HEATHER, athlete and personal trainer: While breast cancer surgery results in significant trauma to the body, the days of limited rehabilitation and restrictions of all exercise are gone. In fact, it is imperative that your physical therapy begins almost immediately post surgery. Without exercise, three common problems can occur - frozen shoulder, back pain, and lymphedema.

Because there is a removal of tissue and incisions are made in the breast and chest regions, there is a chance for the development of scar tissue. The more scar tissue your body produces that you do not manage to break up through exercise, the greater the risk for the development of a frozen shoulder. Your physical therapist will give you exercises to do while in the hospital and for the initial stages of your recovery. They will include movements to increase range of motion and flexibility, and as you recover, you will begin to incorporate strengthening exercises as well.

The next area you must focus on is your back. Your body will attempt to protect itself by slumping your shoulders thus putting your body in a poor postural position. This, in turn, leads to back pain. Not only must you continue working on the flexibility in your chest area, but you need to focus on strengthening your rhomboids, traps, and lats. Exercises such as the row, lat pulldown, and pullover will help develop these areas. Also remember that posture is 80% awareness and 20% strength so take the time to recognize poor positioning and correct it.

Finally, some treatments require the removal of lymph glands which are the filtration system for your body. To limit lymphedema, try to stay away from excess pressure on the effected area, keep your arm elevated to prevent swelling, and be vigilant in expanding your range of motion in that area. Your first six weeks post surgery will be spent minimizing scar tissue with range of motion exercises. After you have received clearance from your physician, the strengthening phase will begin. Remember to provide progressive resistance to your workouts and don’t be afraid to challenge your body by reincorporating exercises you were doing pre operatively. If you are unsure of how to proceed, feel free to drop me a line or enlist the support of another health or fitness professional. Posted October 01, 2003 03:08 AM