“Dear Tari – I am 8 weeks post bilateral breast surgery with tissue expanders. I have to be careful of engaging my pec muscles and lymphedema. I am receiving PT for shoulder / range of motion issues. What is your advice? How should I modify poses? Are there things I should avoid? Thanks, Jane”
Jane — first, how is it going with the expanders? Eight weeks is great timing to start a yoga practice (yoga4cancer) specifically designed to help you maintain range of motion until you have implant surgery. Tissue expanders are typically in place for 6 weeks to 6 months post-mastectomy before that second surgery, so you’re right in the window where gentle, guided movement matters most.
I have personally trained every y4c teacher, and some have gone through bilateral reconstruction themselves.
How the yoga4cancer Method Protects the Pec Muscles
There are many ways to protect the pec muscles while allowing the expanders to do their job. The y4c methodology places focus on each survivor’s individual needs based on research and experience, and every teacher is trained to modify accordingly.
In practice, that looks like:
- Reducing time spent weight-bearing on hands and knees, and using props (blocks under the forearms) to distribute load instead of putting it all through the chest and shoulders
- Replacing high-engagement language like “open your heart” with the more precise cue “chest opening” — spinal extension rather than muscular effort, which is both clearer and safer for anyone with expanders, implants, or scar tissue
- Building range of motion gradually and in coordination with your PT, not in place of it
We understand how to help you feel comfortable while assisting the muscles to stay healthy and function well.
Lymphedema: Prevention and Relief
Lymphedema is a concern for every breast cancer survivor — myself included. [About 42% of breast cancer survivors report mild to severe lymphedema, and the risk is lifelong once lymph nodes have been affected by surgery or radiation. The lymphatic system doesn’t have its own pump the way the cardiovascular system has the heart — it relies on movement, breathing, and gravity to keep fluid flowing. That’s exactly where yoga can help: a small randomized controlled pilot study on yoga for breast cancer-related lymphedema found real benefit, though ongoing practice appeared necessary to sustain it.]
At this time, for you, prevention is the focus. But over your lifetime you’re at risk. Understanding how yoga works for both relief and prevention is part of every y4c class — learning how, and knowing why, gives you confidence and reduces your concerns. If you want to go deeper on this before your first class, see our full breakdown: Yoga and Breast Lymphedema: What Teachers and Survivors Need to Know.
A Few Practices to Start With
Here are some videos to get you started — in class, you’ll experience many more.
Dirty T-Shirt Asana — a gentle shoulder and upper-back mobility sequence, useful for building range of motion without overloading the chest.
Cactus Clap — supports shoulder mobility and lymphatic drainage; this is the pose Tari is assisting with in the photo above.
Lymphatic Massage Pose — a self-massage technique to help reduce lymphedema risk.
Keep Your Care Team Informed
It’s important to keep your “team” aware and informed:
- Share with your doctor and oncology team that you want to attend, or are attending, yoga classes.
- Share your current situation, any challenges, needs, or concerns with your yoga teacher — they can provide modifications and support.
All that said, I hope you’ll join us in a y4c class. You’ll meet others who have been on a similar journey, learned to use yoga properly, and seen and experienced the benefits.
Check out our free on-demand Oncology Yoga classes or find a certified teacher near you.
Best, Tari