Welcome to Week Six of The Chrysalis Method:
Way to go making it successfully through week 5! Recovery is hard and we hope we’ve made it easier by keeping you moving and communicating with others who’ve gone through similar surgeries. You should start to feel back to your normal self this week. Many surgeons give their patient’s clearance to return to their normal activities after this week including use of arms. Be sure and check with your surgeon’s protocol and see if you can begin the upper body levels. If so, send us your upper body waiver so you can begin moving those arms and getting them back to your pre-surgery strength.
““Make yourself a priority. At the end of the day, you’re your longest commitment.”
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.
Remember that you are the only person who controls your priorities. If you don’t make yourself a priority, nobody else will. Use this inspiration to carve out a minimum of 30 minutes each day for yourself. Take advantage of the exercise videos to guide you through optimal recovery! Also, it’s important each and every week to check in to the forum and share your experience with others. You never know who you may help by letting others know they are not alone. Please Click here to go directly to the forum.
Now that you’re entering week 6, check your range of motion for your upper body. Stand in front of a mirror and raise one arm straight out to the side first to a T position, then slowly continue raising in an arc to an overhead position. This is called shoulder abduction. See the photo below.
Do the same thing on the opposite arm. Do you have full range creating an arc around your body? Next, take one arm and raise it directly in front of your body, parallel to the floor. If you are able to do this, then continue raising the arm from parallel to the floor to overhead. Repeat on the opposite arm. This is full flexion of the shoulder.
You should aim at getting full range of motion to return without pain. Never force a motion. Tightness is normal, but significant pain may be an indicator that you need further assistance.
You can repeat these basic motions (WITH NO WEIGHT) to assure you are returning to full range of motion in both directions. Again, never force a motion, go slowly, use caution, and listen to your body. Repeat these basic motions 10 times in the morning and before going to bed to keep your shoulders loose.
Movements Week 6
Movements: Week 6
Typically, this is the last week you will have lifting restrictions for your upper body. In addition to the movements in the video, don’t forget to get your endurance training in. 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. For a total of 5-6 days of activities use a combination of the endurance training and exercises. If you’ve been cleared for upper body, be sure and add those to your lower body 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.
If last week was easy and you’re not having any problems with pain, you may increase your exercise intensity by adding more resistance by tightening your bands or increasing the amount of repetitions you perform. Do all of these exercises 3 times/week with at least one day in between. Do NOT do these on consecutive days!
1. Side Walking with Resistance Loop Around Ankles
o 10 steps on each leg (~20 feet)
o 3 sets total
Place the resistance loop around your ankles. Keeping your toes facing forward, bend at your knees and position yourself in a mini squat. While maintaining this position with the resistance around your ankles, step to the side then together for 20 feet, then repeat to the opposite side.
2. Standing Heel Raises
o 20 reps
o 3 sets total
You don’t have to hold onto anything if you are able to balance without holding on. Keep your knees straight and raise straight up onto your toes contracting your calves. Hold the heel raise for 5 seconds squeezing your calves tight.
3. Side Lunges
o 10 reps on each leg
o 3 sets total
In standing, you will lunge to the side as far over as you comfortably and safely can while bending the outer leg in a low lunge/squat. You need to maintain your toes facing forward on both feet and don’t turn the toes out. You will then push back up into standing and alternate to the opposite side. Squat as low as possible on each side for maximum benefits. You can do this exercise with your arms across chest for protection and stability.
4. Standing Squats with Large Ball & Small Ball Between Knees
o 10-15 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 900 angle. Place the small ball between knees adding another element of difficulty for the inner thighs. Maintain the squeeze of your thighs holding the small ball between your thighs while pushing your back into the large ball for support of your spine. Perform the squat and coming back to neutral keeping both balls in place.
5. Standing Inside Kicks with Resistance Band Loop
o 15-20 reps each leg
o 3 sets total
Place the resistance band loop around the bottom leg of a chair and also around your ankle. While holding onto the back of the chair for stability, and the resistance on the inside of your thigh, pull the band inward towards your other leg and away from the chair. You might be able to cross the leg across the other one. This if for your inner thigh.
Recap of Week 6 Exercises:
Side-Walking with Resistance Band Loop
Standing Heel Raises
Standing Squats with Large Ball and Mini Ball
Standing Inside Kicks
Total of 5 exercises for week 6. Perform all 5 exercises 3 times during week 6 every other day. Perform your endurance training 20- to 25-minute increments on alternating days from your strengthening exercises.
We hope this week's information has been helpful to you.
You should be well on your way to feeling somewhat back to normal this week. But as real life starts to creep back into your daily routine, stick to the program. You have made it halfway through, but these last six weeks are just as crucial to seeing the best outcome possible.
Lauren Simpson, DPT