Guidelines for Heavy Weightlifting After Double Mastectomy

A former personal trainer who underwent a prophylactic double mastectomy documents her return to heavy strength training; great tips for safely regaining lost strength!

The surgeon told me to wait six weeks before resuming upper body strength training.

How long does it take a healthy woman, who’s been intensely and heavily training with weights for many years, to get back to her pre-surgery weightlifting levels following a preventive double mastectomy?

All I found online was a narrative by a woman who strength trained passionately to prepare herself for a prophylactic double mastectomy.

Though she reported that recovery was easy, she didn’t provide information about her upper body regimen postop.

Guidelines for Resuming Heavy Strength Training After Double Mastectomy

Shutterstock/sportpoint

I’m a former personal trainer and will be providing guidelines that apply to healthy patients whose double mastectomy was performed for preventive (prophylactic) reasons — WITH NO BREAST RECONSTRUCTION.

My deadlift for the last time prior to surgery.
5 x 225
3 x 235

Kettlebell Swing (to shoulder level)
13 x 72

Dumbbell Deadlift
4 x 160 (two 80-pounders)

Kettlebell Squat (held at shoulders)
8 x 70

Elevated Pushup (feet on a 24 inch stool)
5

Seated Dip (feet on 18 inch stool, hands on weightlifting bench)
8 x 70 pounds on lap

It will be intriguing to see how fast I return to my weightlifting strength of prior to the preventive double mastectomy. Stay tuned…

POSTOP UPDATE: 3 Weeks
The arm/shoulder movement issues, contrary to what the nurse had told me, have nothing to do with two weeks of inactivity.

I once had my left arm on lockdown for six weeks due to a clavicle fracture, and when I got the green light to reintegrate it into daily living, there were no mobility issues.

The mastectomy affects mobility because you’re left with less skin; the surgeon removes some of it.

It feels like the skin is being stretched too tight when I conduct certain movements. However, every day my range of motion increases.

Nine days postop the surgeon gave me the okay to resume strength training — LEGS ONLY. My legs are getting an intense workout and it feels great!

POSTOP UPDATE: 40 Days
I’m supposed to wait 42 days (six weeks), but I couldn’t help myself; I deadlifted 40 days out from my double mastectomy. But that’s all I did for upper body.

I started with just the bar and worked my way up to 135 pounds (5 x 5-8).

The nice thing about the deadlift is that it doesn’t require active chest muscle recruitment. And there’s no skin stretching due to the limited arm movement.

But pull-ups? Right now I still cannot dead hang due to the skin stretching.

Guideline #1. I have not been practicing hanging at all because I consider this a form of weightlifting — you’re opposing your body weight by clinging to a bar above your head.

And of course, upper body weightlifting is restricted for several weeks following a mastectomy.

POSTOP UPDATE: 41 Days
I deadlifted again today, just to see how high I could go before it began feeling too heavy to add more weight.

I topped out at 1 x 185 with an underhand grip. It wasn’t a struggle, but it felt as though I should not go heavier.

Guideline #2. When you’re off from lifting weights for six weeks, regardless of reason, it’s smart not to jump back in to see how strong you are. Particularly at risk is a low back overload or rotator cuff overload.

Below are my stats for 41 days post-double mastectomy, based on my approach of easing my way back in to heavy weightlifting.

Kettlebell Swing: 20 x 32.

Reverse Row (suspension straps). Surprisingly, the only hindrance was the fact that I haven’t done this for six weeks. I had anticipated a hanging issue with the skin still being tight, but this was absent.

Close Grip Lat Pull-Down. Ditto

Seated Cable Row. The only issue was the six week absence, but because it’s nearly impossible to injure yourself with this exercise with good form, I went heavy but still lighter than pre-surgical.

Dead Hang. Due to tight skin, I’m only placing my fingers around a high ledge with straight arms and simulating a hang, feet making contact with the floor.

POSTOP UPDATE: 42 Days
This was my first chest/shoulder workout since the double mastectomy. I took it very easy.

But not because of the double mastectomy. When you go six weeks without lifting weights, your trained rotator cuffs lose integrity and stability.

So for no other reason, when it’s time to resume strength training that engages the rotator cuff (chest and shoulder moves), GO LIGHT.

And “light” is relative to each individual. We don’t want to throw the rotator cuff to the sharks.

So though I felt that 15 pound dumbbells for a dumbbell press while lying on a fitness ball was ridiculously light, I limited myself to this — to prevent a rotator cuff strain.

Shutterstock/Catalin Petolea

For the same reason, I did pushups off my knees and overhead presses with 10 pound dumbbells.

Everything felt good, and next chest/shoulder session I will use heavier weights — but still within the rotator cuff protection range.

POSTOP UPDATE: 56 Days
Deadlift: 3 x 205, mixed grip.

Dumbbell Deadlift: 5 x 120

Dead Hang: 15 seconds underhand grip. For the overhand grip, I’m sensing that there’s five percent elbow flexion; so it may LOOK like a dead hang, but it doesn’t quite feel 100 percent there.

Pushup. Despite my pre-surgical ability, I’ve resumed these on my knees, due to the aforementioned rotator cuff factor. And the shoulders feel very tweaky.

On the last set of my last session, I felt a twang below a clavicle. It bothered me all evening.

But today, I had no issues with continuing my light chest and shoulder workouts, though I’m going to wait a bit before I resume pushups.

Guideline #3. You may want to consider avoiding returning to pushups UNTIL you’ve been back in the game somewhat with other chest movements.

POSTOP UPDATE: 66 Days
Deadlift at 2 x 215, mixed grip

Dumbbell Deadlift: 4 x 150

Day 76 – Deadlift: 3 x 215 and 1 x 220, mixed grip

Day 80 – Deadlift: 1 x 225, mixed grip

Day 89 – Deadlift: 3 x 220, mixed grip;

Kettlebell swing: 15 x 72.

Day 91 – Pushups with feet elevated on 18 inch stool, two reps. This advancement is very interesting because up to this point, I’d only been doing knee and then eccentric-only (lowering-only) pushups with my feet on the floor.

But on day 91, my shoulder joints felt very solid and capable. Remember, taking weeks off from upper body work means you have to be careful not to get ahead of yourself so that the rotator cuff tendons don’t get injured.

I just had a gut feeling I could do pushups off the 18 inch stool, keeping my body as straight as a board. Two reps were good enough for me.

MILESTONE!

So 97 days after my double mastectomy, I was able to deadlift 225 for three reps, three sets (mixed grip). Also, 1 x 230.

I resumed upper body strength training 40 days postop, so this means it’s taken one day short of eight weeks to regain the strength to do reps with 225.

I’m still not where I was pre-double mastectomy. Just a recap, I took six weeks off from upper body training–six weeks and three days, to be exact.

So it’s taking a lot longer to get some of my exercises back than the time I took off.

Day 101 – Deadlift: 1 x 235 (mixed grip)

Day 106 – Deadlift: 1 x 210 … overhand grip

Day 129 – Deadlift: 1 x 240 … mixed grip

With this single rep at 240, this makes me about where I was prior to my surgery.

My last bit of advice is, with these giant compound lifts, do not strain your guts out (unless you’re training for a powerlifting competition).

This is just a general good rule for strength training, whether you’ve had a double mastectomy or not. Wait until you feel good and ready before moving up in weight.