'Strengthen Your Recovery' Pilates Program

A Pilates program following breast cancer surgery

Maintaining your physical wellbeing is a part of living with and beyond breast cancer, as are your emotional and sexual wellbeing and getting the practical support you need.

Exercise – which can range from simple body movements to strengthening (e.g. resistance exercises) and cardiovascular (“cardio”) workouts and anything in between – can be a useful tool to help you maintain your physical wellbeing while you are going through various stages of your breast cancer experience. This includes prior to and after you have and when you are recovering from breast cancer surgery.

In this section we present information and programs that may help you with your recovery from various types of surgery that are common for those living with breast cancer, including:

breast-conserving surgery (lumpectomy)
lymph node removal
mastectomy.

If you have undergone breast reconstruction surgery after mastectomy, please find out more about specific exercises for people recovering from breast reconstruction surgery.

Guidance from your treating team

The information and exercise program provided on this page are general in nature. They are not prescriptive and are not intended to replace medical or clinical advice from the health professionals on your treatment and care team.

At all times throughout your cancer journey, please speak with your treating team before you start a new exercise program or even individual exercises. Your treating and care team may include your oncologist, surgeon and nurses as well as an exercise physiologist, occupational therapist or physiotherapist. They can help design a set of exercises personalised for your recovery from the specific type of surgery you’ve had.

Referral to specialists

To find an appropriate exercise program tailored to your needs talk to a member of your treating team or GP for referral to an accredited exercise physiologist or physiotherapist.

There may even be some clinical trials or studies in your area looking at how exercise may help those with a breast cancer diagnosis.

Strengthen Your Recovery

“Strengthen Your Recovery” is a gentle exercise program using Pilates techniques. It is designed to help you recover from breast cancer surgery at your own pace.

Pilates is a safe and effective method of rehabilitation and exercise that focuses on muscular balance, improves strength and flexibility (Better Health Channel, 2022).

BCNA developed these videos in 2012 with the expertise of Fiona Eakin, a breast cancer survivor and qualified Pilates instructor, and the generous support of the Estée Lauder Companies.

Strengthen Your Recovery is structured to follow the stages of your healing after surgery.

Strengthen Your Recovery is designed to help:

Relieve neck, shoulder and back pain, common complications after surgery.
Reduce the risk of lymphoedema developing.
Prevent restrictive scar formation and shoulder stiffness
Restore normal posture after surgery.
Improve general flexibility, strength, confidence and wellbeing.
Re-educate muscles to move efficiently.
Improve or maintain muscle tone for a faster recovery.
Work towards overall conditioning and improve general wellbeing.
Increase lung capacity after an operation/anaesthetic.

Please note that the sessions have been designed as a progressive set, meaning that you should graduate to the next session only after you have learned the exercises from the previous session and so on.

Session 1

Fiona introduces a set of small, easy actions that are designed as a follow-up to surgery, lasting for two weeks. These first basic exercises are demonstrated with a person lying on a mat on the floor and their head resting on a folded towel. Alternatively, these exercises can be safely performed while you are still in hospital or lying in bed once you return home.

This Strengthen Your Recovery session includes the following exercises:

breathing – inhaling and exhaling
clocks
nods
shrugs
low arm rotations
hitchhikers.

Session 2

Fiona presents a set of exercises that are designed for weeks 2 to 5 after surgery, teaching gentle shoulder movements and stretches that can be done while you lie in bed, stand in the kitchen or sit at your desk.

This Strengthen Your Recovery session includes the following exercises:

forward and backward shrugs
arm hugs
knee rolls
butterfly wings
back mobility
core strength
hitchhiker with twist
walk up walls
standing chest stretch.

Session 3

Fiona introduces more advanced variations designed for weeks 6 to 8 after surgery.

This Strengthen Your Recovery session includes the following exercises:

long arm stretches
circles
hip rolls
side lie (part A)
side lie (part B)
side stretches
arm strength.

Session 4

Fiona provides a 20-minute program covering basic Pilates exercises as well as some more challenging stretches and exercises.

This session is designed to start a minimum of 10 weeks after surgery and after you have learned the exercises in the previous sessions.

About Fiona

Fiona Eakin

Fiona Eakin has been teaching Pilates since 1994. Following her formal training, she ran two Pilates studios in Canberra and worked closely with the Academy of Sport and ACT Brumbies Rugby Union team.

In 2008, Fiona was diagnosed with breast cancer. Unable to find a suitable Pilates exercise DVD designed thoughtfully and specifically for women after breast cancer surgery, she began the process of designing a program herself.

The Strengthen Your Recovery program was originally distributed via a DVD, before being made available online.

The program which she brings to you in this series incorporates gentle and progressive exercises which have proved effective not only in her own recovery but for many other breast cancer survivors attending her Pilates classes.

Frequently asked questions

Should I talk to a health professional?

If you experience unusual or persistent pain or swelling it is best to seek professional advice.

It is a good idea to let members of your treatment team know that you are following this program.

Is this program for me?

This program is not a substitute for personal advice from a qualified health professional.

You may want to seek advice before participating in this program especially if you:

have had a bilateral mastectomy
have recently had breast reconstruction surgery
have pre-existing shoulder or upper body problems
are experiencing unusual pain, discomfort or swelling.

What can I do to help my recovery?

Here are some ways that you can assist your recovery:

Do not lift or carry anything heavy (over 0.5 to 1 kg) using your affected arm for 6 to 8 weeks. Use both hands to carry things.
Do not introduce weights in this program until you have full and pain-free range of movement in your shoulder and your wound is healing well (usually 6 to 8 weeks) and have gotten the go-ahead from your treating team first.
When introducing weights into your program start with a small weight of 250 grams, and do not progress to more than 0.5 kg (unless prescribed by your surgeon, physiotherapist or lymphoedema specialist).

How should I pace myself?

Here are some ways that you can ensure you exercise at a pace that’s suitable for you:

Progress through this program gradually and slowly and avoid pain.
Take note of the suggested modifications in the videos and/or by your treating team.
Get to know the difference between discomfort and unusual pain. Pain is a sign of overdoing a stretch and may affect wound healing.
If you experience pain or fatigue, stop and rest. It may be necessary to modify and reduce the intensity of the exercises, especially during radiotherapy while the skin is healing, or during chemotherapy if you feel too tired.
Listen to your body. If in doubt, talk to a health professional. At times you may need to re-start the program at a lower level and progress slowly again. The focus of this exercise program should be on quality of movement and a gradual, progressive increase in duration and intensity of this exercise program.

Why do Pilates after breast cancer surgery?

Pilates can be used to support your recovery, helping regain strength and ease discomfort in the affected arm and chest areas. Pilates builds both strength and mobility, making it a valued tool for many people recovering from breast cancer surgery.

Why is exercise important after breast cancer surgery?

As with other surgery, the wound and surrounding tissues need time to heal but there are many people who are not sure how much to rest and how much to move.

It is normal to feel discomfort and muscle tension after surgery. For some, a fear of movement may lead to post-operative complications (such as shoulder, chest and neck pain). Gentle and graduated exercises in the early stages after an operation can help minimise these complications.

Many people are understandably protective of their recovering arm; however, movement is very important to avoid the long-term effects of the surgery on your shoulder and neck.

What is Pilates?

Pilates was originally designed by Joseph Pilates in the first half of the 20th century. It is a method of low-impact exercise that emphasises core strength, control, flowing movement and body awareness. Its focus on breathing promotes relaxation.

Pilates is used broadly by specially trained instructors and physiotherapists to help people gain strength, control and confidence in movement. It is a gentle and progressive exercise technique that suits people of all ages and fitness levels.

Things you can do now

Read BCNA’s exercise and staying fit page for more information
Learn how keeping active can help you reduce your risk of lymphoedema
Read more about Physical preparation and recovery after breast reconstruction
Visit My Journey, BCNA’s online tool for information tailored to your diagnosis
Join our Online Network if you think that talking to others online and sharing experiences will help
Contact BCNA’s Helpline on 1800 500 258 between 9.00 am to 5.00 pm AEST Monday to Friday, for information about the services and support that may be available for you and your family