5 Tips for Returning to Strength Training After a Mastectomy

If you’re a woman who lifts weights and find yourself faced with having a mastectomy, you’ll have a lot of research and reading to do. So for Breast Cancer Awareness month, I wanted to share the top five things I wish I’d known as a woman who strength trains and has had a prophylactic double mastectomy and reconstructive surgery in March and May of 2015, respectively.

Strength training after a mastectomy When considering these surgeries, of course I was not happy about the prospect of losing muscle and enduring a long recovery. But I was truly desperate for a way out of my situation. I don’t regret it, and even if I’d known about the things I’m sharing here, I probably would have continued with my decision. But my hope is that by reading about another woman lifter’s experience, your experience will be a little easier. (I do have plans to write an e-book on my experience, so stay tuned.)

Important note: If you had a mastectomy that wasn’t prophylactic, you can certainly use what you need here and leave the rest. There’s a whole other set of physical and emotional challenges when you have cancer, but you’re still a woman who lifts, and therefore, we’re sisters.

5 Tips for Returning to Strength Training After a Mastectomy

Be sure to also read my article on How To Train After A Mastectomy.

1. It takes a lot of strength and courage to have a mastectomy, but even more so after. Recovery may be much harder and slower than you imagined. It’ll knock you on your ass even if you’re fit, strong, and well-conditioned. Getting back to training will likely take longer than you thought it would, and you will need steely courage and patience as your conditioning and muscles shrink.

Yes, you can diligently walk and try to do light lower body training while your heal, but prepare to have many days when you just don’t feel like doing anything. A mastectomy affects your entire body, and for a few weeks after surgery you might be dizzy and nauseous just from medications. Your body is working furiously to rebuild traumatized tissue, so you’ll be fatigued and lack stamina. You may be in some pain and discomfort  from the surgery or tissue expanders (if you have them), and you most certainly won’t be able to lift anything heavy for at least six weeks.

You will regain your strength and stamina, though – you will. Let yourself cry and feel frustrated – no one said having a mastectomy didn’t include emotional healing, too.

2. There’s no use comparing yourself to anyone else. You can just stop comparing yourself to other women who got back to training more quickly than you. Just because you read about someone else lifting after just six weeks doesn’t mean you will be. Personally, I didn’t feel like lifting much at all until I was cleared for exercise six weeks after my reconstructive surgery. All told, I took about four months off from heavy lifting. I worked on walking longer and faster, progressing with physical therapy, and regaining my range of motion. That is quite enough when you’re healing from major surgery, believe me.

3. You will spend a lot of time regaining shoulder mobility and range of motion. This is perhaps the biggest issue I have with my pre-op discussions. I just was not prepared for losing my shoulder and arm range of motion (ROM). I did not regain full overhead range of motion until nearly my reconstructive surgery, about eight weeks after my mastectomy.

This seemed like an eternity, and why? Because I couldn’t wear any of my existing tops, wash or brush my hair effectively,  or reach things higher than a few inches over my head. My arms would not straighten overhead – period. Be extremely diligent about stretching and doing your PT exercises – you will get there.

4. Your pectorals and scapulae will forget how to operate, so it’s your job to retrain them.

Pectorals: Yep, this is a big one, obviously, because your pectorals not only work hard on upper-body training day, but also when you’re cooking, showering, getting dressed, driving, and pretty much anything else you do.

If you have reconstructed breasts, your pectorals are repositioned over your implants (I really don’t know how it works with DIEP flap procedures). They might spasm and jump around for a period of time and seem very weak as they learn how to function in their new position. Don’t expect to be doing push ups or any chest exercises for awhile, okay? Just slowly rebuild strength and follow your doctor’s advice.

Scapulae: We know how important shoulder retraction and depression are during lifting, right? But your scapulae might forget how to retract after a mastectomy, which is compounded by – and maybe even caused by – rounding of the shoulders after surgery. Limited ROM and a natural tendency to round your shoulders forward to avoid uncomfortable stretching may make retracting your shoulder blades seem foreign. You’ll work on this in physical therapy, but know that by the time you’re released to exercise you might still have trouble retracting them fully. Be diligent with your PT exercises and stretching – as I said before, you’ll get there. You will!

5. Find a physical therapist who will do soft tissue work – and who is kind and compassionate. A good physical therapist is your first line of defense against scar tissue, and thus against range of motion issues and pain. You must find a good PT before your surgery, one who is not afraid to do aggressive deep soft tissue work with you.

My unfortunate experience was that my first physical therapist wasn’t comfortable with, or didn’t see the value in, soft tissue work. She helped me regain my ROM, but I was left with painful scar tissue that nearly caused me to have a third surgery. It wasn’t until I found a PT who specialized in mastectomy patients that I realized what I’d been lacking. Her amazing work helped me out of ongoing muscle tightness and pain. She was also very kind, patient, and compassionate – something my first PT lacked. (Fact: You need to be around kind, caring individuals while you’re going through this.)

So before your surgery, interview PTs and find one you connect with emotionally and who specializes in post-mastectomy rehab. You deserve the best care possible.

Above all, have hope. It will get better. Recovering from any surgery takes time, and with determination and consistency you will get back. I’ve been back to training for four months now, and I’m happy with my progress. Oh, and did I mention patience?

Peace and love to you, my sisters!

This article first appeared on www.workoutnirvana.com.

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  1. Hey Suzanne,

    A great read and some solid actionable advice. It is a life changing experience going through a mastectomy and the health benefits for strength training are huge!

    My wife has currently just had her operation a couple of months ago so this has been helpful!
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  2. CJ Jones says:

    I really appeciate this piece. I was not a weight lifter before having double reconstruction with pectoral implants. I would so appreciate if you would write a follow up piece on how your lifting changed. What exercises you thought were best and what your weight loads were after mastectomy. I am in an isolated area where there are no PT trainers who understand Mastectomy patients and I would very much like to improve my fitness.

    • Thanks for writing, CJ. I hear you that it’s tough to find help in some areas. You’re doing the right thing by reading up!
      You just made me realize I didn’t link to my second article here. Lots more detail in this one: http://workoutnirvana.com/how-to-strength-train-after-a-mastectomy/
      It was a process, of course, and at first many things were hard that weren’t before. But at this point, the main difference is that pull-ups are more difficult than before. I’m not sure I’ll be able to master them again, but I’m trying! Let me know if you have more questions after reading my latest article.

  3. C. Velasquez says:

    Thank you for sharing. I also had double prophylactic mastectomies. I was very worried that I was being crazy for having the surgery without a positive cancer diagnosis. Well it turns out there were 3 focal points of cancer starting to develop. The surgery saved my life. And I didn’t need chemo or radiation because they were still stage 0.

    I want to start exercising, but I am afraid. I was told that I should not do any exercises involving the pectoral muscles, They told me that the muscles can change the shape of the breast implants as the muscle gets stronger. Or that the implant can shift out of place from doing these types of exercises.

    I see how the shape of the breasts changes when the pectoral muscles contract if I lift something or do anything that requires strength. So it worries me that they will change the shape of the breasts permanently. Have you noticed any changes of this sort?

    Thank you.

    • Hi, thanks for writing and congratulations on getting through your surgery! I don’t know where are you in your recovery, but I think it is extremely misleading to tell someone they shouldn’t strengthen their chest after a mastectomyy. If you do not strengthen your pectoral muscles, you could end up with a muscle imbalance and/or poor posture, which translates to pain in your shoulders or back later on. I was told by an orthopedic surgeon, my reconstructive surgeon, and two physical therapists to strengthen my chest. If your implants were inserted propery and you have tissue supporting them laterally (otherwise they’d slide into your armpits), they shoud not move at all. I don’t know how having more strength and muscle could change the shape of your implants. Yes, your implants might shift when your pectoral muscles contract, but they should stay in place. It’s an adjustment when the implants shift, but you don’t even notice it after awhile. I have bench pressed up to 75 pounds in the last two years and had no issues whatsoever. I would suggest, if you are post-recovery, that you start with very light weight and do three sets of 20 reps, then gradually increase the weight. Good luck! I hope you do start strengthening your chest!

  4. Hey Suzanne,

    A great read and some solid actionable advice.THANKX

  5. A'ndrea Emery says:

    You rock!! I’ve been a lifter for almost 20 years & competed one time so I was so nervous about how long/when I would be back in the gym. I’m 6 1/2 wks post op. Thank you for all of this information & giving me hope that all us sisters CAN get back to our old routines eventually. Thank you again!! 🙂

    • Hey A’ndrea! So cool to connect with you. Congrats on getting through your surgery and initial recovery. I get your apprehension about the long time off. You’ll get there… A slow re-entry wins the day. Good luck, and stay in touch!

  6. hi, Suzanne, and thank you thank you thank you! I’m four weeks post-op and feel like I’ve never been in such poor condition… It’s scary and frustrating! It was encouraging to read this article this morning and hear your story. Thank you!!

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