The 411: Re-Building Strength + Confidence post Surgery
By Rethink Breast Cancer March 28 2017
PART 3: Upper Body Strength
Recovering from surgery of any kind actually, brings the mind-body connection to the forefront of one’s awareness. After surgery, it is so easy and very common to feel a lack a trust in your body and your body awareness, second-guessing the impact of even the simplest exercises or movements. Even the most kinesthetically aware people like yoga and Pilates instructors have their self-trust shaken in these circumstances and must undertake a journey of strengthening not only their physical body but also the foundational trust between mind and body.
As your journey progresses, it is important to ask yourself some fundamental questions and rebuild that body relationship and trust: Am I working too hard? Not hard enough? Is this sensation a warning or validation? Taking the time to reflect on these questions will help you regain self-trust and confidence in the long run; allowing you to get strong physically through your ability to gauge and engage in beneficial movement and exercise, having full trust in your limits and new strength.
At this stage in the game, you’ve worked hard to establish support, alignment and strength in your central line/ spine. Now, you are ready to work your upper body (obliques, rotator cuff group–especially subscapularis, shoulder girdle and shoulder muscles), with far less risk of creating tension, and strain which might set you back.
Piggybacking on the muscles that we looked at in the central support section (Link to Part 2), let’s revisit the key role played by the abdominal obliques. These muscles form the base of support for the upper body and help keep the ribs aligned, so shoulders sit properly. Fibres of the obliques weave together with the serratus anterior and latissimus dorsi muscles, two important and powerful muscles that help control movements and stability of the shoulder complex. Once the obliques are awake and providing support in the torso, it becomes easier to work with “spiralling the arm bone” and setting it correctly into the shoulder socket. Next, we turn attention to the rotator cuff group deep in the shoulder. These relatively small muscles need to be strengthened to help secure the arm bone in the socket, giving the shoulder inherent stability. Finally, we are ready to work the entire shoulder complex, integrating torso, shoulder girdle and shoulder muscles to build upper body power with good alignment and smooth movement.
This is a 3-part, stage 1 exercise series designed to recondition your entire body before you return to regular workouts that are weight bearing on your arms. You should not feel any pulling or ripping sensations. If you do feel any strain, ease off and make your range of motion smaller. If this does not help, omit the exercise altogether and revisit in in a week.
- Do 6-10 reps of each exercise one after the other, then do three sets of the entire series (15 minutes).
- Start with 3-5 times a week. Begin these exercises, based on the recommendation of your physician.
- Side Wall Lean (obliques, serratus anterior and latissimus dorsi)
Start by standing with the right side of your body towards a wall and your right hand slightly forward of your body, against the wall. Elbow should be slightly bent. Keep entire body long and straight, and lean (from ankles) into the wall, bending elbow deeply. Straighten the elbow to return to the start position. Feel for muscles in the arm and side torso (obliques) working as you move. As you gain control and feel confident about using the arm and side torso, try pushing off and landing on the wall with your hand. Starts to feel like a sideways push-up!
Caution: If you feel the front of the ball of your shoulder working or straining, move your hand a little more forward on the wall. Ideally, it is arm and torso muscles working and not the front of the shoulder.
2. Side Bend with Arm Sweep (spine and shoulder integration)
Stand with your feet hip-distance apart, (or a little wider if that helps you feel more steady) and place your arms at your sides. Tilt your head and bend your upper body to the right so it feels like your ribs are closing on your right side and opening apart on your left. Simultaneously, reach your right arm out to right as if you are offering someone an apple with your hand. Then reverse to tall standing. The key here is syncing the side bend motion with the arm sweep/reach. The movement should feel fluid and easy–like your arm is an extension of your torso.
- Arm Wave (rotator cuff)
Stand with your feet hip-distance apart (or a little wider if it helps you feel more steady), and cross your arms over the front of your body as if your hands are in the front pockets of a pair of pants. Start to move your arms up and out to sides until you reach a V shape. Then, reverse the motion and cross your arms over your back as if you are placing your hands into your back pockets. The key is turning your arms out on the way up and in on the way down into the pockets (both front and back). Modify or decrease the motion if there is any strain and feel for muscles working in your arms, chest and upper back.
- W to V Arms Against Wall (upper mid-back & shoulders)
Stand with back against a wall and your arms in a W shape, palms facing your head. Try to keep back straight against the wall as you slide your arms upward into a V shape. Reverse the motion to return to the start position. This exercise works your upper body muscles against gravity and can be tiring. Feel for muscles working in your entire upper body, in particular between your shoulders blades. Modify or decrease the motion if there is any strain but remember that it is common to feel fatigue building at the top of the shoulders and back of your neck. A good sign that some critical support muscles for your neck and shoulders are waking up!
Margot McKinnon (B.Ed., M.Ed.) is a Pilates and Movement Specialist dedicated to helping train teachers and the general public to move with ease and integrity.