3 Exercise Tips to Optimise Your Healing after Cancer Surgery

We understand that everyone aims for good recovery after cancer surgery. However, many people get frightened by the pain and discomfort from the wound site and are unsure how to move, what more to say exercise!

While ‘exercise’ can be a daunting word, the negative effects of immobilisation (lying in bed all day or moving too little) after the surgery is not good for recovery. In fact, it exposes you to a much higher risk of getting serious complications: lung infections, prolonged dizziness, delayed healing of the wound, and loss of muscle mass.

In this article, let me guide you through 3 simple exercise tips to optimise your recovery after cancer surgery, and restore your peace of mind while you are trying to move. These tips are going to be helpful for the caregivers too!

Tip 1: Early Movement Right After Surgery

The first and most crucial step is EARLY movement. The emphasis on the word ‘early’ is because most people are fearful of moving due to the pain, and are scared of reinjuring surgical wounds.

One thing we need to understand about early mobilisation in this stage is – not to exercise or push beyond your capacity on the first day after your surgery. The strategy is to GRADUALLY progress your movements: from a lying-down position, to sitting up (with partial support to independence), and standing (from full support to independence).

Being able to turn your body and get out of bed without causing severe pain or putting yourself in an uncomfortable position not only helps to reduce fall risks, it also promotes wound healing, and helps you to return to daily activities earlier. It sounds very simple for people who are well, but most people struggle to get up from bed after an operation due to lack of information. Here are some tips on how to manage it.

Exercises to improve blood circulation & mobility

Lying down on your back, you can do the following:

• Heel slide – slide your heels towards your bottom and straighten your leg again, repeat on the other side. This helps to mobilize your hips and knees, and improve circulation.
• Ankle pump – pointing your feet up and down as often as possible. This helps to return circulation to the heart.
• Bridging – lifting your hip up and down to mobilise and strengthen your lower back and hips.

Getting up from bed to sitting upright – Preventing blood pressure drops and dizziness

Step 1: Turn your trunk together with your knees to one side side, bend both knees
Step 2: Lower your legs from the bed first
Step 3: Use your arms strength to push your body into an upright sitting position
Step 4: Take a moment to breathe and monitor your dizziness and blood pressure

Sitting up regularly helps your body to regulate your blood pressure after surgery and gets you used to being upright again, before attempting to stand.

Tip 2: Breathing Exercises

Breathing can be painful after your surgery especially when the surgical wounds are right below your lower chest or diaphragm muscle (the muscle you use to take deep breaths). The tip is – practice your breathing when the pain is temporarily relieved by painkillers, so right after surgery is the best time to practice this!

Chest expansion and coughing technique are the two major components that you need to master. Having full chest expansion ensures the lungs take in enough oxygen to meet your body demand, it also mobilises phlegm collected in the airways which can be stuck after surgery. Meanwhile, the right coughing technique helps to bring the phlegm from bottom to the top of the airway, and expel it through the mouth. This prevents lung infections.

Chest expansion for better oxygen absorption

As you breathe better, oxygen exchange increases – this helps to keep your SpO2% reading above 95%, which is optimal for oxygen exchange in our cells (wound healing needs oxygen too!).

Step 1: Sitting at the edge of the bed, place your hands on the lower chest / rib cage
Step 2: Take a deep breath in, feel your rib cage expand and push your hands outward

You may feel a little stretchy around the wound, but don’t worry – it won’t tear the wound! Early mobilisation also reduces scarring around the wound which may complicate the healing later.

Coughing to expel phlegm (yes, bacteria) and prevent infections

Once we are done with deep breathing, you want to get those stuck phlegm that contains bacteria out of the airway. This is how we do it effectively, yet not aggravating the wound pain, with what we call the ‘splinted coughing’ technique.

Step 1: Hug a pillow or place your hands over the incision wound
Step 2: Tighten your abdomen muscles and apply a firm pressure on the abdomen, initiate coughing.

Tip 3: Progressing your daily movements to bedside exercises AND start walking so you can be discharged soon!

After practicing Tip 1 and 2 above, you should be ready to sit comfortably at the edge of your bed, start to stand and walk. Moving your body as early as possible after your surgery is important as it promotes healing, and gives you the confidence to manage daily activities with the presence of the new surgical wound when you go home. These are what you can do:

Exercises at the edge of the bed/ Sitting on a chair

• Hip march – sitting at the edge of the bed, lift your leg, one leg at a time – this helps to work our core and the hip flexors.\
• Thigh muscles strengthening – squeeze your thigh muscles to straighten the knee, and bend it.

Sit to stand

Sit on a firm chair with arm rest, push against the armrest to help with the beginning phase of standing. While you are getting up, transfer your hand to hold on to a stable walker in front of you (if needed). Pause for a moment after standing upright to ensure you are not dizzy.

Exercises in Standing with or without support

Stand up with the walking frame, you can do marching exercises to get ready to walk. Lift up the legs one by one, as if you are walking on the spot. Lift the legs as high as you can while monitoring your breathing and exercise tolerance (especially if you have been in bed for a few days and this is your first time standing up after surgery).

You can also practice sit to stand repetitively to strengthen your legs.

Walking with an ambulator / walking aid – or not!

Finally, we can begin walking again! Not everyone needs a walking frame to walk, but this is encouraged if you are feeling weak or not confident to walk on your own. Your physiotherapist should be with you throughout to ensure that you are able to walk safely. Once you are able to walk independently, your wound heals well, and all your vitals are good – that’s when you are most likely to be discharged from the hospital.

So don’t be afraid of moving – start early to help with recovery!

With all this information, it can still feel worrisome when you are on the hospital bed right after surgery. Don’t worry, that’s where physiotherapy comes into picture. A trained physiotherapist will guide you through movements with their expertise to promote independence. After all, the main goal of recovery is to get you back to moving independently again, so you can focus on the next steps of cancer recovery.

If you have any questions, the best way is to bring your questions to your doctor and/or physiotherapist so they can help to clear your doubts. You can schedule a pre-operative physiotherapy session before your cancer surgery so that the physiotherapist can assess your movements and pre-empt you for what to expect after your cancer surgery is done. For an appointment, contact us today!

Want to know more about cancer rehab after surgery? Click the link below to find out more:
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