When I first meet someone who is returning to movement after cancer treatment, I often ask a question that sounds almost too simple:
“Does breathing feel comfortable right now?”
Most people pause. Until that moment, they have been thinking about the scar, the shoulder, their strength, or how quickly they should get back to exercise. Breathing has been happening in the background. Then they notice that it is shallow, held high in the chest, or interrupted whenever the surgical area feels tight.
That is not a failure. After surgery, the body protects itself. A smaller breath may feel safer because the ribs, abdomen, or chest wall do not have to move as much. The problem is not that this happens. The problem is when the protective pattern becomes the only pattern the body remembers.
This is general education, not individual medical advice. After surgery, follow the instructions of your surgeon and medical team. Stop and seek medical guidance if breathing is painful, suddenly difficult, or accompanied by concerning symptoms.
I learned this beside my mother
In 2011, my mother underwent surgery for colorectal cancer. In the early days, even a small amount of movement left her short of breath. “Exercise” was not a useful word then. It sounded far too large.
So I sat beside her and we did something smaller. We noticed one breath coming in and one breath leaving. I did not tell her to take the deepest breath possible. I did not count loudly or turn it into a performance. We simply allowed the breath to become a little less guarded.
I watched her recovery over the next five years, until she was declared cancer-free. That experience changed how I teach. Breathing is not merely preparation for the real exercise. Sometimes it is the first active way a person begins to participate in recovery.
What breathing changes in Pilates
In Pilates, breathing is part of the movement rather than decoration placed on top of it. The diaphragm descends as we inhale. The ribs widen and move in three dimensions. As we exhale, the rib cage settles and the deep trunk muscles can respond without the need for aggressive bracing.
After breast surgery, that gentle rib movement can be especially meaningful. A person who has been protecting one side may discover that the breath avoids that area. We do not force air into a scar or try to “fix” the body in one session. We use the hands, a towel, or the contact of the mat to help the person notice where movement is available.
Breathing alone does not treat lymphedema, restore a surgical wound, or replace physical therapy. What it can do is provide a low-demand starting point for rib-cage mobility, relaxation, body awareness, and coordinated movement.
A small practice
If your medical team has said that this kind of gentle activity is appropriate, try the following without trying to make the breath impressive.
Rest in a comfortable supported position. Place one hand on the lower ribs and the other where it feels natural—perhaps the abdomen or the opposite side of the chest. Let the inhale arrive through the nose. Notice whether the ribs move sideways into your hand. Exhale slowly through the nose or softly through the mouth and feel the ribs return.
Three easy breaths may be enough. If you feel dizzy, strained, painful, or anxious, stop. The goal is not to collect repetitions. The goal is to finish feeling as safe as—or safer than—when you began.
Why I still begin here
Over more than eighteen years of teaching rehabilitation Pilates, I have learned that people are often eager to recover by doing more. Sometimes the better question is whether the body can do less without fear.
A quiet breath gives me useful information. Does the neck tighten? Does one side of the rib cage barely move? Can the person exhale without gripping the jaw or pressing the back into the mat? These observations help shape everything that comes next: arm movement, spinal mobility, balance, and eventually strength.
There is also something emotionally important about the breath. Treatment can make the body feel like a place where things are done to you—tests, procedures, medication, instructions. Breathing is still yours. Paying attention to it can be a small way of returning to your own body without demanding that it be the body you had before.
Recovery does not have to announce itself
The first signs of progress are often quiet. A fuller exhale. Less tension around the collarbones. The ability to turn or reach without holding the breath. None of these changes looks dramatic, but they create the foundation for more confident movement.
If breathing is the only exercise that feels manageable today, it still counts. Start there. Let the next step arrive when your body and your medical team say it is time.
This post is part of the educational series Pilates for Breast Cancer Recovery, informed by Pilates for Breast Cancer Survivors: A Guide to Recovery, Healing, and Wellness by Naomi Aaronson and Ann Marie Turo (Demos Health, 2014), which Jaehoon Yang co-translated into Korean.
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