While recovering from breast cancer surgery — whether a mastectomy, lumpectomy, or reconstructive surgery — some chest tightness is normal. For some people, however, this limited range of motion lingers long after their scars have healed. Fortunately, there are ways to manage this uncomfortable condition, which is called postmastectomy pain syndrome (PMPS) or “iron bra syndrome.”
One MyBCTeam member shared that years after their bilateral mastectomy, their “only issue is that tight chest feeling.”
Many others have had similar experiences: “Eureka moment. … I am not alone. I am in pain from chest tightness all the time,” a member wrote.
In this article, we explore six ways to address PMPS at home, along with tips on when to see a doctor to manage your discomfort. Always speak to a health care professional before starting any new therapies, treatments, or exercise routines, especially while recovering from breast cancer surgery.
When developing a plan to address weakness, tightness, and pain in your chest wall after breast cancer surgery, one of the first people you can turn to is a licensed physical therapist or rehabilitation doctor. Speak to your surgeon for a referral to a physical therapist who understands iron bra syndrome and has worked with people after breast cancer surgery.
Under a physical therapist’s supervision, you can create an exercise routine that will help reduce tightness without pushing yourself too hard. The exercises you do might change over time as you heal, but it’s important to start early while scar tissue is still forming.
Even when you aren’t in the physical therapy (PT) clinic, you can do the exercises you’ve learned at home. One member shared, “I do the PT arm exercises and lymphedema exercises two to three times a day, and lift light weights.”
Seeing a physical therapist can help lead you in the right direction on your path to recovery from PMPS.
One cause of iron bra syndrome is a lack of mobility in the pectoral (chest) muscles and surrounding areas. When you have a tight muscle, it’s important to stretch carefully to reduce the tightness. “I do a dozen other stretches,” one MyBCTeam member said. “Since I have so many different tight areas in my body, I try to combine stretches.”
Stretching is helpful not just for your chest muscles but also for your arms, back, hips, and other body parts. The American Cancer Society provides instructions for some stretches to try after breast cancer surgery. Incorporating a daily stretching routine into your day can help reduce chest tightness and begin to combat PMPS
Disruption of the pectoral muscles can also cause chest tightness after breast cancer surgery and breast reconstruction. This is why some members, long after their surgeries, turn to weight-bearing exercises after getting their surgeon’s OK. “I am hoping that helps to try to rebuild whatever muscle I have left,” one member said. “I started easy with the 15-pound bar, I did chest presses, tricep presses, lunges, rows, bicep curls, overhead press, and weighted squats. I want to work up so eventually I can go back to the gym and use bars and barbells."
If you don’t know how to lift weights, you may benefit from having a personal trainer on your recovery team. “I started meeting with a personal trainer at the gym (six-month membership was paid by my oncologist’s office),” another member said. “I also found a great CORE class at that gym, with an awesome trainer, and that has helped me tremendously.”
There are many ways to begin weight lifting, whether you’re a beginner or a veteran who had to take a break due to surgery.
Weight lifting not only builds up weak muscles — it also strengthens your bone health and decreases the risk for osteoporosis (decrease in bone density and mass). However, when starting intense physical activity after surgery, it’s important to proceed with caution. Your surgeon may ask you to wait a few months before lifting weights again, and adhering to their instructions is critical to making a full recovery. Once you have their approval, you can work your way up from lighter to heavier weights.
If resistance training isn’t your thing or your surgeon hasn’t allowed you to start lifting weights, you may find swimming to be a good alternative. It can increase mobility, strengthen muscles, reduce fatigue and pain, and improve cardiovascular fitness. Together, this can help reduce some of the discomfort associated with iron bra syndrome through a low-impact workout. “I found swimming, especially breaststroke (HA HA HA), really helpful,” one member shared.
Before you begin swimming, make sure your incision sites have completely healed to prevent the risk of an infection. This usually takes at least three weeks, as long as there are no complications. Speak to your surgeon before you begin incorporating swimming into your healing routine.
When you’re experiencing iron bra syndrome, wearing uncomfortable undergarments is the last thing you want to do. Members often discuss what kinds of bras are most comfortable to wear after breast cancer surgery.
One member said, “I can’t wear anything that has any tightness around where a bra would lay, especially below the breast. Will go down a size and hope maybe that will give me a less tight feeling."
This means avoiding underwire bras, tight sports bras, bathing suits, and shirts with built-in shelf bras if those make your chest tightness even more unbearable.
Another member said, “I wear bralettes without any discomfort."
On top of a good exercise regimen, keeping yourself comfortable with good-quality bras can help you manage chest tightness on a day-to-day basis.
If your PMPS is causing you severe pain or soreness and is disrupting your well-being, speak to your oncologist, surgeon, or primary care doctor. They can make sure you’re recovering normally from surgery, radiation, and/or chemotherapy.
Your doctor can help rule out any other potential causes of your pain with imaging or other testing. If you need additional pain relief, they may recommend treatments such as pain medications, nerve blocks to treat nerve damage, or other medications and procedures.
On MyBCTeam, the social network for people with breast cancer and their loved ones, more than 64,000 members come together to ask questions, give advice, and share their experiences with others who understand life with breast cancer.
Have you experienced chest tightness after undergoing breast cancer treatment? What do you do to increase the range of motion and facilitate the healing process? Share your experience in the comments below or join the conversation on your Activities page.