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Arm exercises after a mastectomy | CION Cancer Clinics
Gentle arm movement starts the day after a mastectomy, and it is the most useful thing you can do for your own recovery. The shoulder on the operated side stiffens fast if it is kept still. This page explains what is safe while the drain is in, how the stretches build up over the weeks, the four that matter most, and the signs that mean you should stop and call. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
MI
Medically reviewed by Dr. Mohammed ImaduddinConsultant Surgical Oncologist · MBBS, MS (General Surgery), MCh (Surgical Oncology) · last reviewed September 2026, next review due September 2027
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On this page
- When should you start moving the arm after a mastectomy?
- What can you safely do in the first few days?
- How does the programme progress over the weeks?
- The four stretches that matter most
- What families say about the arm, and what is actually true
- What this page cannot tell you
- Common questions about arm exercises after mastectomy
The short answer
When should you start moving the arm after a mastectomy?
Gentle arm movement starts the day after the operation, and it is the most useful thing you can do for your own recovery. The shoulder on the operated side stiffens quickly if it is kept still, and stiffness that sets in early is much harder to undo later.
Why the arm stiffens at all
A mastectomy removes the breast, and often some of the lymph nodes (small glands that filter fluid) from under the arm. The skin and muscle are sore, so the natural instinct is to hold the arm pressed against the body. Held like that for a week, the shoulder loses its range, the scar tightens, and combing your hair or draping a saree becomes a struggle.
What the exercises are actually for
They are not about strength. They keep the shoulder moving through its full range while the wound heals, so the scar forms around a joint that already moves freely. They also help fluid drain from under the arm, and they lower the chance of long-term arm swelling.
Everything on this page is a general pattern. Your surgeon's instructions and your physiotherapist's plan come first.
!
Stop the exercises and call the same day if
The arm or hand on the operated side swells suddenly, feels hot, or turns red. The wound opens, bleeds or leaks more than before when you stretch. You get a fever along with pain in the arm. These can mean an infection or fluid collecting under the skin, and both are easier to settle early. Do not push through pain to finish a set.
Not sure whether this applies to you?
Ask an oncologistWhile the drain is in
What can you safely do in the first few days?
Small movements, done sitting up in bed or in a chair. They keep the shoulder from locking without pulling on the wound.
Hand and wrist pumps
Open and close the fist slowly, then bend the wrist up and down. Do this often through the day. It moves fluid out of the hand and forearm and needs no shoulder movement at all.
Elbow bends
With the upper arm resting by your side, bend the elbow to bring the hand to the shoulder, then straighten it. This keeps the elbow free while the shoulder is still protected.
Shoulder shrugs and rolls
Lift both shoulders towards the ears, hold for a breath, then let them drop. Roll them slowly backwards. This eases the neck and upper back, which tighten when you guard the arm.
Arm lifts to shoulder height only
Lift the operated arm forwards, no higher than the shoulder, and lower it. Stop where it pulls. Going higher usually waits until the drain is out, because the tube sits under the arm.
Building up
How does the programme progress over the weeks?
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The first days at home
Keep the bed exercises going, in several short sessions a day. Use the arm for light tasks, such as eating, brushing your teeth and buttoning a blouse. Do not lift a bucket or a child.
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Once the drain is out
The surgeon or physiotherapist usually clears you to take the arm above shoulder height. The wall climb, the back scratch and the hands-behind-the-head stretch begin now. Expect a pulling feeling along the scar and under the arm. That is tightness, not damage.
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Before radiotherapy, if it is planned
Radiotherapy needs you to lie with the arm raised above the head for the whole session. If the shoulder is still stiff, planning has to wait. This is the most common reason a surgeon chases a patient about exercises.
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Long term
Keeping the shoulder mobile is a habit, not a course. The scar keeps tightening for months, and people who stop stretching once they feel better often find the stiffness creeps back.
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Once you are cleared
The four stretches that matter most
Do each one slowly, to the point of a firm stretch, never sharp pain. A few repetitions, a few times a day, beats one heroic session.
Wall climb
Stand facing a wall, toes almost touching it. Walk the fingers of the operated arm up the wall as high as they will go, hold, then walk them back down. Mark the height with a pencil and try to beat it each day.
Hands behind the head
Sit or lie down. Clasp both hands, lift them over the head, then let the elbows drop outwards towards the bed or the wall behind you. This opens the front of the chest where the scar pulls tightest.
Back scratch
Reach the operated hand behind the back and slide it upwards, as if fastening a hook. A towel held in both hands, one over the shoulder and one behind the back, lets the good arm help the stiff one.
Chest opener in a doorway
Stand in a doorway with both forearms on the frame at shoulder height and lean gently forward. You will feel the stretch across the scar. Breathe slowly through it and do not bounce.
If any stretch makes the hand tingle or go numb, ease off and tell your physiotherapist.Commonly believed
What families say about the arm, and what is actually true
"She should rest the arm completely until the wound heals."
Complete rest is the main cause of a frozen shoulder after this operation. The wound heals just as well with gentle movement, and the shoulder heals far better. Rest the wound, move the joint.
"Pain means the exercise is damaging something."
A pulling, stretching ache along the scar and under the arm is expected and is the sign the exercise is working. Sharp pain, sudden swelling or the wound leaking are different, and those are the reasons to stop and call.
"Once she can lift the arm, the exercises can stop."
The scar and the tissue under it keep tightening for many months. People who stop when the arm first feels free often lose range again quietly. Keep the stretches as a daily habit for as long as your team suggests.
"Exercise on that side will cause lymphoedema."
Gentle, gradual movement lowers the chance of long-term arm swelling rather than raising it. What to avoid is sudden heavy lifting and carrying with an arm that has not been built up to it.
Being straight with you
What this page cannot tell you
This page cannot tell you when your own arm will be cleared to go above the shoulder. That depends on how much was removed under the arm, whether a drain is still in, and whether reconstruction was done. It is a decision for the team who did the surgery.
When a physiotherapist should be involved
Ideally from the start. If the shoulder has not reached its full range by the time the wound is healed, if you feel a tight cord under the arm when you stretch, or if the arm starts to swell, ask for a referral rather than working harder on the same sheet.
Who this programme does not suit as written
People with an existing shoulder problem, a previous fracture on that side, severe arthritis, or a heart or lung condition that limits effort need a programme adapted for them. So do people who have had a flap reconstruction, where the muscle that was moved needs protecting. Tell the physiotherapist about all of these at the first visit.
If there is no physiotherapist near you, call the helpline. We can talk you through the programme by phone.Questions we are asked
Common questions about arm exercises after mastectomy
How many times a day should she do the exercises?
Little and often works better than one long session. Most programmes suggest a few repetitions of each movement, repeated several times through the day. Pair them with things that already happen, such as meals or a bath, so they are not forgotten. Your physiotherapist will set the exact number.
Can I do the exercises while the drain is still in?
Yes, the early ones. Hand pumps, elbow bends, shoulder shrugs and lifting the arm to shoulder height are all fine with a drain in place. Movements that take the arm right above the head usually wait until the drain is removed, because the tube sits under the arm and pulls.
The arm feels heavy and tight. Is that normal?
Heaviness and tightness along the scar and under the arm are very common in the first weeks and ease as you stretch. What is not normal is the arm or hand becoming visibly bigger than the other side, or the skin turning hot and red. Those need a call the same day.
Can she cook, sweep and do housework?
Light tasks with the arm below shoulder height are good for it, and cooking a simple meal is fine once she feels up to it. Sweeping with a short broom, wringing wet clothes, carrying water and lifting a gas cylinder should go to someone else until the surgeon says otherwise.
I felt a tight string under my arm when I stretched. What is it?
That is most likely cording, a tight band of tissue that can form under the arm after lymph nodes are removed. It is not dangerous but it does limit the stretch. Gentle stretching helps and a physiotherapist can release it further.
Do I need a physiotherapist, or can I do it myself?
Many people manage well with a written sheet and a check at each follow-up. A physiotherapist matters more if the shoulder is not freeing up, if cording appears, if you had reconstruction, or if you already had a shoulder problem. One visit early on is worth more than several later.
Why is my surgeon so insistent about the arm before radiotherapy?
Because radiotherapy to the chest wall is given with the arm held up above the head, for the planning scan and every session. If the shoulder cannot reach that position comfortably, the treatment cannot be planned safely and has to be delayed.
Is it too late if she has not exercised for a month?
No. A shoulder that has stiffened can still be brought back, though it takes longer and usually needs a physiotherapist rather than a sheet. Do not force it at home. Book a review, mention the stiffness plainly, and ask for a referral.
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Sources
- American Cancer Society — Exercises After Breast Cancer Surgery
- NHS — Mastectomy: recovery
- Cancer Research UK — Surgery for breast cancer
- National Cancer Institute — Lymphedema
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Shoulder Stiffness and Cording After MastectomyWhat the tight string under the arm is and how it is releasedWhen Can You Lift Your Arm Fully Again?What a typical return of movement looks likePreventing Lymphoedema After MastectomyWhy exercise protects the arm rather than harming itThe Drain After MastectomyWhy the bigger stretches wait until the drain is outRecovery, Eating and Getting Back to LifeThe wider picture of getting back on your feet
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Call the helpline or send us a message. A CION surgical team member will talk you through where you should be and whether a physiotherapy review is needed. One helpline serves every centre.