10 Ways to Build Strength After Lung Cancer Surgery
Each year in the U.S., 200,000 people undergo surgery for non-small cell lung cancer (NSCLC), the most common type of lung cancer. Post-op, very few of those same folks exercise—even a little. But one recent study shows how gentle workouts—done regularly—following lung cancer surgery can aid recovery by decreasing shortness of breath and improving cardiopulmonary fitness and lower-body muscular strength. Other experts say that training the muscles surrounding the lungs helps them heal better, reduces scar tissue, and prevents mobility restrictions. Ready to get moving?
Start Exercising Slowly, One Step at a Time
“When we breathe better, we feel better,” says Ashley Adamczyk, P.T., who oversees exercise therapy at Rush University Medical Center in Chicago. And your journey to recovery starts with those first few steps you take after your procedure, says Philip Diaz, M.D., a pulmonologist at The Ohio State University Wexner Medical Center in Columbus, OH. You'll build on those every day. In the meantime, don’t carry anything more than 10 pounds for at least two weeks, follow all activity restrictions, and get the green light to do this (or any) workout from your surgeon before you attempt it.
How to Do the NSCLC Workout
Got the official go-ahead? Some people still feel apprehensive “because they aren’t sure what kind of activity they can do,” says Dr. Diaz. Start with light walking or stationary cycling for 10 minutes. Then try out one or more of the following moves, courtesy of Adamczyk. You can perform them in order or break them up throughout the day into mini workouts. The goal is to exercise for a total of 30 minutes per day. Start at a level that feels easy—a 3 or 4 on a scale of 10—and allows you to carry on a conversation without effort.
Once you’re warmed up, kick off with breathing exercises that strengthen the diaphragm and other muscles that control breathing, Adamczyk recommends. Sit, stand, or lie down. Place your hands on your abdomen. Inhale through your nose, expanding your abdomen into your hand as your lungs fill. You should see your hand move. Take a short pause, then fully exhale through pursed lips, deflating your abdomen and feeling your hand lower. If your doctor sent you home with a spirometer, you can exhale into it. Do two to three sets of 10 to 15 reps.
To strengthen your lungs’ ability to expand, Adamczyk says to hold light weights (start with 2.5 lbs. or 5 lbs.) with your hands down at your sides, palms facing in. Keeping your back straight, hinge forward from your hips. (Your torso should be at roughly 45 degrees.) You can do this seated on an armless chair or standing with your knees slightly bent. Squeeze your shoulder blades together and pull your elbows straight back, together or one at a time. Pause, then slowly lower the weights. Do two to three sets of 10 to 15 reps.
It’s common to feel tightness and weakness in the shoulder and chest of the operated side, Adamczyk says. You’ll be told to avoid lifting your arms above shoulder height for several weeks post-op, but when the time comes, raises can help. Stand with your feet hip-width apart. Hold a weight in each hand, palms facing in. (You can also do this sitting in a chair.) Without arching your lower back, raise both arms diagonally in front of your body to shoulder height. Pause, then slowly lower the weights. Do two to three sets of 10 to 15 reps.
Lower-body muscle atrophy can happen quickly with bedrest, Dr. Diaz says. But stepping up and down, one foot at a time, improves muscle strength in a big way. It also increases your heart and breathing rates. Stand tall in front of a low step with your feet hip-width apart. Hold onto a railing or a sturdy chair for balance, and place your right foot completely on the step. Drive up through your right thigh and place your left foot onto the step. Pause, then step back down to the floor. Do two to three sets of 10 to 15 reps on each foot.
Standing Hip Abductions
This exercise is great for strengthening the outside of your hips, helping to keep you stable on your feet, Adamczyk says. Stand tall with your feet hip-width apart and hold onto a kitchen counter or a sturdy chair for balance. Shift your weight to your left foot. Keeping your right leg straight, slowly lift it to the side. Pause, then slowly return your foot to the floor. You can do this with or without a mini resistance band around your thighs. Do two to three sets of 10 to 15 reps per leg.
To stay independent during recovery, you need to get out of bed, and up off of the couch and toilet, on your own, Adamczyk says. So, don’t let your squat strength slip! Stand tall with your feet hip-width apart. Place your hands on a kitchen counter or the back of a sturdy chair for balance. Imagine you’re about to sit in a chair: Bend your knees and send your hips back, sinking a few inches. Pause, then press through your feet to stand. Do two to three sets of 10 to 15 reps.
Standing Heel Raises
Heel pumps are a mainstay in reducing the risk of post-surgical blood clots, and they can also help promote ankle strength and stability, too, Adamczyk says. Stand tall with your feet close together and place your hands on a kitchen counter or on the back of a sturdy chair for balance. Keeping your legs straight, raise up onto the balls of your feet, pause, then lower your heels back to the floor. Do two to three sets of 10 to 15 reps.
Doorway Chest Stretch
With surgical incisions focusing on the front and side of the chest, it’s natural to feel some tightness and restriction, Diaz says. To improve muscle elasticity, stand in the center of a doorway. Place your forearms on each side of the frame. Step forward until you feel a very gentle stretch in your chest and the front of your shoulders. Don’t push to a point of any discomfort. Do three 30-second holds.
Overhead Side Stretch
Most surgical procedures for NSCLC involve incisions between the ribs near the side of the chest. Scar tissue can be a result, but you can minimize its development with this gentle mobility and flexibility exercise, Adamczyk says. While standing or sitting, reach your right arm straight up over your head and lean over toward the left, bending sideways at your waist until you feel a gentle stretch. Again, don’t push to a point of discomfort. Do three 30-second holds per side.
This yoga move can reduce post-surgical tightness through the back and lats and improve shoulder mobility, she says. Get onto your hands and knees on the floor with knees wider than hip-width apart. Sink your hips back to the floor between your feet. Keep your hands in place against the floor, arms outstretched and chest near or against the floor. You should feel a gentle stretch through your middle and upper back. Relax into the posture. Do three 30-second holds—or stay in this relaxing position for as long as it feels good!