- Reference Number: HEY1646/2026
- Departments: Physiotherapy
- Last Updated: 30 April 2026
Introduction
This leaflet has been produced to give you general information regarding breast reconstruction surgery. Most of your questions should be answered by this leaflet. It is not intended to replace the discussion between you and your doctor but may act as a starting point for discussion. If after reading it you have any concerns or require further explanation, please discuss this with a member of the healthcare team caring for you.
Why do I need the exercises?
The exercises described in this leaflet are for anyone who has had breast reconstruction surgery. These have been approved by the breast consultants and the physiotherapy department. The exercises are designed for use from the day after your surgery, however it may be useful to practice them prior to your surgery so you know what they will entail, how to do each exercise and to identify what your normal range of movement is.
The exercises provided in this leaflet will help you regain your range of movement in your arm, prevent you from getting a frozen shoulder, to reduce the lack of full movement in the upper limb and to help with the swelling post-surgery.
Can there be any complications or risks?
There may be a slight risk post-surgery of muscle strain if advice is not followed or exercises not completed as advised. It is normal to feel muscle discomfort when performing or after completing exercises, but this should gradually improve. If any exercises do cause continuous discomfort or pain, then please stop that certain exercise and speak to your consultant or breast care nurse at your follow up appointment.
Things to avoid after surgery
RANGE OF MOVEMENT
It is really important that you do not raise your arm above shoulder height for the first four weeks following your surgery.
Surgery involving breast reconstruction will have a 4-week precaution. For the first 4 weeks, you will be given exercises that will only allow your arm to go up to shoulder height (90 degrees). After 4 weeks, the precaution will no longer apply, the extra exercises should be started and allow you to go past shoulder height. This will lead on to you working towards your normal full range of movement.
DRIVING
Post-surgery, it is advised to wait until your 4 week follow up appointment with your consultant to discuss when you can start driving again. If advice is not followed, it could lead to your insurance no longer being valid.
ACTIVITIES
Activities should be avoided which result in heavy lifting, pushing or pulling. The most we would advise post-surgery is nothing heavier than a kettle of water. You may use the opposite arm but try not overcompensating.
It is also advised to:
- Avoid over exertion, do not strain and do not be over vigorous.
- Avoid keeping your arm, on the side which your surgery was performed, in one position for a long period of time.
- Try and avoid pushing up off the bed/chair with your arm on the side that your surgery was performed.
- Avoid reaching up or to the side taking your arm on the side in which your surgery was performed, above your shoulder (for example reaching up to a high cupboard) as this may over stretch the muscles which have been operated on and therefore risk damage or delayed recovery.
- Avoid reaching behind you, for example reaching for your seatbelt; try to use your unaffected arm for this.
DRAINS
Depending on the consultant performing the surgery, drains may be in place post-surgery, and you may be discharged with a drain still in situ. Exercises post-surgery can still be carried out but just make sure you are keeping it as a comfortable range of movement that doesn’t cause pain or discomfort and the drain tubing is not pulled. Nurses will follow on before discharge with any advice/training required prior to discharge. If discharged with a drain, drain bags can be provided by the ward to assist ease of doing exercises, mobilising as well as privacy and dignity to cover the drain
How do I prepare for the exercises?
Please read the information leaflet. Share the information it contains with your family (if you wish) so that they can be of help and support. There may be information they need to know, especially if they are taking care of you following this examination.
When should I start the exercises?
The exercises provided for the first 4 weeks should be started the day after your surgery (day 1).
The exercises provided for the first 4 weeks should be done three times a day. For example, morning, lunch and teatime and complete 5 repetitions of every exercise. After 4 weeks post op, you can begin to add on the extra exercises provided allowing you to go past shoulder height, and the same rule applies, 3 times a day and 5 repetitions of every exercise.
You may find the exercises uncomfortable at first. Normally you will experience a pulling sensation but keep it a comfortable range of movement. If any exercises cause any pain or discomfort and it continues, then we do advise you stop doing that exercise.
In certain exercises shown, if you are unable to usually reach that position, do not worry, it is more about the movement and reaching the range of movement that is normal for you.
If the exercise involves using only one arm, use the arm on the side which your surgery was performed. If both sides are operated on, you can either do them separately or at the same time.
How long should I do the exercises for?
You should continue these exercises until you feel you have gained your full range of movement, i.e. the range of movement that you had before your surgery. This should take about 8 weeks.
If you begin to develop stiffness in your arm after you have stopped these exercises, re-introduce them until this has eased.
Exercises for the first 4 weeks
The following exercises should be carried out in a slow, rhythmical and gentle way to reduce the risk of lymphedema (localised fluid retention and tissue swelling). If swelling does occur, contact your Breast Care Nurse.
Shoulder Pendulum
Stand and bend at the waist, holding a chair or table with the unaffected arm, leaving the affected arm hanging.
Rotate your arm in a circular motion, progressively getting bigger, as comfort allows.
Repeat both clockwise and anti-clockwise.
Repeat 5 times.
Side to side pendulum
Support yourself with your hand on a chair or table with your none operated side while keeping your knees bent and back straight.
Let your arm relax straight down by your side.
Gentle swinging arm motion (just like a pendulum) from side to side, as comfort allows.
Repeat 5 times.
Back and forth pendulum
Support yourself with your hand on a chair or table with your none operated side while keeping back straight.
Let your arm relax straight down by your side.
Gentle swinging arm motion (just like a pendulum) from front to back, as comfort allows.
Repeat 5 times.
AAROM Partial Shoulder Flexion
Sit straight on a chair and cross your arms over your chest with your hands holding the opposite elbow.
Lift the arms up and away from your chest to work the range of motion. Only raise up to shoulder height.
Repeat 5 times.
Exercises to start after 4 weeks
AAROM shoulder/elbow flexion
Sit or stand. Place your hand on your shoulder. Lift your elbow up towards the ceiling as far as possible. To be carried out on operated side only.
Repeat 5 times.
Shoulder flexion in standing
In standing, slowly lift your arm/arms directly in front of you until they are overhead towards your shoulder blades.
Repeat 5 times.
Shoulder flexion at a wall
Sit up or stand up straight in front of a wall, approximately one meter away from it.
Place your fingertips on the wall and climb up the wall slowly with your hand/fingers.
Climb up as high as you can.
Lower your hand back down.
Do not shrug your shoulder or lean to the opposite side. Keep your body straight and your shoulders level.
Repeat 5 times.
Shoulder Abduction
Sit up or stand up straight beside a wall, approximately one meter away from it.
Place your fingertips on the wall and climb up the wall slowly with your hand.
Climb up as high as you can.
Lower your hand back down by your side.
Do not shrug your shoulder or lean to the opposite side. Keep your body straight and your shoulders level.
Repeat 5 times.
Shoulder Internal Rotation Assisted
Standing, bring one hand behind your back (operated arm) and the other hand supporting underneath (none operated arm).
Move your hand up towards your head with the help of the other supporting hand.
Slide the hand flat without twisting the wrist.
Hold and lower
If both sides have been operated on, repeat on both sides.
Repeat 5 times.
Shoulder Butterfly in lying
Lie on your back with your head on a pillow.
Bring your hands behind the bottom of your head, then let the elbows fall toward the ground on each side.
Repeat 5 times.
Shoulder Flexion in Lying
Lying on your back with knees bent and arms by your sides, palms facing the ceiling.
Slowly raise your arms straight overhead in an arc fashion as far as possible, keeping your chin tucked-in.
When you have reached as far as you can manage, hold for 20 seconds.
Repeat 5 times.
The following exercise should only be performed once you are able to raise your arm above your head
Side Trunk Flexion Stretch
Stand straight with your feet hip width apart and look directly ahead of you.
Lift one arm up above your head and slowly bend sideways while reaching down with the opposite hand, until you feel a stretch at the side of your trunk.
Maintain the stretch without twisting or leaning forward. Slowly return to initial position.
Repeat 5 times
Useful contacts
Should you require further advice on the issues contained in this leaflet, please do not hesitate to contact:
The Breast Care Nurses on telephone number – Tel: 01482 622013 (Castle Hill Hospital)
Breast, ENT and Plastics Ward 16 – Tel: 01482 468616
If you are located on the South Bank of the Humber, and you should require any support or further advice, please contact your specialist breast nurse.
Breast Cancer Care
Kiln House
210 New Kings Road
London
SW6 4NZ
Macmillan Cancer Support
London (Head office)
The Forge, 3rd Floor, Bronze Building,
105 Sumner Street, London SE1 9HZ
Freephone – tel: 020 7840 7840
Helpline – tel: 0808 808 00 00
Breast Cancer Now
6th Floor
the White Chapel Building
10 Whitechapel High Street
London
England
E1 8QS
Phone: tel: 0333 207 0300
Images – https://wibbi.com
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