Form: D-8546

Prevent and Reduce

Stiffness Caused by
Radiation Treatment

For patients with head and neck cancer

Read this pamphlet to learn more about:

• Why are stretching exercises important

• Why should I do these exercises

• How often should I do these exercises

• When should I stop doing these exercises

• Safety information about these exercises

• Cancer exercise and wellness programs

 Why are stretching exercises important?

Radiation treatment can make your muscles and soft tissues (for example,
ligaments and skin) stiff and tight.

This condition is called radiation induced fibrosis.

If your muscles and soft tissues are tight it can be:

• painful

• change your posture

• affect your joints

When your muscles are not moving properly they can cause pain or limit
movement in other parts of your body. Stretching exercises help reduce
muscle stiffness.

Why should I do these exercises?

Your neck and shoulders can become stiff and tight:

• during your radiation treatment

• immediately after your radiation has ended

• a long time after your radiation has ended

The exercises in this pamphlet will help:

• prevent you from feeling stiffness

• improve any stiffness you may feel in your neck and shoulders from
your radiation treatment

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 How often should I do the exercises?

• Do the exercises every day during radiation treatment

• Do the exercises every other day after your radiation treatment is done

You may find it too hard to do the number of repetitions stated for each
exercise. If so, start with a small number of repetitions and build up to the
numbers shown.

If you get tired doing all of the exercises at once, take breaks between exercises.

Start slow and build up.

When should I stop doing these exercises?

You should do the exercises during your radiation treatment and for
4 to 6 weeks after your radiation treatment is done.

If you feel stiff after your radiation treatment is done, you can do the
exercises at any time.

Safety information about the exercises

• You may feel a pull in your muscles.

• If you find the exercises uncomfortable, you may want to take your pain
medication 20 to 30 minutes before exercising.

• You should not feel any pain. If you feel pain, try not to stretch so far.

• If you have had surgery, some exercises may not be possible. You may
have been told by your surgeon not to do certain movements for 4 to
6 weeks.

• These exercises are provided as a general guide. If you have questions

about the exercises, talk to your health care team.

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Exercises

1. Sit or stand to do this exercise.

2. Tilt your head down toward your chest until you feel
a stretch behind your neck.

3. Hold for about 20 seconds.

4. Do this 3 times.

1. Sit or stand to do this exercise.

2. Lift your head up and look toward the ceiling as

much as you can.

3. Hold for about 20 seconds.

4. Do this 3 times.

1. Sit or stand to do this exercise.

2. Turn your head to look over your shoulder until you

feel a stretch in your neck.

3. Hold for about 20 seconds.

4. Repeat on the other side.

5. Do this 3 times.

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1. Sit or stand to do this exercise.

2. Tilt your head toward your shoulder until you feel a

stretch in your neck.

3. You may put your hand on your head and use your
hand to gently pull your head toward your shoulder.

4. Hold for about 20 to 30 seconds.

5. Repeat on the other side.

6. Do this 3 times on each side.

1. Sit to do this exercise.

2. Put your hands behind your back and hold your

hands together.

3. Tilt your head toward your shoulder and lift your

chin up toward the ceiling. You should feel a stretch
on the other side of your neck.

4. Hold for 20 to 30 seconds.

5. Repeat on the other side.

6. Do this 3 times on each side.

1. Stand or sit to do this exercise.

2. Hold a towel or belt above your head. It should hang

down behind your back.

3. Reach behind your back and hold onto the bottom of

the towel or belt with your other hand as shown.

4. Pull the towel or belt up to lift your lower arm up as

high as it can go.

5. Hold for 20 to 30 seconds.

6. Do this 3 times and then repeat on the other side.

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 1. Stand in a corner of a room, face the corner as
shown.

2. Lift both your arms and place them on the wall so

that your arms are level with your shoulders.

3. Lean your upper body toward the corner until you

feel a stretch in your chest.

4. Hold for 20 to 30 seconds.

5. Do this 3 times.

1. Stand with your elbows close to your body.

2. Bent your elbows so they make the shape of the

letter L.

3. Squeeze your shoulder blades together.

4. Hold for 5 seconds.

5. Do this 10 times, 2 or 3 times a day.

1. Lie on your back.

2. Tuck your chin in toward your throat so you make a

double chin. Keep your neck flat on the floor.

3. Hold for 20 to 30 seconds.

4. Do this 3 times, 1 or 2 times a day.

If you find it hard to do this lying down, you can do it sitting on a chair or up
against a wall.

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1. Lie on your back.
2. Hold your hands together over your body and then raise them over your
head so that you feel a stretch.
3. Keep your hands together but keep your arms straight and let them fall
toward the floor.
4. Hold for 20 to 30 seconds.
5. Do this 3 times, 1 or 2 times a day.

To increase the stretch, hold a small weight like a soup can in your hands.

1. Lie on your back, if possible.

2. Put your hands behind your head as shown.

3. Let your elbows fall out to the sides so that you

feel a stretch in the front of your chest.

4. Hold for 20 to 30 seconds.

5. Do this 3 times, 1or 2 times a day.

If you find it hard to do this standing, you can do this lying down on
the floor.

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 1. Sit on a chair to do this exercise.

2. Sit with your back straight.

3. Turn to look over one shoulder. Put one arm

over the back of the chair and hold the side of
the chair as shown.

4. Put your other arm across your body and hold

the side of the chair as shown.

5. Use your arms to gently pull your body for an

extra stretch.

6. Hold for 5 breaths.

7. Repeat on the other side.

8. Do this 3 to 5 times on each side.

Cancer exercise and wellness programs

If you would like to know about other exercise and wellness programs at the
Princess Margaret, speak to a member of your health care team.

They can refer you to ELLICSR Health, Wellness and Cancer Survivorship
Centre for programs that support patients living with the long term effects
of cancer.

To search for exercise and wellness programs outside of Princess Margaret,

you can visit Head and Neck Cancer Rehabilitation Resources (information
below). This site was prepared by Princess Margaret clinicians through a
grant from the Canadian Cancer Society Research Institute.

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 For more information, contact:

ELLICSR Health, Wellness and Cancer Survivorship Centre

Phone: 416-581-8620
Email: ellicsr@rmp.uhn.on.ca
Website: www.ellicsr.ca

Head and Neck Cancer Rehabilitation Resources

Email: info@hncrehab.ca
Website: www.hncrehab.ca

Visit www.uhnpatienteducation.ca for more health information. The development of

patient education resources is supported by the Princess Margaret Cancer Foundation.

Contact us to provide feedback or request this brochure in a different format, such as

large print or electronic formats: pfep@uhn.ca

© 2019 University Health Network. All rights reserved.

Use this material for your information only. It does not replace advice from your doctor or other health care professional.
Do not use this information for diagnosis or treatment. Ask your health care provider for advice about a specific medical
condition. You may print 1 copy of this brochure for non-commercial and personal use only.

Form: D-8546 | Author: Colleen Dunphy | Revised: 01/2019