LINDA G., A BREAST CANCER SURVIVOR, IS JOYFUL EVERY DAY — A FEAT THAT BECAME MORE DIFFICULT AS SHE DEVELOPED A FROZEN SHOULDER AND THEN A MILD CASE OF THORACIC OUTLET SYNDROME IN THE YEAR FOLLOWING HER SINGLE MASTECTOMY. “I KNOW THAT I SHOULD BE GRATEFUL THAT I KICKED CANCER, BUT IT WAS REALLY DIFFICULT TO BE HAPPY WHEN MY SHOULDER ACHED ON A DAILY BASIS,” LINDA SAID.

FOR MANY YEARS, women receiving breast surgery were told to “baby” their arm to prevent lymphedema (a swelling of the armpit, arms or hands). And while this advice seems appropriate when trying to prevent agitation of the surgery site, it has a drastic effect on the mechanics and health of the shoulder girdle. As we develop a better understanding of the role healthy muscles play in overall body health, research is starting to show that gentle use of the arm during the healing process can keep the tissues of the shoulder girdle mobile, help the scar tissue lie down in the correct direction and actually reduce swelling in the arms.

In addition to aiding in the healing process, working on skeletal alignment can actually create a healthier environment for the breast tissue before there is an issue. In fact, many asymptomatic women are slowly collecting lymph in the armpit area due to poor tone of the rotator cuff, pectoral and latissimus muscles. This excessive swelling around the bra area is often accumulated waste, even though it looks and feels like fatty tissue.

How does your lymph system work?
Circulating alongside your blood vessels, our lymph system drains the cellular waste products removed from the cells. But unlike the heart in the cardiovascular system, lymph has no pumping mechanism. It depends on the movement of the muscles in the area. And even if you work the large muscles in the gym, the smaller muscles often get neglected. Whether you are interested in preventing waste accumulation or reducing swelling due to stagnant lymph, exercises to slowly stretch and strengthen the area are greatly encouraged!

The “egg-hole” test
This is a simple way to evaluate the tone of the muscles that define your armpit. Muscles that are easy for you to innervate (which means to “supply with nerves” by contracting) indicate the lymph has a better chance at being removed from the area.

Stand in front of a mirror with a clear view of your armpit. The less clothing you have on, the easier it is to see. Bring your elbow out to the side and lift it until it is the same height as your shoulder. Gently pulling your shoulder blade downward should create a hole about the size and shape of an egg. If you have some lymph in the area, the wall of your armpit will be flat. If you have a lot of lymph in the area, your armpit will bulge.

If you have a generous amount of swelling in the armpit, it may be a good time to schedule a breast examination and have your nodes checked — and start these exercises right away!

What types of movement are safe?

When you first have surgery, most movement is uncomfortable and there is a lot of fear of re-injuring or damaging the surgical site. Your surgeon should let you know when the suture has healed and you are no longer at risk of opening the site. During that time, however, you can still move the surrounding areas without impeding the healing process.

Keep your hands active to keep neurological activity moving through the arms. Do “piano player” exercises with your fingers, touching each finger to the thumb, going up and down the scales working on speed and fine motor skill. Add gentle hand and finger stretching often, to keep the tissues from atrophying while you are healing. Also, add the “head hang,” (pictured below ) to stretch the back of your neck. Healing tissues tend to be stiff from disuse, so keep the neck supple by allowing the chin to drop until it touches the chest.

Put the swing back into your step!
Of all the exercises you could do with your shoulders, walking with natural arm swing is the most important to breast health! Many people have adopted the race-walking posture of bending the elbows when going for their daily exercise, but long-armed swings pushing behind you (imagine pushing ski poles behind you) is the more natural and calorie-burning way to walk. Remember, race walking is a sport, so these athletes are trying to conserve energy and expend less calories — why would we want to do that?

Stretching your chest with floor angels

Reclining on a bolster or stacked pillows, reach your arms out to the side, keeping the palms up. Try to get the backs of your hands to the floor, keeping your elbows slightly bent. Once your chest can handle that stretch, slowly raise your arms above your head, trying to keep them on the floor. Do this for five to 10 minutes per day, and be gentle with yourself!

You may not feel up to heavy bouts of exercise right after treatment or surgery, but as you begin to feel better, small movements can aid the body in healing and have an overall energy-increasing result.

These exercises from the Aligned and Well™ program can be used as both preventive health measures as well as part of a recovery program. They are designed to gently restore the circulation of electricity, blood and lymph mechanics, which all lead to better breast health!

This is exciting!  Our very own Rose is, this minute, flying to Washington D.C., where she will tour the White House vegetable garden and meet with the movers and shakers in the front-line of national food policy.  Go Rose!  I am super-excited for her as well as super-excited that I am not the one traveling via car, plane, shuttle, plane, taxi, limo, repeat.  Not that I don’t adore traveling.  I would gladly take the next free trip to rural Africa, thank you very much!  It is the sitting for hours upon hours I detest.

I have worked hard to make the “movement” component of my life reflect that of yesteryear, minimizing car, gas, and gear-powered travel, opting to use my fabulous hips instead.  Hips are, by definition, the greatest joint you have.  Greatest joint in size, greatest joint in terms of engineering (check out all those muscles that attach there!), and the GREATEST joint, by far, in your pants.  Really…if you don’t have those muscles in your hips innervating, you probably have a fantastic belt collection!

So for Rose (or whomever sits as a desk or spent this weekend driving) I recommend this great stretch for your piriformis muscle.  This hip muscle often aggravates sciatic pain in the sacral (low back) area and can limit the health of the hip joint.  I call it the Number 4 stretch, because when you get into it, you kind of resemble the number “4”.   The most simple version is, while perched on the front of a chair, cross your ankle over your opposite knee.  Try to reach forward to the floor…yikes, that’s tight!  P.S.  If you have a hip or knee replacement, please avoid this stretch.  If you want to avoid a knee or hip replacement, do the Number 4 stretch often!

Thank you, Shelah W. for making me a cartoon!

I do this one a lot when flying – both in the airport and in the back of the plane.  You can do it in a chair, against a wall, or if you have very good balance, you can do it without any support.  While filming our DVD line, the camera operator was having sciatica pain, so I showed him this stretch and the entire crew did it in their chairs, standing, and using the set walls.

Take "5" - Five minutes to stretch, that is!

I’m also fairly positive you can do it while reading a blog…hint hint.