Exercise under mastectomy constraints
June 12, 2020 11:19 PM   Subscribe

What exercise can I do immediately post-mastectomy (once surgeon says it's safe to be active, but not to carry any weights or stretch my arms at all)?

I've been exercising in response to coronavirus isolation stress. Stationary bike, yoga, rowing, dancing. It is great and it will suck to lose the flexibility and progress when I get a double mastectomy.

I will follow surgeon's orders as to my limits, but once she says it is safe to be active as long as I'm not carrying or putting any weight on my arms, and not stretching my arms/chest at all (like I still won't be able to put a tee shirt on unless it buttons down the front, I can't raise my upper arms away from my body like at all), I'm not sure what else I can do except walk?

Does anyone have experience or suggestions?

Stationary bike requires arm stretch to mount and sometimes for balance. I'm guessing a physical therapist is out as this area will still have coronavirus and I want to limit contact while healing just in case, although I might be able to at least talk to one over telemedicine. Thank you.
posted by anonymous to Health & Fitness (7 answers total) 1 user marked this as a favorite
 
I have no experience with major surgery but do a lot of random exercise; my suggestions should probably be vetted by a PT through telemedicine, but I'm going by 'how would I exercise if I had to keep tennis balls in my armpits'.

On top of that, a consideration is not just to find exercises that don't use the arms in the exercise itself, but don't use the arms to get you started, to get you into position, won't tempt you to use your arms to break a fall, etc.

1. Jump rope, if you're already good at it? You keep your upper arms glued to your torso.
2. Leg press machine, if you have access to one? Normally they're nonsense because you could just do squats, but this seems like a great reason to use them.
3. Failing that, bodyweight squats and lunges at a slow enough pace that you're not using arms to counterbalance?
4. Supine leg lifts / 'low boat' for the core?

And I mean, dance teachers aren't kidding when they say dancing is just walking -- e.g. you can work on salsa shines and footwork as long as you can move your ribcage / thoracic spine.

Wishing you a routinely successful operation and easy recovery!
posted by batter_my_heart at 11:40 PM on June 12, 2020 [2 favorites]


What about a recumbent exercise bike? While a lot of the pictures in the Google image search show people using arms, I've never found that necessary for a recumbent exercise bike. Getting onto the bike is basically the equivalent of just sitting in a chair. I recognize that if you don't already own one of these, it may not be possible to buy it.

I've used a recumbent exercise bike, but not after surgery, so definitely check with your PT or doctor about this, but I feel like a recumbent exercise bike allows you to isolate your lower body and not use your arms in a way that you can't manage with a stationary bike. Some recumbent exercise bikes seem like they would be easier to sit stably in without arm involvement then others, so I would definitely look around at your various options.
posted by litera scripta manet at 3:14 AM on June 13, 2020


I'm going to suggest that before you get your mastectomy done you go around with your arms folded in front of your chest and experiment with doing all your regular exercises in that position. Try dancing, figure out which exercises are modifiable and throw a large bedsheet over your rowing machine to keep the dust off. You can figure out how you can get on your exercise bike without using your hands or arms at all, such as stepping onto a stool and transferring from that onto your bike. You're going to be spending around two weeks figuring out how to do everything, from brushing your teeth and combing your hair to punching your significant other on the shoulder and you'll soon figure out a way to do all of them with a large number surprising you by not needing any modification at all. Some of your intense exercises should be possible, or at least modified versions of them. You can peddle on the bike without leaning forward and using the handlebars. It'll feel weird if you are used to bending forward into racing posture and peddling like a demon but there's nothing stopping you from doing 10 K as soon as you're not too groggy to do it. I think you'll actually be quite reassured once you start trying things out.

Very likely if you do try to exercise to the point of collapse post surgically you will feel really awful, more so than if you thoughtlessly extend and do a lunge reaching for the can of beans that just fell of the back of the far shelf in the pantry. A lunge like that will bring you up short, ow and take some moments to wear off, whereas exercising yourself into a sweaty collapse will probably be followed by nausea and inability to move and some hours of self pity. It'll put you back a day or so in recovering. But the thing is you probably won't want to exercise like that. You'll get on your bike and be frustrated that you can't lean forward on the handlebars and just do your usual twenty k in fifteen minutes at highest resistance, but after five minutes at medium resistance sitting bolt upright you'll start feeling like you not only don't want to speed up, but that you'd like to get off the bike soon. A little exercise is going to be a lot more effective than it used to be.

I had a bilateral done with lymph nodes removed as well and I was able to do a lot of stuff well before the end of the first week. The period when I couldn't raise my arms and lift was actually pretty brief, only a couple of weeks. During that time you're going to want to do a lot of very gentle wriggling and stretching. The better your circulation the quicker you heal and the less you seize up and stiffen. You may be be able to do a bunch of things like just sitting there with good posture and doing tiny shoulder rolls half an inch in diameter and exercises like that and find it a satisfying exercise session. That won't give you cardio and burn off your stress hormones but it will burn off the metabolic toxins, including the ones created by the cutting during your surgery. I think you may not actually want to get your heart pumping marathon runner hard for the first week or two anyway when your drains are flapping around everywhere you go. You may feel like talking it easy. Tiny easy slow motions sound like they won't feel satisfying at all right now, but that's going to be the kind of movement your body is going to want, so it may be a lot more satisfying that you'd predict.

There's going to be a lot of gentle stretching to do and it probably won't be as frustrating as you may expect either, because the day they do the bilateral mastectomy you're going to be moving really gingerly, and the next day you're going to be reaching for things carefully, even if it's only the box of Kleenex beside your bed, and deciding if you can cut back on the post op pain meds, and the day after that you're going to hefting things like heavy mugs of coffee but deciding that a full sauce pot of water to boil macaroni was a wee bit tricky and required a bit of thought and the day after that you'll find full sauce pots of water are not too bad although you have to pay attention and the day after that you'll have some fast temp music on and you'll be dancing and moving your fists in front of your face and to either side of your ears. The stiffness will start wearing off so quickly that it will be fun to see how much more movement you can do and how much stronger you are every day. It's only frustrating if you don't like the idea of going from completely immobilized to almost fully functional over a period of maybe two weeks. You may never again see such rapid improvement in your abilities in your life. If you like to see yourself improve you'll enjoy the early stages a lot.

You'll still be left with some things you can't do for quite awhile, maybe months, things like pumping iron and fencing lunges and unfortunately rowing. That's still going to leave you with tons of intense exercise possibilities, like running hard or Irish step dancing. Have you ever seen Riverdance videos? Now's your chance to get into fast footwork. This is also a good time to get into core muscle building because you'll want to use your torso muscles for balance correction instead of windmilling your arms, and you'll be doing that instinctively, clenching your belly muscles to keep yourself from overbalancing instead of flinging an arm out.

For things like biking you lean your shoulders way forward bending from the waist more than usual and you won't be stretching your arms at all. You just bring your shoulders way closer to the handle bars. You'll know if you are doing something you're not supposed to because you'll get a pain message as you start to do it, just the same as you get a pain message when you start to reach into a fire. Unless you already have a history of doing yourself a lot of damage while doing sports you can trust that your body will let you know what you can do.

For physio advice there are a ton of videos on YouTube that show the exercises they recommend and ways to do things that require a work around.
posted by Jane the Brown at 3:32 AM on June 13, 2020 [3 favorites]


Maybe Pilates? You wouldn’t be able to do arm work, of course, but you should be able to do a fair amount of ab and leg focused work while lying down with your arms relaxed at your sides.
posted by insectosaurus at 10:55 AM on June 13, 2020


For me, the time I couldn't exercise was the same time I wasn't cleared to lift, about 3-4 weeks. I asked about indoor biking before then and the surgeon didn't want me to get sweaty before wounds healed and drains were out. Before that, I just walked. I had reconstruction over the muscle so lifting restrictions didn't last long. Good luck!
posted by beyond_pink at 12:15 PM on June 13, 2020


When I did jazzercise we learned a lot of dance moves that you could do :step-touch, kick-ball-change, step-kick, wide-jog, sashay, step-squat, step-knee-up, soccer-kick, etc. Do them with arms down like Riverdance. Some of those can add hip swings to the movement too like knee-up then over to the side then down. You can also do step aerobics with arms down.
posted by CathyG at 9:30 PM on June 13, 2020


I don't know if you have any mastectomy sports bras that would work for activities like yoga, hiking, Pilates, stationary biking, etc., after surgery.

If not, consider Ana Ono Intimates, designed by breast cancer survivor Dana Donofree. None of the bras has wires and all have adjustable straps and are made of a soft fabric called modal (derived from beech trees). I can't vouch for them personally, but I'm a bra nerd and people I trust say that they're great.

The line includes four sports bras. XS up to 2X (3X in some styles).

The Paige Wrap Front Sports Bra and Bianca Front Closure Sports Bra both have a mesh panel in the back for more breathability. Each is popular, judging from the number of four- and five-star reviews. But Bianca -- which looks suited for a higher level of activity -- is out of stock in L and XL. (Not surprising when shopping with a small company.)

Also in Ana Ono's sports bra category are the Leslie Leisure Bra (a pullover or step-in bra with mesh inserts and 111 reviews averaging 5 stars) and the Monica Full Coverage Bra (which has a four-hook clasp in the back, a modest neckline and medium support).
posted by virago at 2:20 AM on June 14, 2020


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