Welcome to Week Four of The Chrysalis Method:

Climbing Mountains

You are at the beginning of week 4 and you are likely starting to feel better and better each day. You have come a long way and worked really hard to get where you are. If you’re having difficulty, increased emotions, doubts, or the opposite and you are feeling much better than you anticipated, please remember to share your experience with other women in the forum. Nobody wants to feel alone during recovery and by sharing your experience you are helping others. Please click here to go directly to the forum.

“So wear your strongest posture now - and see your hardest times as more than just the times you fell but a range of mountains you learned to climb.”

-Morgan Harper Nichols-

Exercise Protocol for Post-Op Breast Surgeries

Every woman’s procedure is unique. Every surgeon’s technique is unique. Every single recovery is unique. This program was designed to give women general guidelines to follow to maintain fitness, reduce post-op complications from occurring, and most importantly provide an emotional support group for all women to have as an outlet for questions and concerns while feeling part of a community avoiding isolation.

Your surgeon is the expert for your procedure, what exactly was performed, and what specific restrictions you should follow for your specific case. Only your surgeon knows exactly what tissues were cut and how your body responded during the surgery. It is important that you continue to listen to your surgeon’s precautions and follow his/her recommendations for your follow-up to ensure proper tissue healing and optimal recovery.

This program is a guideline to follow for lower body movements to keep you active during your recovery. Once your surgeon gives you permission to begin using your upper body, you will have access to unlock upper body movements that will gradually increase your range of motion back to normal as well as regain your strength.

Precautions for 4-6 weeks per most surgeons:

NO lifting, pushing, pulling more than 10 pounds. If you have a baby, toddler, or child this goes for holding him/her as well. You will need to make modifications to care for your child/children during this acute phase of healing. (Samples of things weighing about 10 pounds: average 3-month-old baby and older, a gallon of milk (1 ¼ gallon), sack of potatoes, large bag of sugar/flour, large watermelon, a holiday ham or turkey, most cats/dogs, most vacuum cleaners, laundry basket filled with towels or jeans, etc.)
- If you MUST hold your baby/toddler and do not have anyone to assist you, keep your arms/elbows in tight to your sides and keep the child close to your body. In other words, do not reach out and/or hold the child away from your body as this will cause added strain on your muscles and potential harm.
NO jumping, running, bouncing (Even if you’re a marathon runner and you want to get back to running ASAP, you can’t do this until your surgeon gives you clearance which will typically be a minimum of 4 weeks post-op)
Caution must be taken with any activities engaging your core. Again, we want to make sure the incisions are healed completely before activating your core. Many incisions are made below the breasts which attaches to the same skin that covers your stomach muscles. You don’t want to compromise the healing incisions so make sure to take caution when activating your stomach muscles. This is hard to do when your core is the center of everything. Just don’t do any specific abdominal exercises like crunches/planks/sit-ups/etc.
Wear a nice supportive bra when performing any physical activity. Your surgeon will tell you whether he/she recommends you wear a bra at rest during recovery. Different surgeons have different preferences on this so it’s always important to specifically ask your surgeon about how much and what type of bra you should be wearing post-op.
As always-follow YOUR surgeon’s protocol and make sure you use caution in the very early days to let the incisions heal. Once the incisions are healed completely and there are no stitches, you can then perform cross-friction massage to the scar to lessen the scar tissue. Again-ask YOUR surgeon when this is okay to do for your specific case. It will be several weeks before your incisions are completely healed to perform any cross- friction massage.

Week Four

During week 4 some women see an increase in their swelling and others don’t. Both are normal and shouldn’t be alarming. Your incisions are starting to heal and look better and better each day. Remember to keep them clean and dry for optimal healing and minimal scarring.

If you feel they aren’t healing properly, it’s always okay to ask a Chrysalis representative via email or the online forum, and we will direct you accordingly. Sometimes when your stitches haven’t dissolved, they can give a strange sensation of bumps or slight redness. This is normal, but does need to be differentiated from actual signs of infection. Don’t hesitate to ask and seek guidance accordingly. As always, if you have any of the red flag symptoms, you should contact your surgeon immediately. See some common Red Flags below:

- A high fever (over 101 degrees)
- Severe nausea and vomiting
- Continued dizziness or incoherent behavior, such as hallucinations
- Any pain that cannot be controlled by your pain medication
- Bright red skin that is hot to the touch
- Excessive bleeding or fluid seeping through the incisions
- A severely misshapen breast or bruising that is localized to one breast or region of the chest

Weekly Tip:

One thing that we are all guilty of is letting our posture go every once in a while. Think about how we spend so much time now on our phones, computers, reading books, etc., where our necks are bending forward, and our overall posture is forward.

With the added strain of weight (if you’ve had surgical implants) or just the tightness of the incisions from any breast surgery, it’s especially important that you are aware of your posture and you don’t let your surgery contribute to poor posture.

In the weeks to come if you haven’t already, be mindful of your posture. Set a timer on your phone and force yourself to pull your shoulders back and perform gentle neck rolls to remind yourself to bring your shoulders back.

There are studies that have actually shown a connection between good posture and confidence. Use this simple tip to add to your mood and self-confidence as well as decrease back pain and unnecessary added strain.

Movements Week 4

Movements: Week 4

Endurance Training:

You’re now nearing the end of one month from your surgery date. Continue 15 minutes of regular walking, treadmill walking, recumbent biking, Stairmaster climbing, or stationary armed elliptical. Do NOT use arms on these machines!! Remember to keep it at a low intensity. If you’re able, perform two 15 minute intervals on the days that you have the time. If possible, do this endurance activity 2x/week during week 4. On the other days do lighter endurance activities just to keep your joints moving with light walking, stair climbing in your home, etc.

Movements:

Usually it’s okay to begin doing upper body movements without any weights IF YOUR DOCTOR HAS GIVEN YOU THE GREEN LIGHT. If you have gotten the green light, the arm stretches/exercises will be unlocked to you on the website. You must sign the upper body waiver agreeing that your doctor has given you approval to go forward with these before you have access to them. Use extra caution when adding the upper extremities to avoid any stress to your implants but don’t be afraid to use your arms either. Listen to your body and if something feels wrong, stop doing it. Regardless, if your surgeon has given you the green light for beginning upper body range of motion, perform the lower body movements on 3 days during week 4.

1. Walking Lunges:
o 15 reps
o 3 sets total

With your hands-on hips, perform walking lunges keeping your knee over your toes and not in front of your toes. Bend straight down then straight up before switching legs. Always keep your back straight and core tucked in tight.

2. Standing Mini Squats with Large Ball
o 15 reps
o 3 sets total

Place the large ball at your mid back between the wall and your back and press your back into the ball for support. Place your feet shoulder width apart and a few inches out front so when you lower into a squat your knees are at a 90oangle. Lower down to a seated position (squat) and return to standing.

3. Standing Hamstring Curls
o 15 reps
o 3 sets total curls

Stand at a counter or table and keep your knee pointed down while bending it up towards your butt then return to neutral. Your knee should stay pointing to the floor and not raise up to isolate the hamstring (the muscle in the back of your upper leg/thigh).

4. Butterfly Leg Stretches
o 15 reps
o 3 sets total curls

Sitting on your bottom with your feet touching and your knees open wide, stretch your inner thighs by gently leaning into your groin attempting to touch your nose as close to your toes as possible. Keep your arms in close to your body so you’re not stretching your chest area and you’re focusing on your thighs. Hold this stretch for 30 seconds then come to neutral sitting. You can relax your legs by bringing them out in front of you and extending your knees straight if necessary.

Recap of Week 4 Movements:

Walking Lunges
Standing mini squats with ball between back and wall
Standing hamstring curls
Butterfly stretches

There are a total of 4 movements for week 4. Perform all 4 movements 3x/week during week 4 on non-consecutive days. Walk for 15-minute increments, OR use the recumbent bike, Stairmaster, or elliptical for a change in your endurance activity. You should do a minimum of 2x/week during week 4 of your endurance training. Your total activities will consume 5-6 days during week 4 of a combined lower body movements and endurance days.

You have made it to week four! We hope this week's information has been helpful to you. We do our best to clearly outline nutrition and movements, but there's also that emotional element we know can be a struggle as well. So please take advantage of our forum and see how other Chrysalis members were feeling during your stage of recovery. Sometimes knowing you aren't alone is all you need!

Sincerely,

Lauren Simpson, DPT