Welcome to Week Five of The Chrysalis Method:

Love Yourself

At this stage of your recovery, hopefully you are starting to feel more like yourself and starting to see the results of your surgery. When you learn to love yourself, your mood beams with positivity and confidence prevails. Remember this quote and work on loving yourself first and all else will fall into line!

“Love yourself first and everything falls into line.”

-Lucille Ball-

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 Five

You’ve completed one full month of CHRYSALIS. Don’t get back into your normal grind and leave out your exercises and healthy eating just because you’ve started to feel back to your normal busy self. Stay committed to The Chrysalis Method and you will maximize your recovery. After the investment you have made for yourself, you will want to complete the journey to its fullness. Let’s get week 5!

Try carving out 30 minutes of your calendar daily to commit to yourself. Utilize this time for exercise, meditation, reading, or anything that is for you.

Weekly Tip:

If your incision is completely closed and your scabs have all fallen off by themselves, you can begin massaging your scars. Scar massage can effectively decrease the scar tissue build-up making them less noticeable after surgery.

If your surgeon has given you any recommendations on creams to use, apply these and gently take your index finger and middle fingers together firmly and massage back and forth across the scar in a perpendicular direction.

This is called cross-friction massage and is a technique commonly used by physical therapists to decrease scar tissue build up. It aids in tissue mobility and decreases the formation of scar tissue and adhesions. If you notice bumps under your incision, it’s most likely the sutures that haven’t dissolved yet.

If they continue to bother you and don’t dissolve on their own, you will need to contact your surgeon to have them removed, which is very common. It’s a simple procedure and provides relief from those bumps in/around the incisions. They should be totally dissolved by week 8 or sooner.

Movements Week 5

Movements: Week 5

This week’s exercises continue to be very dynamic in nature and will be challenging for some. As always, make modifications as needed to your comfort level. Modify by decreasing the amount of reps performed or taking additional rest breaks as needed. In addition to the movements in the video, don’t forget to get your endurance training in. This week you should try and walk for 20- to 25-minute increments, or another endurance activity without using arms in addition to doing the exercises on 3-4 days during the week. Always pick 1-2 rest days during the week so your muscles have time to recover. So, for a total of 5-6 days of activities use a combination of the endurance training and exercises.

Endurance Training: 3-4 days this week of treadmill walking, recumbent biking, Stairmaster climbing, or stationary armed elliptical. Do NOT use arms on these machines!!

Boost your intensity level up to 70% of your HRM (If you’re keeping track of your heart rate and tracking intensity). Try to do 20-25 minutes of activity on one of these activities keeping your heart rate in that 70% range. On the other 3-4 days do your exercises so you alternate your cardio days with your exercise days this week.

Exercises:

Continue to follow the NO CHEST exercises until at least week 9 or your surgeon gives you clearance. If you’ve been given clearance to start the arm exercises/stretches this week, you can access those online in the locked section of the program with signed upper body waiver that must be emailed prior to accessing. Pick 3-4 days this week to do these exercises.

1. Forward-Backward Lunges
o 10 reps on each leg
o 3 sets total

With your hands-on hips, stand with your feet hip width apart. Step forward and lower yourself by bending at your knees keeping your back upright and straight. Lower until your front knee is at a 90 degree angle (or front thigh is parallel with the floor). Push back to neutral standing. Next-step backward with the same foot that advanced forward on the previous step. Thus, one foot will be stationary as the pivot foot and the other will alternate between forward and backward lunging.

2. Monster Walk with Resistance Loop Around Ankles
o 10 steps on each leg ~20 feet
o 3 sets total

Place the loop band around your ankles and bend at the knees keeping your back straight. Step out to the side and forward and you will feel the burn in your outer thighs. Walk the length of the longest room and switch directions.

3. Side-Walking with Resistance Loop Around Ankles
o ~10 feet in each direction (~20 feet)
o 3 sets total

Place the loop band around your ankles and bend at the knees keeping your back straight. Keep your toes facing forward and maintain a small bend in the knees. Step to the side and then together. Walk the length of the longest room and switch directions.

4. Single Leg Step-Ups on Step/Stairs
o 10-15 reps on each leg
o 3 sets total

Stand facing a stairwell. Place your hands on hips for stability. Place one leg on a step (and if one step is too easy, place your foot onto the second step) Push up through your foot (stepping up onto step) and squeeze your gluteal muscles while kicking your other leg back. Keep your back straight. Return to starting position and then repeat.

5. Pigeon Stretch
o 20-30 second hold on each leg
o Repeat 3 times on each leg

On the floor, bend one leg inward with your foot in a half “criss cross” position. The other leg will go straight backward with the knee straight. Lean as far forward into this stretch as your hips will allow without pain/injury. You will feel this in your butt of the leg that’s bent and the front of the hip of the leg that is straight and outstretched behind you.

Hold this position for 20-30 seconds and lean forward onto your elbows if able without putting more the 10 pounds onto your elbows. Use your elbows for stability and balance but don’t put weight through them.

Recap of week 5 exercises:

o Forward-Backward Lunges
o Monster Walk
o Side-stepping with Band Loop
o Step-Ups on stair
o Pigeon Stretch

Total of 5 exercises for week 5. Perform all 5 exercises 3-4 times during week 5 every other day. Perform your endurance training 20-25 minute increments on alternating days from your strengthening exercises.

Congratulations on getting to week five! You are inching your way towards a full recovery. Stay focused, keep eating right and moving as recommended. Each week from here on out will produce drastic improvements if you can stick to the plan!

Sincerely,

Lauren Simpson, DPT