Day 12 → 4 weeks
- LISTEN TO YOUR BODY and ask your surgeon for specific restrictions
- Scar massage (usually 3 times a day for 5 minutes) as soon as approved by MD (usually around 2-3 weeks); incisions should be fully closed and healed, and proceed slowly with scar massage, this should NOT hurt. It is good to mobilize scars, but too much can cause them to stretch. Be gentle.
- Silicone tape/strips or silicone gel as approved by surgeon
- Manual Lymphatic Drainage (neck, shoulders, arms, around 2 weeks add chest gently stretching skin towards neck and same side arm pit avoiding interaxillary and inguinal axillary pathways)
Approx 15 min sessions, 2-3x/day, to tolerance
- No lifting greater than 8 pounds
- Walking to tolerance/cardio that doesn’t stress the upper body
- Continue arm range of motion for upper body (neck, shoulder, elbow, wrist and finger range of motion and breathing exercises). You can start to progress to gentle overhead stretches AS TOLERATED around 14 days post op (see video for supine range of motion stretches). Once full shoulder range of motion is easy, this can be done 3x/wk rather than daily.
- Once those feel comfortable, you can start upright stretching (see video): wall walks (forwards and sideways), hands behind back stretch, trunk range of motion to tolerance (extension/anterior pelvic tilt, rotation, lateral flexion).
- PAIN IS NOT GOOD!!!! Gentle stretch is ok.
- Lower body exercises to tolerance without weight bearing through the upper body (marching, leg circles starting with knees bent progressing to knees extended, leg lifts, hip abduction/adduction, supine hook lying windshield wipers)
Supine range of motion stretches
Please remember that every body is unique. This is a GENERAL guideline. It is best to seek guidance from a rehab professional (OT/PT who specializes in top surgery rehab) and listen to your own body. If any recommendations are painful or cause negative symptoms, STOP! Discuss these guidelines with your surgeon as surgical protocols may vary.