Helen Birmingham, Alabama
Jaki Nett’s reply:
A lumpectomy is the removal of a lesion from the breast, preserving the essential anatomy of the breast. In a lumpectomy the incision is made directly over the tumor. After the tumor has been removed, usually the skin is the only incision that is stitched. This provides a better cosmetic result than trying to stitch the breast fat and subcutaneous tissue.
For optimal cosmetic results, dissection of the axillary nodes is performed through a separate incision in the armpit. During the process connective tissue is dissected and many muscles, nerves, and veins of the upper torso are affected. Some of the major muscles that may be affected are the pectoralis major and minor, latissimus dorsi, serratus anterior, and subscapularis.
When restarting your yoga practice, start with poses that free up the shoulder area. Bring as much balanced freedom of movement to the shoulder blade, collarbone, and humerus (the head of the arm bone) as possible. Learn to move the shoulder girdle through its full range of movement, which involves:
Elevation—To do this shrug the shoulders upward, toward the ears.
Depression—Lower the shoulders downward, away from the ears.
Protraction (also called abduction) —Reach forward as though you’re about to grab something. The shoulder blades will move away from the spine.
Retraction (also called adduction) —Squeeze the shoulder blades together behind you.
Also learn all the movements of the arm bones, which are:
Flexion—Raise the arms overhead.
Extension—Sweep the arms back behind you with arms straight.
Medial rotation—Rotate the arm bone internally.
Lateral rotation—Rotate the arm bone externally.
Adduction—Bring the arms toward each other, in front of you.
Abduction—Lift the arms away from the body at shoulder height.
To practice these different movements, try doing the arm variations of the following poses in a comfortable seated position:
Urdhva Hastasana (Upward Salute)—Keep the arms shoulder width apart and spread the shoulder blades away from each other, in protraction.
Urdhva Namaskarasana (Upward Prayer Position) —Teaches elevation of the shoulder girdle and external rotation of the upper arm bone.
Paschima Namaskarasana (Prayer Position behind the back)—Teaches internal rotation of the arm bone.
Garudasana (Eagle Pose)—Demands that the arms move into full adduction and the shoulder blades into full protraction, thus helping to open the shoulder blades.
To open the area around the armpits, take Extended Balasana (Extended Child’s Pose) with the arms reaching forward along the ground. A gentle way to open the chest while standing is to take Tadasana (Mountain Pose) and interlace your fingers behind your back (into extension). Gently lift the arms away from the buttocks and actively squeeze the shoulder blades together as you do this. This will start to release the front chest muscles and adhesions. This arm position and action can also be practiced in Prasarita Padottanasana (Wide Legged Standing Forward Bend) .
To build strength, notice the arms in standing poses— Trikonasana (Triangle Pose) and Virabhadrasana I, II, and III (Warrior Poses I, II, and III) demand holding the arms out in space against gravity.
Wait before doing poses that are weight-bearing on the upper body. Urdhva Dhanurasana (Upward Bow Pose) , Dwi Pada Viparita Dandasana (Two-Legged Inverted Staff Pose) , and Pincha Mayurasana (Forearm Balance) can be problematic until healing occurs and strength returns.
Most importantly, be very gentle. This is a different body now. Give it time to heal. Start on the path of recovery with slow, aware steps.
Jaki Nett is a certified Iyengar Yoga instructor in St. Helena, California, and a faculty member of the Iyengar Yoga Institute of San Francisco. She teaches public classes in the San Francisco Bay Area and leads workshops in the United States and Europe, including specialty workshops on female issues.