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Shelley K. Perkins, MD Breast Surgery

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Surgery & recovery

Arm and shoulder exercises after breast surgery

After surgery in the armpit or across the chest, the shoulder stiffens quickly if it is not moved. Getting it moving on the right schedule matters more than most people expect. Do each exercise slowly, breathe, and stop at the point of a stretch, not pain.

From Dr. Perkins’ instructions

Gently move the arm on the side of your surgery, slowly and as comfort allows. It lowers the chance of a frozen shoulder, a stiff shoulder that is hard to move.

Gentle arm movement from the first day after surgery

Three or four times a day, five to ten repetitions each, with the arm kept below shoulder height.

Shoulder shrugs. Lift both shoulders toward your ears, hold for three seconds, let them drop. Then roll them slowly backward.
Elbow bends. Arms at your sides, bend the elbows to bring the hands to the shoulders, then straighten.
Hand squeezes. Squeeze a soft ball or a rolled sock, hold for three seconds, release. This helps fluid move out of the arm.
Deep breaths. Hands on your lower ribs, breathe in slowly so the ribs push out against your hands, then out through pursed lips. Five breaths, several times a day, for your lungs and for the stiff chest wall.

Shoulder stretches once the drain is out, or from about one week

Twice a day, five to ten slow repetitions each, holding each stretch for a count of ten. Aim to gain a little each day. Full reach overhead usually returns by four to six weeks.

Wall climb. Face a wall, fingertips at shoulder height. Walk the fingers up the wall as far as comfortable, hold, walk back down. Mark how high you get and try to pass it tomorrow.
Wand raise. Lie on your back holding a broom handle or cane with both hands, shoulder width apart. Use the good arm to lift both arms up and back over your head as far as comfortable, then lower.
Hands behind the head. Sitting or lying down, clasp the hands behind your head and let the elbows drift apart and back. Hold, then bring the elbows together in front.
Shoulder circles. Arms out to the sides at whatever height is comfortable, make small circles, then gradually larger ones, forward and back.
Hands behind the back. Reach both hands behind you and clasp them at the level of your lower back. Slide them up your back as far as comfortable. This is often the last movement to come back.
Stop and call if

An exercise causes sharp pain rather than a stretch, pulls at the incision or the drain site, or the arm swells or feels heavy afterward and does not settle by the next morning. Cording, a tight band from the armpit down the arm, is not a reason to stop; it is a reason to mention it at your visit and possibly to see a physical therapist who works with breast surgery patients.

Protecting the arm long term after an axillary dissection

When many of the lymph nodes under the arm have been removed, fluid from that arm has fewer paths back to the body, and , a lasting swelling of the arm, becomes possible. It can start months or years later. The habits that help most are the ones that are easiest to keep:

  • Keep the skin of that arm and hand clean and moisturized, and treat any cut, burn, or insect bite promptly with soap, water, and a dressing.
  • Use the arm. Normal activity and exercise, built up gradually, lower the risk rather than raising it.
  • Keep to a healthy weight; excess weight is one of the strongest risk factors.
  • Wear gloves for gardening and washing up, and sunscreen outdoors.
  • Many surgeons still advise avoiding blood pressure cuffs and needle sticks on that arm, and Dr. Perkins agrees with that advice. Sometimes it is not possible to avoid blood pressures and blood draws on the side of your surgery, so talk with your doctor about what he or she recommends for you.
  • If the arm feels heavy, tight, or looks fuller than the other and it does not settle overnight, call. Lymphedema treated early stays small.

Where this comes from

Sources, reviewed 13 September 2026

The instruction to move the arm gently to lower the chance of a frozen shoulder, and the advice about blood pressures and blood draws, are Dr. Perkins’ own. The exercises, their start days, and the lymphedema habits are standard post-operative guidance for breast surgery. Dr. Perkins read the page and approved it on 13 September 2026.

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