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Breast Unit, Physiotherapy

Physiotherapy exercises for breast pain with chest wall musculoskeletal symptoms

Information for patients

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You have been seen in the breast clinic and your symptoms are thought likely to be musculoskeletal in nature. This is a common problem that will often present with pain and/or tenderness in the breast and armpit.

The symptoms will usually settle over a period of time but can be persistent in some women. Posture, activities of daily living and sports and exercise can all impact on the symptoms. For some women, other medical problems, such as arthritis, may also contribute. There isn’t always a clear cause for pain.

A programme of exercise can help by gently mobilising areas that have become stiff. It can also support strengthening muscles that have weakened over time. These benefits will build gradually over weeks to months.

This leaflet includes some exercises that have been found effective in helping to treat chest wall musculoskeletal symptoms presenting with breast pain.

With all exercises, start gently and gradually aim to extend what you can manage. We recommend performing these exercises daily. If you find your symptoms worsen, please see your General Practitioner for a review.

Other things you may find helpful include using topical heat therapy (microwave pillow heat pads or hot water bottles) and gentle massage of the neck and shoulder area. If using heat, ensure the pad is comfortable and not too hot. Some women find it helpful to use ice packs instead of, or as well as heat packs. It can be useful to alternate the two.

1. Open book

Lie on your side with one arm on top of the other stretched out in front of you.

Bring your upper arm up in an arc to finish with it behind you. Follow your hand with your eyes. Try to touch the floor behind you with your hand. Keep your knees together touching the floor.

Slowly return to the starting position. Do 5 on one side and 5 on the other side.

Illustration 1 of Open Book exercise - a person lying on the side, with both arms out straight in front of them with hands together, the person's knees are together, with the legs pulled up and bent at the knees. Illustration 2 of Open Book exercise - the person has kept their legs in the same position but brought their top arm up and over in a circular movement, bending at the waist with their back turning towards the floor.

2. Standing pec stretch

Stand in a door frame with your hands on the frame, one above your head, and one at hip height.

Move your body forwards until you feel a stretch across your chest and hold for 5 breaths.
Alternate arms to stretch both sides.

Illustration for Standing pec stretch exercise. A person is stood in a door frame with one hand on the frame above their head, their other hand is on the other side of the door frame at hip height. There is an arrow signifying the person is moving their body forwards.

3. Corner stretch

Stand facing a corner with your left foot a few inches from the corner and your right foot about a couple of feet away.

Bend at the elbows and press your right hand into the right side of the wall, your left hand into the left at chest height.

Push forward until you feel a stretch in your chest and hold the position for 10 seconds.

Illustration of Corner stretch exercise - a person stood facing the corner of a room, their hands are flat against each perpendicular wall at head height with the elbows bent. There is an arrow to indicate the person is pushing their body towards the corner.

4. Hands behind the head stretch

Sit on a chair with both feet on the floor. This can also be done standing. Bring your hands behind your head and interlace your fingers.

Squeeze your shoulder blades together and push your chest out. You can vary the height of your hands on your head to intensify the stretch in either your shoulders or your chest.

Hold the pose for 5 to 10 breaths.

Illustration of Hands Behind the Head Stretch - it shows a person sat in a chair from behind with their hands behind their behind their head with fingers interlaced. There are two arrows going from the shoulder bladed towards the person's spine, indicating squeezing the shoulder blades together.

5. Active / assisted flexion

Either lying down or standing, slowly bring both arms up in front of you as far as you are able, pointing your thumbs up as you go.

Aim to get your hands high above your head. If one side is harder, you can use your other arm to help support it. Slowly lower your arms and repeat 5 to 10 times.

Illustration of active / assisted flexion exercise in a lying down position. A person is lying down on their back with their knees drawn up feet flat on the ground. Their hands are on their stomach, they are holding one wrist with the other hand, the elbows are resting on the floor. In the second part of the illustration there is a circular arrow indicating the arms have been raised up and over the person's head towards the floor. Illustration of active / assisted flexion exercise in a standing position. A person is stood up, they are holding their wrist with their other hand just in front of their chin. In the second part of the picture the hands have been raised vertically above the head with an arrow to indicate the movement.

6. Downward dog

Press your hands into the wall or floor. Push your hips backwards as you bring your head down in between your arms, keeping a gentle bend in your arms and legs.

Feel a stretch from your armpits into your back and across your chest.

Hold for 10 seconds then slowly come back to upright. Repeat 3 to 5 times.

Illustration of downward dog exercise with arms against a wall. A person is stood with the feet flat on the floor, they are bent at the waist at 90 degrees with their arms out straight with both hands flat against the wall in front of them. Illustration of downward dog exercise on the floor. A person is bent at the waist at 90 degrees, their arms and legs are straight. Both feet and hands are flat on the floor and their rear is raised high in the air.

7. Abduction

Slowly bring both hands out to the side as far as you are able, aiming to get your hands high above your head.

Slowly bring them back to your sides.

Repeat this movement 5 to 10 times.

Illustration of Abduction exercise. A person is sat in a chair, their arms are straight out to their sides at 90 degrees level with the shoulders. There are circular arrows on either side of the person indicating the arms are being raised up above the person's head, then back down to their side, with the arms remaining straight.

Another option if this is uncomfortable is to rest your hand on a wall at your side and gradually ‘walk’ your hand up and down the wall.

Illustration of Abduction exercise done in another way. It shows a person stood next to a wall. Their arm is out straight from their side with their hand touching the wall. There are arrows indicating that the hand is going up and down the wall.

8. Abduction with lateral flexion

Bring one arm overhead and lean to the opposite side to stretch and strengthen your lateral trunk.

This can also be done with your hand on a wall.

Hold this pose for 5 breaths then repeat on the other side.

Illustration of abduction with lateral flexion exercise with hand on a wall. A person is showed stood next to a wall, their hand is straight up above their head against the wall, their other arm is down by their side. There is an arrow to indicate the person is moving their waist away from the wall to stretch the lateral trunk. Illustration of abduction with lateral flexion exercise. A person is stood with feet apart, one hand is on their hip, their other hand is raised straight up above their head. They are bending at the waist to the side in a circular motion towards the side with their hand on their hip. they are showed doing this exercise towards both sides.

If you’re struggling to get your hand behind your head or behind your back, you may benefit from self-referring to physiotherapy.

You can ask to see a First Contact Physiotherapist at most GP surgeries, or your GP can refer you to be seen by the MSK physio team.

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  • LN: 005629
  • Edition number: 001
  • Developed by: Emma MacInnes, Consultant Breast Surgeon
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