How to exercise for swollen arms due to breast cancer

Breast cancer is one of the most common malignant tumors in women, and its incidence is on the rise. Genetics, infertility, unhealthy lifestyle and excessive mental stress are some common factors that cause breast cancer. It is not uncommon to have arm edema after radical mastectomy, which is about 20 to 30%. Once it occurs, it will cause a lot of inconvenience to the patient's daily life.

1. Causes of arm edema after breast cancer surgery

Arm edema is actually a type of lymphedema. This is because some breast cancer patients undergo axillary dissection, which removes some lymphatic tissue, blocking the "pathway" for lymph fluid to return and causing it to accumulate in the subcutaneous tissue. If the axillary area is radiotherapyed after surgery, it will also aggravate upper limb edema.

2. Arm edema is divided into two types

Arm edema is divided into short-term upper limb edema and long-term upper limb edema. If upper limb edema occurs soon after surgery, these patients are very likely to have the edema subside through timely rehabilitation exercises and recovery of upper limb function.

Long-term upper limb edema usually occurs 1 to 2 years after surgery. If there is no recurrence or metastasis after surgery, the patient may feel that he has recovered and is more relaxed psychologically, thus ignoring the problem of upper limb function. Excessive use of force and fatigue on the affected arm can induce it, and the condition will gradually evolve, causing the edema of the affected limb to get better or worse or gradually worsen, and some arms will become thicker and thicker.

3. How to prevent arm edema

In the early stage, the edema area is relatively soft and pitted, and can gradually worsen. The protein-rich lymph fluid will cause the skin to turn brown to a certain extent during the fibrosis process, followed by hardening, excessive keratinization and thickening. In severe cases, there will be upper limb dysfunction such as limited shoulder joint movement, limb weakness, paresthesia such as numbness and pain, and limb deformity leading to psychological disorders.

(1) After surgery, place a buckwheat pillow (avoid a soft pillow) under the affected limb to support the entire arm, clamp the arm, and place it horizontally in front of the chest to maintain a functional position. Raise the affected upper limb to reduce swelling and promote lymphatic return.

(2) When getting out of bed and moving around, the affected limb should be put in a sling to maintain a good functional and horizontal position and avoid prolonged sagging. When sleeping, the limb should be appropriately raised to avoid pressure.

(3) Functional exercise guidance: on the 1st to 2nd day after surgery, practice making fists and flexing wrists; on the 3rd to 4th day after surgery, practice elbow flexion; on the 5th day after surgery, practice touching the opposite shoulder and the ipsilateral auricle with the palm of the affected limb; one week after surgery, practice shoulder exercises; on the 12th to 14th day after surgery, practice raising the affected upper limb and doing finger wall climbing exercises; in the 2nd week after surgery, practice placing the palm of the affected limb behind the neck, start lowering the head, and gradually raise the head and straighten the chest.

(4) Avoid increasing resistance to lymphatic return. Avoid wearing tight underwear, necklaces and suspender bras, and try to wear loose rings, bracelets and watches.

(5) Avoid lifting heavy objects with the affected limb, avoid excessive blood flow to the upper limb, and avoid high-intensity upper limb exercise. When muscles are exerting force, a large amount of oxygen needs to be supplied to the muscles, which will cause a large amount of blood to flow into the arm, and then the venous blood and lymph fluid must be transported out from the congested arm.

(6) Avoid drug injections, blood draws, immunizations, and blood pressure measurements on the affected upper limb.

(7) Avoid high temperatures on the affected upper limb, such as hot water soaking, sun exposure, sauna bath, etc.

(8) Avoid skin damage and infection on the affected limb. Avoid mosquito bites; once the skin is damaged, it should be disinfected locally and antibiotics should be used appropriately. If the condition is serious, the patient should go to the hospital for treatment. Because the interstitial space after lymphedema is rich in protein, even a small skin damage can cause bacterial infection.

(9) Moderate activities and exercises can help improve lymphatic circulation. For example, stretching and abdominal breathing can change the pressure in the thoracic cavity and promote lymphatic return. Upper limb lifting exercises can cause muscle contraction and stimulate lymph flow.

(10) If the patient has severe edema, wear an elastic cuff to reduce lymphatic return.