Program Goals Periodization Do's & Dont's Breathing Exercise Progression Exercise Tips... and More Phase 1 Phase 2 Phase 3 Phase 4 Beyond Phase 4: Abdominals Spinal Stabilization Lower Extremities Adjuvant Treatments Above & Beyond Equipment Sample Pages Contact Order the Book Browse the Book: Excerpts from Phase 1 These exercises are a sampling from Phase 1. (Immediately Post-Surgery) Timing of each phase is dependent upon the physical condition of the individual, the length of the healing process, the type of surgery involved, the courses of adjuvant treatments, and the recommendations of physicians, nurses and specialized physical therapists. Many variables may exist that will effect particular exercise choices at given times. Everyone should begin with Phase 1 in order to practice optimal postures and techniques. Be certain to obtain as much information as possible to prevent the onset of Lymphedema, which can occur spontaneously and indefinitely. (Refer to Links page for related Lymphedema web sites.) Phase 1 is a series of simple exercises to be performed as soon as possible after surgery to prevent swelling and tightness, to relieve discomfort and muscle tension, and to promote healing. These movements are to be performed very slowly and gently a few times per day. Try to start moving the involved arm as soon as possible after surgery. Take a few short walks every day to increase stamina and to prevent muscle weakness. Deep-breathing exercises are most important at this time to relieve pain and tension. Towel or dowel stick may be used for stretching and basic strengthening exercises upon recommendation of physician. When exercises become less challenging, do not increase number of repetitions. Instead, increase number of sets. It is safer and more beneficial to perform 2 sets of 5 repetitions with a short rest between each set, as opposed to performing 1 set of 10 repetitions. It is more important to perform a few different exercises during the course of the day in the early stages of healing, as opposed to one lengthy session. This is a concept that will apply to all modes of exercise until you are capable of maintaining more increased endurance activities (a 20-30 minute session). However, upper body repetitions will always be limited to a maximum of 3 sets of 10 repetitions. Remember to deep-breathe. Before exercising, warm up with Shoulder Shrugs and Shoulder Rolls. Stretch gently at the end. Shoulder Rolls: Sit or stand, looking forward with neck straight, shoulders relaxed, elbows slightly bent, and spine held as straight as possible. Circle both shoulders forward slowly, deliberately trying to draw big circles, feeling movement in the chest and shoulder blades. 4 repetitions. Rest. Repeat the exercise rolling shoulders backward slowly. 4 repetitions. Perform this movement a few times per day. Remember to breathe as you circle. Front Bar Lift: Sit or stand as straight as possible with shoulders, back and neck straight. Look forward and relax neck and shoulders. Hold stick* with palms down, hands about 2 1/2 feet apart, arms straight, and down in front of body. Keeping arms straight and shoulders back, lift stick slowly and gently, exhaling as you lift and hold, and inhaling and relaxing as you lower. Try to lift a little higher with each repetition, hold for a second, breathe, then slowly lower the stick. Repeat 5-8 times. (Dowel stick may be substituted with a yardstick or a towel pulled tightly at both ends). * Stick may be substituted with a yard stick, a taut towel or even a thin roll of wrapping paper. Front Bar, Side Push: Stand with spine as straight as possible. Hold stick in front of body with hands about 2 - 2 1/2 feet apart. Palm up in right hand and palm down on left. Thumbs extended, keeping stick close to the body, use left (downturned) hand to push stick to the right. Exhale as you push. Inhale and to return to center. Repeat 4 times, attempting to push arm a bit farther each time. Change hands and repeat exercise to other side. Palm up in left hand and palm down on right. Use right (downturned) hand to push stick to the left, exhaling as you push and inhaling as you return to center. Repeat 4 times. Back Bar, Side Push: Stand as straight as possible. Hold stick behind you against body, palms up and hands about 2 1/2 feet apart. Keeping arms straight, gently lift stick, exhaling as you lift (only to comfortable point). Rock stick as far to the left as possible, then center, and then as far to the right as possible, breathing slowly to relieve pain in upper body. Try to isolate the movement only in the shoulders. Return stick to center and relax. Repeat full exercise 5-6 times. Next Page: Phase 2 Go to the top of this page. Back to the previous page.

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