Exercises Post Axillary Dissection

This leaflet has been designed in conjunction with the CanMove – exercise for all cancer patients programme.

CanMove - exercise for all cancer patients are group exercise session run every week and are free to people with a cancer diagnosis or ongoing effects from cancer and its treatments.

What is axillary dissection?

Axillary dissection is a surgical procedure that opens the armpit to identify, examine or remove lymph nodes. Lymph nodes are small glands that are part of the lymphatic system, and filter fluids. These nodes are normally removed in order to determine the necessity of further treatment based on cancer cell spread.

Why do the exercises?

The aim of these exercises is to regain normal arm and shoulder movement after axillary node surgery or radiotherapy in the armpit area. It is important to move the arm so the tissues in your shoulder don’t get tight and cause pain.
The exercises should always be done slowly. You may feel some discomfort but they should not be painful. If you develop lasting pain for 30 minutes or more you might need to change the exercises by doing less of them or doing them more gently.
If pain continues consult your Exercise Physiologist or Nurse.

When do you start?
 
It is best to start these exercises as soon as possible after surgery, so if possible aim to start the day after your surgery. Always check with your Surgeon that they are happy for you to start.

Week 1       Start with the Level 1 exercises and if tolerated add in Level 2.
Week 2       Move on to doing Level 1 and then Level 2 exercises
Week 3       Move on to the Level 1 and then Level 3 exercises
Week 4+     If you have full range of motion start with gentle strength exercises
                   (Seek further advice about which exercises are suitable)

When do you need to seek further advice?
 
Before starting these exercises check with your Nurse or Surgeon that they are happy for you to start.

If you notice any excessive oozing, redness or severe pain please stop the exercises and consult your doctor or nurse as soon as possible.

If you are in doubt about the exercises and how to do them, or if you feel you are ready to progress, you can contact the CanMove programme for further advice or assistance.

How often should I do the exercises?
 
Start by running through them twice a day and if you can aim for 3 times a day. Pick times of the day when it will be easy for you to remember to do the exercises. When you first wake, after lunch and before bed can be good times to get in the habit of doing the exercises.
Always focus on having good technique during the exercises so if you notice you are tiring during the exercises and can’t do them properly it is better to have a break and try again later. Little and often is better than doing one long session.

Over time the exercises should start to become easier. If you notice you can regularly do an exercise fully you need to move on to one of the more advanced exercises in this book or consult with a healthcare professional to find the next step.

It is important to continually progress exercises so you get stronger. Continue to exercise even if symptoms or side effects have reduced.

If you have not regained full range of motion within 3 weeks or would like further assistance please contact your Nurse or Exercise Physiologist.

LEVEL 1

Shoulder Shrugs
Aim for 3 sets of 15 repetitions per day
Keeping your arms relaxed by your side
Shrug by lifting the shoulders up towards your ears.
Return to start.

Shoulder circles
Aim for 3 sets of 15 repetitions per day
Keeping your arms relaxed by your side
Shrug by lifting the shoulders up towards your ears then roll them backwards and down.
Return to start.

LEVEL 2
 
Back scratch
Aim for 3 sets of 15 repetitions per day
Slowly reach round behind your back to just under your shoulder blades.

 

Bent arm raises
Aim for 3 sets of 15 repetitions per day
Start with arms by your side, then lift fore arm so palms are touching the shoulder and elbows are pointing forwards.
Lift the elbows up to shoulder level and then return to the start.
 

Bent arm side raises
Aim for 3 sets of 15 repetitions per day
Start with arms by your side, then lift fore arm so palms are touching the shoulder and the elbows are out to your side.
Lift the elbows up to shoulder level and then return to the start.

LEVEL 3 – These can be done seated

Arm Lifts
Aim for 3 sets of 15 repetitions per day
Lie on your back and relax the shoulders.
Hold your hands together and then lift both arms up above your head.
Aim to get the arms as near to the ground as you can without arching your back.
Hold them in this position for 5 seconds then return them to the start position.

 


















Elbow pushes
Aim for 3 sets of 15 repetitions per day
Lie on your back, relax the shoulders and place your hands behind your head.
Gently push the elbows towards the floor. Hold for 5 seconds and return to the start position.
 

Snow angels
Aim for 3 sets of 15 repetitions per day
Lie on your back, relax the shoulders and place your arms by your side with the palms up.
Keeping the backs of the hands as close as possible to the floor. Slowly bring the arms up above your head.
Return the arms to the side by keeping them as close as possible to the ground.

Side wall climbs
Aim for 3 sets of 15 repetitions per day
Stand side on to a wall with your affected arm next to the wall.
Put the hand on the wall below shoulder level and gradually crawl the finger up the wall.
Aim to get higher with each attempt.
Hold for 5 seconds and return to the start position.

 



 
Wall Climbs
Aim for 3 sets of 15 repetitions per day
Stand a wall.
Put both hands on the wall, below shoulder level, and gradually crawl the finger up the wall
Aim to get higher with each attempt.
Hold for 5 seconds and return to the start position.

  















Once you have regained full range of motion in your shoulder area and your wound has healed it is beneficial to start some gentle strength exrcises. Strength exercises will help further improve and maintain function in the area.