your comments, reviews and feedback with us by sending to ecn-tr.patientinformation@nhs.net Leaflet Ref: Published: 10/15 Review: 10/18 Page 10