Swimming after breast surgery is an excellent means of exercising all the major muscle groups, and avoiding muscular atrophy often seen in post-surgical patients who remain sedentary for prolonged periods.

When the doctor says it’s okay to begin moderate exercise, swimming is one of the best first steps. Many doctors and swimming experts endorse it as one of the safest and most comfortable ways to get back into exercise.

"One of the big pluses of swimming comes from the magic buoyancy of water. There is no pressure or strain placed on the muscles and joints" says Jane Katz, Ed.D., professor of health and physical education at John Jay College at City University of New. There's also the built-in cooling effect of the water, which keeps your temperature down throughout your workout. This is especially important for women who may be experiencing hot flashes associated with chemical or natural menopause.

After breast surgery, a woman is likely to have a slightly different center of gravity, and she must learn to posture herself differently. Swimming strengthens the abdomen, back and shoulders, which help post-mastectomy women carry their weight more easily, reducing the likelihood of back discomfort. Stronger and more toned muscles, especially the abdominal, shoulder and chest muscles, make for an easier recovery from breast surgery. The cardiovascular benefits are great too. Once you have worked up to a fast and steady pace, you will be improving your heart condition – the most important muscle in your body – each time you swim.

"Swimming strengthens the abdomen, back and shoulders, which help post-mastectomy women carry their weight more easily."

Burning calories is great for the post-chemotherapy weight gain so many women experience. Yet, for many women, high-impact sports such as running can be uncomfortable and even risky if you fall. Swimming and water exercises, on the other hand, can help you exercise to burn calories gently and safely. Unlike tennis or other competitive sports, you can swim alone, at a pace you set, and stop when you feel tired.

Here are some tips for beginning your swimming routine:

The dog-paddle is good for upper-body conditioning. The breaststroke is a relaxing stroke helpful for toning and stretching leg muscles. The backstroke helps strengthen back muscles. The sidestroke may work well after a lateral mastectomy (working the opposite arm). The butterfly stroke is strongly discouraged since it is very strenuous and requires an arched back.

Five minutes of each. These can be done both in and out of the pool. You can sit at the edge of the pool and kick water or stretch your calf muscles. In the pool, you can do a slow walk or jog to help your body adjust to the water. Avoid overstretching the surgical site.

Changes in your body may make it less adaptable to heat so always be careful. If you live in a warm climate and swim outdoors, swim in the early morning or later in the day to avoid the hottest part of the day. Make sure you drink water before and after your swim.

If you feel tired then stop. You should be relaxed, not enervated. Now is not the time to rev up your target heart rate.

If you aren't a swimmer, don’t start now with 50 laps of breast stroke. Instead, try water exercises, such as arm circles and wall push-ups, that will give you many of the same benefits.