A number of complications can arise after a mastectomy. One of these complications is impaired hand mobility from the side of the operation. A set of special exercises that the patient needs to start doing while still in the hospital, as well as massage and physiotherapy procedures, helps to restore mobility.

After surgery to remove the mammary gland, the woman undergoes a rehabilitation course. It usually consists of several components:
physiotherapy exercises;

• massage;
• psychological recovery;
• breast reconstruction;
• drug treatment;
• physical procedures.

For the first times after the operation, it is very difficult for a woman to perform even the simplest exercise therapy... But you shouldn't give up gymnastics. It is necessary to conquer yourself, and start doing exercises, in addition to performing them regularly.

Often, after breast removal, a woman begins to slouch and lower her shoulders to hide the consequences of the operation. As a result, this only complicates the situation, since such actions lead to a curvature of the spine or chest. The already difficult condition in the postoperative period is complicated by depression.

Gymnastics after mastectomy performs therapeutic and prophylactic action:

• helps to restore hand mobility;
• does not allow curvature of posture, drooping of the shoulders, and so on;
• eliminates pain that occurs in the arm, back or neck due to muscle strain.

Warming up muscles

The set of exercises must be started with warming up. Muscles need to be prepared for exercise. If you load the body from the very beginning, then it will do more harm than good. Do the following exercises to warm up:

1. You need to start with the fingers of the hand. Sit down and put your hands on your knees. Squeeze your fingers as tightly as possible into a fist, and then unclench and be sure to relax your hands.
2. Continuing to sit, raise your palms to the top, and then lower them. Keep your fingers relaxed while doing this exercise.
3. Place the cysts on your shoulders. Raise your elbows forward and up, then lower. Follow correct breathing and move very slowly.
4. There is no need for haste in this movement either. Lower your hands at the seams. Slowly lift them up and sides, and then lower them.

A set of basic exercises

After the warm-up, the muscles are prepared for heavy loads, so you can start performing more complex exercises:

1. Press your hands to the body, lowering them down, for 2-3 seconds, then relax.
2. Pull your hand forward, then to the side, then lower it. Perform the movements slowly. When raising your hand, inhale, and when lowering, exhale.
3. Place the hand on your shoulder, and make circular motions with your elbow to one side and then the other.
4. With your hands down, join them behind your back. Try to reach your shoulder blades. Do the exercise very slowly.
5. With the shoulder joint, make circular movements in one direction and the other. In this case, the hand should be lowered.
6. Raise the affected hand up. This can be done while sitting or standing. The exercise is very difficult at first, so you can support the hand with your good hand.
7. While standing, bend over to the side of the operated breast. Hold for a couple of seconds and get up. When tilting, inhale, when lifting, exhale.
8. Lean your back against the wall. Spread your arms out to the sides. While raising, hold up for 2-3 seconds, then lower slowly.
9. Stand against the wall. Stretch your hand up from the side of the operation. Mark the point to which you managed to reach. With each successive time, this point should move higher and higher.
10. Take a stick, 60-80 cm long, in your hands. Raise the stick to shoulder level. Make sure that the stick rises horizontally evenly.
11. With a stick in hand, make turns to the right and left. Increase your range of motion each time.
12. Sit down and put your hands on your knees. Pick up the stick from the bottom. Raise the stick to the top. At the same time, bend forward. After take starting position.
13. Take a stick and lift it up. After that, wrap the stick behind your back. If you don't have a stick, you can use a towel to do this exercise and pull it between your hands.
14. Raise your arm from the operated side up. Bend it at the elbow, then take your elbow to the side.

The final part

At the last stage of the exercise, relaxation occurs, as well as restoration of breathing. To do this, follow these steps:

1. Breathe in deeply and exhale slowly while straightening your shoulders.
2. Stand up straight, bend over straight and lower your arms, relaxing them.
3. Raise your arms up as you inhale, then slowly lower your arms as you exit. Relax your arms.

Massage - an aid

Massage will help enhance the effect of gymnastics and speed up the process of restoring hand mobility. It will be much better if a specialist does a therapeutic massage. But if there is no opportunity to turn to a professional, do the massage yourself.

By the way, massage not only helps to restore hand mobility, but also prevents the development of another complication after mastectomy - lymphostasis.

At self-fulfillment massage, do light stroking movements without pressure on the tissues of the hand. Movements can be along the arm from the fingertips to the shoulder, or circular around the arm. In some cases, a special cream or oil is used for massage.

Massage helps restore muscle mobility, normalize blood circulation and lymph drainage.

Gymnastics after a mastectomy is one of the most important milestones rehabilitation. The first exercises must be performed already a few days after the surgery. In order for physiotherapy exercises to give visible results, it is necessary:

1. Start training almost immediately after the operation.
2. Start with simple movements. Remember to gradually increase the difficulty and amplitude of the exercises.
3. Increase the number of exercises performed, gradually increasing the load. In this case, it is advisable to consult a doctor or specialist.
4. For correct posture perform movements not only on the arm from the operated side, but also on the healthy arm. Usually exercises are performed with two hands or alternately.
5. Start with 10-12 reps.
6. Do not postpone the exercise if it is difficult.
7. Do remedial gymnastics daily. It is advisable to do this at the same time.
8. Perform all exercises slowly. Do not make sudden movements that could harm you.

Be prepared for things that won't be visible at first. visible results from exercise. But the sooner you start doing gymnastics, the less time it will take for rehabilitation. Exercise is good for dealing with arm or shoulder problems after breast surgery. No matter how difficult the exercises are, do not stop doing them. Otherwise, the rehabilitation period will drag on.

A set of exercises, as well as other rehabilitation actions, help a woman recover both physically and psychologically after breast surgery.

It is constantly growing. This disease is dangerous, which is why appropriate measures should be taken in a timely manner. Operation is often the only option.

Removing the breast is called a mastectomy. The reasons for using this method of treatment are the high probability of complications, up to the death of the patient. Timely diagnosis at the initial stage and treatment is a guarantee of complete healing. After a mastectomy, there are a number of consequences that cannot be avoided. However, there are activities aimed at the rehabilitation of mental and physical condition women.

Complications and their causes

Awareness of the consequences of the operation often causes feelings of fear and depression, but in addition to psycho-emotional decline, other complications are possible due to the trauma of the operation:

• suppuration of the wound (accession of infection);
• scar formation at the sites of surgical sutures;
• violation of posture due to changes in the load on the spine;
• phantom pain and pain syndrome in the shoulder joint (its stiffness and muscle tissue atrophy);
• lymphostasis, expressed by edema, numbness and trophic disorders in the hand.

The frequency of such complications does not always depend on the severity of the underlying disease. Among the factors contributing to their occurrence, it is necessary to highlight the lack of awareness of patients about the possibility of treatment and rehabilitation.

Life after surgery

Approximately 25% of women operated on have severe depression (difficulty reconciling with their appearance, breast loss, fear of relapse). During this period of her life, a woman needs special support from loving and understanding relatives. Their patience and faith in recovery is what will help her cope with all difficulties.

What can be done to get life back on track when the operation to remove the breast is behind? Take care of the upcoming changes in the postoperative period. Health should come first, you should:

• change the daily routine (sleep for 8 hours, eat on time, take a warm shower, directing the stream to the place after the operation);
• be careful about the hand on the side of the operated breast: do not strain it, do not wear heavy, do not lie on it, do not hold it down for a long time, do not squeeze, do not wash with hot water, and also avoid injuries, bruises and bites;
• refrain from bad habits in food and drinks, consume more vitamins and less fat;
• take a course of exercise therapy, massage and visit the pool;
• communicate more, visit a psychologist if necessary;
• do not miss visits to your doctor.

If there are no contraindications, over time (when it will be passed full course rehabilitation), you can do breast reconstruction surgery. What methods of this procedure exist, read the link.

Psychocorrection of depression

Women who have undergone mastectomy tend to exaggerate the cosmetic consequences of the operation, negatively assess their appearance, and focus on the, in their opinion, the attitude of those around them that has changed.

Psychotherapy is carried out in natural conditions of group communication with the same women, allowing you to remove the inferiority complex and believe in recovery. Work with patients is carried out in an extremely tactful mode and helps to accept the fait accompli of the operation as an episode of a past life, and not an oppressive state for the whole future life. It is important to learn to relax, to rejoice at the opportunity to live on. Finding something “to your liking”, a hobby and being more in public - the main thing is to do everything that prevents self-isolation and immersion in thoughts about the disease.

A special place in overcoming depression belongs to natural and climatic factors during spa treatment. Getting into a new environment, patients quickly get out of a difficult stressful situation.

Gymnastics

In the first 7-10 days after a mastectomy, it is important to do special restorative exercises. This is necessary to maintain posture and normalize general condition... During classes, it is necessary to breathe correctly, cough, turn and sit down. This should be taught by a doctor or nurse. To achieve the result, the exercises may be easy, but they must be done many times a day. These include "combing the hair" with the operated hand and "straight posture" (while standing with your back to the wall, you should try to touch it with the back of your head, shoulder blade, buttocks and heels).

Exercise therapy (physiotherapy exercises) after mastectomy for the first time should be carried out under the guidance and supervision of an instructor.

To restore the mobility of the sore arm, you can perform gymnastics (lifting, swinging, pulling back).

Approximate set of exercises:

1. Place your hands, palms down, on your knees, straightening at the elbows, turn upward without straining your fingers. In the same position, tightly clench / unclench your fingers into fists.
2. Place your arms bent at the elbows on your shoulders with your palms, slowly raise and lower.
3. Make rocking movements with your hand, leaning slightly towards the operated part of the body.
4. Raise your hand up, hold for about 10 seconds, lower it.
5. Make slow circular movements in the shoulder joint, alternately - forward / backward.

Below in the video, a metadist instructor demonstrates exemplary complex exercises for patients after breast surgery:

Massage

Massage is mainly used for the prevention and treatment of lymph congestion, after removal of the lymph nodes during mastectomy. It can be manual, hardware and canned. Manual can be done independently or with the help of relatives.

Hand
lifted up and supported on a vertical surface. With the fingers of the second hand, stroke the first, starting first from the shoulder to the elbow, then from the fingers to the shoulder. Smooth movements perform slight pressure on the fabric, but excluding unpleasant sensations. The massage is repeated several times a day for 5 minutes.

Pool

Classes in the pool are called hydrokinesis therapy and there are full-fledged rehabilitation courses where water is considered as an alternative therapeutic agent. Water affects all body movements, facilitating exercise and strengthening health-improving effect... But even simple swimming, in any comfortable style, has a beneficial effect.

Despite the benefits of such activities, many women avoid going to the pool due to shyness and unwillingness to appear in public without clothes. To make them feel attractive, there are special mastectomy swimwear on sale.

Carrying out comprehensive rehabilitation measures will ensure a quick recovery and a woman's return to normal life. This video compiles the stories of four women who underwent a mastectomy for breast cancer:

photographee.eu/depositphotos.com, Karuka / depositphotos.com, olly18 / depositphotos.com

According to statistics, one in eight women on this planet can get breast cancer. This disease can be fatal if left untreated.

In addition to cancer, a woman's breast is susceptible to other diseases of a tumor nature:

• fibroadenomas;
• papillomas;
• cysts.

They are all treated with:

• chemotherapy;
• radiation therapy;
• folk remedies.
• mastectomy.

Consequences of a mastectomy

Mastectomy is a surgery to remove tumors that affect breast tissue. There are several types of mastectomy:

The first two types of mastectomy are used quite rarely: in the most advanced cases of infiltrative cancer and its recurrence.

The last two are used much more often, as women do not want to be breastless.

That is why scientists are busy developing more gentle methods of treating breast cancer, and doctors often offer a course of radiation therapy before removal. The fact is that after radiation the tumor is significantly reduced, this allows you to choose a more gentle type of mastectomy.

It is good if the course of radiation therapy has been completed and the tumor has shrunk to an insignificant size, or the disease was detected on time, and the neoplasm was removed with the help of gynecomastia - then rehabilitation will not take much time. It will be necessary to exclude heavy loads and use various ointments so that the scars heal faster. When more severe methods were used to treat breast cancer, patients need more time to recover from surgery, as a lot of complications can arise:

During rehabilitation, you need to perform special exercises... Sometimes massage courses can be prescribed. A set of exercises for the patient is selected by the doctor. They are designed to stretch and strengthen pectoral muscles, acceleration of blood circulation and lymph circulation. In addition, exercise helps to improve overall well-being, align posture, and eliminate mobility problems. shoulder joint if required.

Therapeutic gymnastics and massage

Exercise therapy - therapeutic physical education... It is very often prescribed to patients for recovery after various operations, including mastectomy. Gymnastics after a mastectomy may include the following set of exercises:

Each of the exercises should be performed 6-8 times. You can do more if you feel good. It is not uncommon for doctors to prescribe a set of stationary bike and swimming pool exercises, usually performed with a protein diet that eliminates the following foods:

Sweet and confectionery products are significantly limited.

• dairy;
• fish;
• meat (lean meats and poultry);
• vegetables and fruits.

One of the complications that most often affects patients during rehabilitation is hand lymphostasis. Its appearance is provoked by a radical mastectomy. During this condition, one or two hands become swollen and enlarged. Often lymphostasis complicates the movement of the hands. Sometimes the disease is complicated by erysipelas.

Violation of lymph flow is observed in the first days after surgery. To relieve unpleasant symptoms and eliminate the disease, they are prescribed:

The massage of the affected hand is first done by specialists, then independently, using cooling and warming ointments.

Together with this procedure, you must take special drugs and perform a set of physical exercises. Massage promotes the therapeutic effect of venotonic drugs and helps to completely eliminate the disease.

1. Stroking.
2. Kneading.

Before doing a massage, the sore hand should be smeared with a healing gel and kept in an upright position.

Other methods of breast reconstruction

Breast reconstruction after mastectomy is not only about gymnastics and massage. After surgery, women want to restore the attractive appearance of their breasts. To do this, first of all, you need to stretch the skin on it. Means for stretching the skin of the breast:

There are silicone and saline implants:

1. Silicone implant. Simulates the likeness of a breast as much as possible. Implanted under the skin, it does not differ at all from a real breast.
2. Saline implant. The silicone rubber shell is filled with brine. A breast with such a prosthesis always has a rounded shape, sometimes it can wrinkle, therefore it is easy to distinguish it from a real breast. But the cost of such an implant is cheaper, and the rupture does not pose a danger to the owner.

If a mastectomy was performed without preserving the skin of the nipple, then a tattoo is drawn on the chest, imitating the areola and nipple.

If you follow all the doctor's prescriptions, rehabilitation after breast cancer treatment is much faster. Recovered women will be able to return to their usual way of life, forever forgetting about the past illness.

After completing courses that include massage, drug treatment, exercise therapy, patients usually completely get rid of the disease, although side effects in the form of lymphostasis or erysipelas. But, unfortunately, lymphostasis is not the most a big problem that occurs after cancer has been treated with surgery.

The above methods are very effective for physical recovery after cancer treatment, but what to do if the patient is having a difficult psychologically, since almost all of her mammary gland has been removed? Immediately after the removal of most of the mammary gland, a woman often needs the help of a specialist, since there are various psychological disorders, depression, and an inferiority complex. And this is not surprising.

After all, she remains disabled, feels discomfort from an aesthetic point of view, and therefore in communication with the opposite sex, which significantly reduces the chances of getting married and having a child, if this has not happened yet.

After surgical recovery and visits to a psychologist, performing exercise therapy and massage, the condition of the patients is normalized, they can again live a full life: build relationships, get married, and learn the joy of motherhood. It should be noted that pregnancy and childbirth are not only the best prevention of breast cancer, but also the best method physiological and psycho-emotional recovery of a woman after an illness.

This guide is for women who have undergone axillary lymphadenectomy when developed by the Breast Tumour Group at the B.C. Cancer Agency to help you during your rehabilitation after surgery.

What should be done after lymphadenectomy? Even before the drain is removed, you can begin to gently move your shoulder. Once the drain is removed, it is important to start working on fully restoring shoulder motion.

Initial Postoperative Exercise (Days 1-6)

Shoulder shrug and rotation (performed while sitting or standing)

• Raise both shoulders up to the ears and then lower them down, relax.
• Bring the shoulder blades together. Hold and then relax.
• Perform gentle circular movements with the shoulders forward and up, and then back and down. Repeat the rotation in the opposite direction.

Shoulder movement exercises

• Raising the arm: Close your hands together in front of you, move your elbows to the sides, raise your arms up until you feel a slight tension. Linger at the top point, then slowly return to the starting position.
• Lying on a bed or on the floor with arms bent at the elbows, imitate wing flaps (hands slide over the surface).
• In a standing position, carefully pull the hand back from the operated side until you feel discomfort. Try waving your hand a little while walking.

Read also:

Static exercises (sitting or standing position)

• Place the hand on the operated side on the opposite shoulder and press gently. Hold for 5 seconds.
• Put your hand from the operated side to the opposite bent knee and press gently. Hold for 5 seconds.
• Perform these exercises in the first week of drainage, twice a day, starting with 3 reps and gradually increasing the number of reps to 10.
• You will feel some pulling and stretching feeling in the scar area as you do these exercises.
• Slow stretching exercises are most effective when held for 15 to 20 seconds.
• Breathe deeply and often as you exercise.

Exercises that can be done starting 7-10 days after surgery

"Chicken wings" (lying on your back, hands behind your head)

• Raise your elbows up, try to touch your elbows together at the level of the nose. Hold this position for 15 seconds.
• Pull your elbows back, try to touch the surface of the bed or floor. Hold this position for 30 seconds.

Stick exercises:

• Lying on your back, hold a cane or long stick with both hands shoulder-width apart. Bend your knees, feet flat on the floor. Raise the stick evenly over your head, trying to touch the floor. Then bend your elbows and try to lower the stick down behind your head.
• Starting position standing. Hold the stick behind your hips and try to gently lift up to the middle of your back.

"Door stretch":

• Stand in the doorway, touch the doorframe with your hands, raise your hands as high as possible, smoothly sliding your palms along the doorframe.

Read also:

"Up the wall"

• Face the wall, elbows bent thumbs legs a few cm do not reach the wall. Place your palms on the wall at shoulder level. Move both hands smoothly up the wall until you feel some stretch or discomfort at the site of surgery. Use pencil marks to see progress.

Wave your hands (in front of the mirror)

Try to "work" with your hand from the operated side, as well as the healthy one.

• Swing two arms forward and overhead as far as possible
• Swing both arms to the sides and overhead as far as possible
• Close your hands together and raise them above your head. Bend over to the non-operated side to stretch chest and the armpit of the operated arm.

For balance and posture, and to assess normal level of movement, do the exercises with both arms at the same time. Watch your posture and movement in the mirror. To maintain good posture, it is sometimes useful to walk with your hands clasped behind your back, bringing your shoulder blades together.

Continue doing these exercises until the range of motion of both arms is the same. This can take 2 to 3 months. Shoulder mobility can be considered fully restored when you can touch the opposite ear over your head without feeling tension in the armpit.

Anchoring

Within 4-6 weeks after the operation, you can start exercises using a load (0.5 to 1 kg) (for this you can use plastic bottle filled with pebbles or sand).

Some physiotherapists advise lifting up to 2.5 to 5 kg for 6 weeks after surgery.

Start by working out the biceps (biceps) by holding a 0.5kg weight on your outstretched arm (palm up) to the side and bending your arm up toward your shoulder. To stretch the muscles of the triceps (triceps) muscle, slowly lower your arm downward with a load.

Do 8-12 reps at least twice a week.

Other ways to “fix” include gradually resuming normal household chores, gardening, childcare, and entertainment (after 6 weeks). From the first day after surgery, try to use your arm as usual, however, without overworking, to Everyday life(washing dishes, brushing, eating). However, avoid using your hand as a support when getting up or lying down in bed and sitting down or getting out of a chair. Use pillows to raise and support your arm when sitting or lying down. Avoid sudden, sudden movements until the incision has healed and the drain has been removed.

When doing exercises with a load (more than 5 kg) or activities where the upper body is involved (for example, skiing, canoeing, kayaking, tennis or bowling), use an elastic sleeve on the operated arm (or wrap it with an elastic band). slimming sleeve to fit.

Scar tissue massage

About a month after surgery, when the postoperative scar has healed and is no longer too sensitive, you should begin daily massage of the scar tissue with your fingertips. Use aloe lotion or any lotion of your choice. Use your fingertips in deep, circular motion along the scar to loosen the scar tissue.

Continue to massage the scar for a year or two after surgery to prevent muscle congestion under the scar.

To reduce your risk of developing irreversible lymphedema:

Maintain your ideal weight(obesity is a risk factor for developing lymphedema)

You cannot measure blood pressure, as well as do injections or vaccinations on the operated arm.

Keep your skin clean and avoid wounds, burns, or infection on your operated arm.

Wear elastic sleeve when lifting heavy weight or do strength exercises on upper part body (skiing, rowing, tennis).

Exercise after breast removal plays a big role in the recovery of the body. The postoperative period after removal of the mammary gland is difficult for a woman. From the side where the surgery was performed, the hand is limited in movement, the woman is worried about difficulty breathing and stoop. To prevent Negative consequences, it is recommended to engage in physiotherapy exercises as a preventive measure.

Basic principles

Surgery is the main treatment for breast cancer. Any operation on the chest leads to difficulty in movement, and the quality of life for women deteriorates. They are unable to complete everyday household chores. It becomes difficult even to comb the hair.

Physical education will help a woman regain a full life. Please note that all exercises must be approved by your doctor.

You can start practicing immediately after the operation. But some exercises, in which you need to raise your arms up, are performed only after removing the drainage.

Not doing therapeutic exercises can lead to the development of negative consequences:

Poor posture, development of diseases of the spine;
painful sensations in the shoulders and arms due to muscle strain;
depression.

The first days of gymnastics will be very difficult. But all painful sensations need to be overcome and not to give up. It is necessary to exercise regularly. The increase in loads can be done only gradually and under the supervision of specialists.

Warming up

Warming up muscles is an important stage in physiotherapy exercises. It is dangerous to neglect this step. An unprepared body that receives heavy loads can quickly fail. This will lead to the fact that the rehabilitation process will take longer. In addition, stretching helps prevent tissue swelling that occurs due to surgery. Warming up includes five exercises:

1. Sit on a chair with your palms on your lap. Try to clench your fingers into fists as tightly as possible. Repeat 8-10 times.
2. Sitting on a chair, slowly raise your arms upward, palms facing upward. Please note that during the exercise, the fingers should be relaxed.
3. In a seated position, place your hands on your shoulders. Gently lift your elbows up as you inhale. Movements should be made as slowly as possible, while not forgetting to monitor posture and breathing.
4. This exercise must also be done with great care. Hands need to be lowered at the seams. Slowly lift them to the side and lower them down again.

By doing these simple exercises you give the body minimum load and do not harm him.

Main complex

After preparing the body, you can proceed to more complex loads:

1. Lower your arms along your body, press them to your torso for two or three seconds, then relax.
2. Raise your hands forward, then spread them to the sides and lower. We perform the exercise smoothly, without jerking. When raising our hands, breathe in air, lower it on exhalation.
3. We put the brush on the shoulder and make circular movements with the elbow, first in one direction, then in the other.
4. The next exercise should be done very slowly. Put your hands behind your back and try to gently reach your shoulder blades.
5. Lower your arms along your torso, do circular motion shoulder.
6. Gently raise your hand up from the side of which the operation was performed. At first, the movement will be given with great difficulty. At first, you can help with your healthy hand.
7. In a standing position, tilt from the operated side. When bending down, inhale, when returning to the starting position, exhale.
8. The next exercise should be done while standing with your back against the wall. Spread your arms out to the sides for a few seconds and slowly lower them.

You can use sports equipment for classes:

• take a stick no more than a meter long, while standing, raise the stick to the level of the collarbones;
• perform turns with a stick in your hands, you need to start with small amplitudes, gradually increasing them;
• lift your hands with a stick up, gently tilt in both directions;
• with raised arms, make turns to the right and left, we hold the stick in our hands above our head.

Please note that when doing physiotherapy exercises, it is very important to perform all the movements. slowly... The pace must be increased gradually. When removing bilateral breast cancer, gymnastics is done on both hands at the same time, or alternately.

The final part

The set of exercises must be correctly completed in order to restore breathing and relax the muscles. This is the main stage of physiotherapy exercises. The final exercises include:

• breathe deeply and evenly, relaxing your shoulders;
• bend forward, hands should be relaxed;
• raise your arms as you inhale, as you exhale, lower them down.

The sooner you start to engage in physical education for recovery, the faster this period will pass. You need to do the exercises daily, pain should not be the reason for the pass.

The exercises will help to eliminate the failure in the motor activity of the hand. The complex effectively affects not only the physical, but also the psychological state of a woman.

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