Will I be able to do abdominal (stomach) exercises after TRAM reconstruction?
What you will be able to do following reconstruction will depend greatly on your fitness level prior to surgery. If you had strong abdominal muscles and a strong lower back prior to surgery, your recovery and subsequent return to your previous fitness level will be much easier. If you did not have a strong “core” to begin with, the TRAM procedure will leave you weakened even more and subject to low back pain and possibly even hernia.
Another consideration is whether you had a single or bi-lateral reconstruction; in other words, did they use part or all of your rectus abdominis to create one, or two new breasts? For obvious reasons, having both parts of your rectus used will leave your core tremendously weakened and can lead to postural deviations (swayback) and low back pain. It is highly unlikely that you will be able to do “crunches” or Pilates if you have had bi-lateral reconstruction. It will be very important, however, to work your obliques, intercostals, and erector muscles of the lower back to reinforce your core stability.
It is essential to address the weakened core muscles and postural deviations that arise following the TRAM. Most if not all of these issues can be corrected with the proper combination of stretching and strength training. Please consult a Cancer Exercise Specialist (CES) in your area for safe and effective guidance and programming.

Can I lift more than 8-10 pounds following an axillary node dissection?
The National Lymphedema Network recommends that you avoid lifting objects over 8 lbs. following an axillary lymph node dissection to prevent the onset of lymphedema. My recommendation is this; avoid lifting excessive weight whenever possible. What this means is if you don't have to take out the trash, carry your luggage with the affected arm, or carry your twenty pound child on the affected side, DON'T! On the other hand, if you take proper precautions to avoid lymphedema, including measuring your arm and not overheating, you can gradually begin to increase your weights at the gym. Following your surgery, you will need to begin with the lightest weight and just a few exercises/repetitions, regardless of how much you were lifting prior to surgery. As your arm tolerates it (no visible swelling), gradually begin to add a few more repetitions and then a few more exercises. Other than not letting yourself overheat, there are no limitations for your lower body (unless you have a pre-existing issue). The bottom line is be safe; start and progress slowly and realize that you may have to take two steps backward before you can take one step forward. For those of you who did not lift weight prior to surgery, you will need to take it even more slowly. I strongly recommend that anyone who has undergone lymph node surgery contact a Cancer Exercise Specialist prior to beginning or resuming a weight training program.

Why can't I raise my arm to the side or over my head anymore after my mastectomy?
Following a mastectomy, lymph node dissection, and/or radiation, the muscles may react by going into painful spasms affecting range of motion and posture. While the pectoral (chest) muscles are not removed, they undergo quite a bit of stress during the process. The incision across the chest, as well as the one under the armpit, may be bound down with scar tissue and adhesions. The skin may also be damaged by radiation. Depending on the degree of limitation, you may need to consult a physical therapist to help you with such modalities as ultrasound, massage, and electric stimulation. You should have a Cancer Exercise Specialist assess your range of motion and posture to determine whether or not you need a physical therapist and, if not, what the most effective exercise programming will be to help you regain your range of motion as well as correct postural deviations that may have resulted from the surgery and/or treatment. It is essential that you do not "push through" pain. Listen to your body and take it slowly. The degree of recovery will vary from person to person, but with the proper balance of strengthening/stretching exercises, there should be significant noticeable improvement in a very short time.

Back     More>>