Guest Blog: Kelly Pereira, NASM Certified Personal Trainer
Recovering after a single or double mastectomy often brings more than wounds and drains; many people notice stiffness, limited shoulder movement, chest tightness, and a heavy, constricting sensation people sometimes call the iron bra. These range of motion problems can make everyday tasks (for instance reaching up, putting on a shirt, or driving) frustrating. Limits to the range of motion can slow one’s return to normal strength and activity.
But there is good news: targeted gentle exercises after mastectomy started early, plus simple self-care steps and timely referral to physiotherapy, dramatically improve shoulder range of motion (ROM), reduce pain, and help resolve chest tightness (that iron bra feeling) and cording.
Below is a survivor-friendly guide that incorporates safe exercises after mastectomy as well as progressions and self-care steps for managing iron bra, along with reliable references so you can verify and learn more.
Please always check with your surgeon/oncology team before starting or progressing exercises after mastectomy (especially if you have drains, breast mound implants/reconstruction, or have concerns about healing).
Quick overview — how exercises after mastectomy usually progress
- Immediate (day 0–7): Gentle breathing, shoulder pendulums, and light elbow/hand movement are usually recommended to prevent stiffness while protecting the wound. Start very gently and only to the level of comfort.
- Early (1–6 weeks): Gradual introduction of assisted range-of-motion (wand, wall crawl) and mobility work to regain shoulder flexion/abduction and rotation. Avoid heavy lifting until cleared. Canadian Cancer Society+1
- Later (6+ weeks): As healing permits, add gentle strengthening, posture work, scar desensitization/mobilization, and more aggressive mobility if needed. Physiotherapy is especially helpful for stubborn tightness, cording (axillary web syndrome), or frozen-shoulder patterns.
Important safety notes
- Check with your surgical team or physiotherapist before starting exercises after mastectomy — especially if you have active drains, infection, uncontrolled pain, or reconstruction that may need special precautions.
- Stop or slow down if an exercise increases sharp pain, causes new numbness/tingling, or if you notice swelling or changes that worry you — contact your care team.
- If you have concerns about lymphedema, get specific guidance from a certified lymphedema therapist before engaging in exercises after mastectomy, aggressive massage or deep scar work. Some movements are helpful, but compression/lymph drainage guidance should be individualized. Canadian Cancer Society
Phase-by-phase exercise list (with how-to and tips and links)
Below are exercises after mastectomy commonly recommended by surgical teams. Do them 2–3 times daily (short sessions), progressing slowly as you gain comfort. Aim for gentle rhythm and breathing; don’t hold your breath.
Phase 0–1 (first days to week 1) — gentle mobility & breathing
- Deep breathing + chest expansion
- How: Sit or lie comfortably. Take slow, deep breaths, aiming to expand the upper chest and ribs on the surgical side. Repeat 8–10 breaths.
- Why: Helps full chest expansion, improves lung inflation, and gently mobilizes the ribcage and upper chest. ACS
- How: Sit or lie comfortably. Take slow, deep breaths, aiming to expand the upper chest and ribs on the surgical side. Repeat 8–10 breaths.
- Pendulum (clock) swings
- How: Lean forward (support with your non-surgical arm on a table), let the surgical-side arm hang relaxed. Gently swing it forward/back, then small circles clockwise/counterclockwise. Keep movements small and painless. 1–2 minutes.
- Why: Uses gravity to mobilize the shoulder without active lifting. Excellent first-stage ROM. Sunnybrook
- How: Lean forward (support with your non-surgical arm on a table), let the surgical-side arm hang relaxed. Gently swing it forward/back, then small circles clockwise/counterclockwise. Keep movements small and painless. 1–2 minutes.
- Hand/elbow/wrist movement
- How: Bend and straighten the elbow, open/close the hand, rotate the wrist — keep circulation and reduce stiffness.
Phase 1–2 (about week 1–6) — assisted ROM and wall progressions
- Wand or broomstick-assisted flexion/abduction
- How: Hold a broom handle/wand with both hands in front. Use the good arm to help lift the affected arm up (forward or out to the side) as far as comfortable. Lower slowly. 8–12 reps.
- Why: Assisted motion increases range of motion while minimizing strain on the operated tissues.
- How: Hold a broom handle/wand with both hands in front. Use the good arm to help lift the affected arm up (forward or out to the side) as far as comfortable. Lower slowly. 8–12 reps.
- Wall crawl/wall walk (finger walk)
- How: Face a wall and “walk” your fingers up the wall as high as comfortable, keeping the arm relaxed. Slowly walk fingers back down. Repeat 6–10 times. Progress by moving farther from the wall to increase difficulty.
- How: Face a wall and “walk” your fingers up the wall as high as comfortable, keeping the arm relaxed. Slowly walk fingers back down. Repeat 6–10 times. Progress by moving farther from the wall to increase difficulty.
- Doorway stretch (pec stretch)
- How: Stand in a doorway, place your forearm/hand on the doorframe at elbow height and gently lean forward to feel a stretch in the chest. Hold 20–30 seconds, repeat 2–3 times.
- Why: Reduces anterior chest tightness that contributes to the iron bra sensation and helps posture. Use caution if you have fresh scars — gentle only.
- How: Stand in a doorway, place your forearm/hand on the doorframe at elbow height and gently lean forward to feel a stretch in the chest. Hold 20–30 seconds, repeat 2–3 times.
- Pullover (lying) — gentle thoracic/shoulder mobility
- How: Lying on your back, knees bent, hold a stick or towel overhead with both hands and slowly lower toward your head as tolerated (stop if pain). Come back up. 6–10 reps.
- How: Lying on your back, knees bent, hold a stick or towel overhead with both hands and slowly lower toward your head as tolerated (stop if pain). Come back up. 6–10 reps.
Additional targeted techniques (for cording/axillary web and nerve mobility)
- Snow angels (supine arm slides)
- How: Lie on your back with knees bent. Keep elbows straight and slowly slide arms overhead like a snow angel until mild tension, then return. Great for gentle shoulder flexion and thoracic mobility. Alberta Health Services
- How: Lie on your back with knees bent. Keep elbows straight and slowly slide arms overhead like a snow angel until mild tension, then return. Great for gentle shoulder flexion and thoracic mobility. Alberta Health Services
- Nerve gliding / median nerve flossing
- How: Gentle nerve glides (physiotherapist taught) can reduce nerve tension in cording. Usually involves coordinated elbow/wrist/shoulder movements — seek instruction first. Useful for axillary web syndrome (cording). Alberta Health Services
- How: Gentle nerve glides (physiotherapist taught) can reduce nerve tension in cording. Usually involves coordinated elbow/wrist/shoulder movements — seek instruction first. Useful for axillary web syndrome (cording). Alberta Health Services
- Scapular retraction & posture work
- How: Seated or standing, gently squeeze shoulder blades together and down (as if closing a book between them). Hold 3–5 seconds, repeat 10–15×.
- Why: Improves shoulder mechanics and counters forward-rounded posture that makes chest tightness worse. PMC
- How: Seated or standing, gently squeeze shoulder blades together and down (as if closing a book between them). Hold 3–5 seconds, repeat 10–15×.
Phase 3 (6+ weeks) — strengthening & return to function
- Light resistance band rows or wall push/pull
- How: Using a band or bodyweight, do gentle rowing to strengthen the back muscles that support shoulder movement. Progress slowly. Canadian Cancer Society
- How: Using a band or bodyweight, do gentle rowing to strengthen the back muscles that support shoulder movement. Progress slowly. Canadian Cancer Society
- Progressive overhead reaches/modified strengthening
- How: Under guidance, begin adding light weights or functional tasks as you regain full ROM and your surgical team clears you.
Specific steps to reduce iron bra tightness (post-mastectomy pain syndrome/chest tightness)
Iron bra is an informal term many survivors use to describe persistent chest wall tightness, scar adhesions, and a sensation of constriction. It can come from scar tissue, muscle shortness, radiation fibrosis (if treated), poor posture, or protective guarding. The following are practical, evidence-based strategies used in breast cancer rehabilitation:
- Scar massage and mobilization (once wounds healed)
- Technique: After the incision is fully closed/healed, gentle circular massage and mobility of the scar and surrounding tissue can reduce adhesions. Use a small amount of oil or cream. Do not massage directly over open wounds. If lymphedema risk exists, please check with your therapist first. Canadian Cancer Society+1
- Technique: After the incision is fully closed/healed, gentle circular massage and mobility of the scar and surrounding tissue can reduce adhesions. Use a small amount of oil or cream. Do not massage directly over open wounds. If lymphedema risk exists, please check with your therapist first. Canadian Cancer Society+1
- Myofascial release / soft-tissue work
- How: A trained physio or massage therapist can apply gentle fascial techniques to the chest, pec muscles, and scar area to reduce tightness and restore sliding of tissues.
- How: A trained physio or massage therapist can apply gentle fascial techniques to the chest, pec muscles, and scar area to reduce tightness and restore sliding of tissues.
- Heat before stretching, cool/ice after if inflamed
- How: A warm shower or heat pack before stretching can relax tissues, making mobilization easier. Use ice for short periods afterwards if a sudden increase in inflammation/pain occurs.
- How: A warm shower or heat pack before stretching can relax tissues, making mobilization easier. Use ice for short periods afterwards if a sudden increase in inflammation/pain occurs.
- Posture re-training and thoracic mobility
- Why: Rounded shoulders and a stiff thoracic spine magnify the iron-bra feeling. Thoracic extension exercises, doorway stretches, and scapular retraining can produce big improvements. PMC
- Why: Rounded shoulders and a stiff thoracic spine magnify the iron-bra feeling. Thoracic extension exercises, doorway stretches, and scapular retraining can produce big improvements. PMC
- Targeted breathing and diaphragmatic techniques
- How: Relaxed deep breathing and ribcage expansion reduce chest rigidity and improve overall mobility. Practiced daily, breathing work helps desensitize tightness. ACS
- How: Relaxed deep breathing and ribcage expansion reduce chest rigidity and improve overall mobility. Practiced daily, breathing work helps desensitize tightness. ACS
- Early management of axillary web (cording)
- If you develop visible cords or tight bands under the arm (axillary web syndrome), early gentle mobilization, stretching (snow angels, wall walks), and referral to exercise therapy or physiotherapy improves outcomes. Avoid aggressive stretching without guidance. Alberta Health Services
- If you develop visible cords or tight bands under the arm (axillary web syndrome), early gentle mobilization, stretching (snow angels, wall walks), and referral to exercise therapy or physiotherapy improves outcomes. Avoid aggressive stretching without guidance. Alberta Health Services
- Referral to specialist rehab
- When self-care and basic exercises after mastectomy aren’t enough, a breast cancer exercise specialist, physiotherapist or occupational therapist can use manual therapy, prescription exercise progression, nerve/glide techniques, and scar desensitization to relieve iron-bra symptoms. Studies show supervised rehab improves shoulder function and quality of life. PMC+1
Living beyond the 6 weeks after surgery: Integrating movement into everyday life
Beyond these exercises after mastectomy, everyday posture and light activity play huge roles in recovery:
- Set reminders to move: Gentle arm circles, shoulder rolls, or standing stretches every hour prevent stiffness.
- Focus on posture: Imagine a string gently lifting your chest upward — this helps retrain your muscles and fascia to support open movement.
- Breathe deeply throughout the day: The rib cage expands in multiple directions — front, side, and back — each breath is a micro stretch.
- Join a cancer-specific exercise program: Many Canadian hospitals and community centers (e.g., Wellspring, Alberta Cancer Exercise program, Ontario’s EXCEL program) offer supervised exercise tailored for survivors. Kelly Pereira from Fit2beatdisease.ca offers tailored programs and community based online exercise instruction.
Emotional Recovery Through Movement
Beyond the physical benefits, regaining mobility can be deeply emotional. Many survivors share that these exercises after mastectomy help them reconnect with their bodies and rebuild confidence after treatment. Each stretch represents strength — the courage to move forward despite fear, discomfort, or uncertainty.
As you move, remind yourself:
“I am healing. I am strong. My body is learning to trust movement again.”
Recovery isn’t linear — some days exercises after mastectomy will feel easy, others more restricted — but every movement brings you closer to comfort and freedom. Learning to love your body for what it can do, can be so powerful in healing after surgery.
Other AskEllyn Exercises After Mastectomy Blogs
About the author
Kelly Pereira, BSc (Honours) Kinesiology and NASM-Certified Personal Trainer, is a dedicated Cancer Exercise Specialist and founder of Fit2BeatDisease. She has been seen in Strong Fitness Magazine and is an ambassador for After Breast Cancer. A breast cancer survivor and flat advocate, Kelly turned her personal journey into a mission to help others harness the power of movement to heal, thrive, and prevent disease. She leads live Zoom strength training classes and offers personalized one-on-one training programs that combine exercise, nutrition guidance, and ongoing support. Kelly also contributes to national initiatives such as the University of Toronto’s EXCEL study, which brings free cancer-focused exercise to communities across Canada. With a strong belief that “Exercise is Medicine,” she empowers people to rebuild strength, manage treatment side effects, and foster resilience, all while creating a supportive community where individuals feel seen, encouraged, and capable of achieving lasting health. Her philosophy is simple yet powerful: through movement, healthy habits, and connection, people can reclaim their wellbeing and feel supported living with confidence, strength, and hope.
Check out Kelly Pereira in the recent Best Body Guide by Strong Fitness Magazine on shelves in Canada, the U.S. and Europe. Or on the website: https://www.strongfitnessmag.com/training/workouts/upper-body-push-pull/
