Working Out After Top Surgery: A Week-by-Week Recovery Timeline
Post-op training workouts for trans masculine, FTM, trans man, and non-binary individuals.
Getting back to the gym is one of the first questions people ask after top surgery, and the honest answer is that it happens in stages rather than on a single date.
I am a trans personal trainer, and I have been through this myself. This guide is for trans men, trans masc and nonbinary folks in recovery: what you can safely do each week, how to get your shoulder mobility back, and how to return to lifting without putting your incisions at risk.
The short version: most surgeons clear patients for gentle mobility work around week 1 to 2, light cardio around week 4, a gradual return to resistance training around week 6, and full-intensity lifting around weeks 9 to 12. A full return to your previous training capacity often takes 16 weeks or more. Always follow your own surgeon’s clearance, since timelines vary by procedure type and by person.
If you have not had surgery yet, it is worth knowing that people who train consistently beforehand tend to recover faster. Our guide to working out before top surgery covers what to prioritize in the months leading up.
What to expect after surgery
After surgery, many surgeons require you to wear a compression binder or drains for a few weeks. Your chest will feel tight and swollen as incisions heal and scar tissue develops. It's common for your shoulders to round forward and reaching overhead or behind is temporarily restricted. How long drains and compression stay on varies by procedure type — double incision, periareolar, and keyhole recoveries can look quite different — and by surgeon.
While you likely won’t be cleared to return to lifting until around week 6, gentle movement and mobility can (and should) start much earlier, depending on your recovery rate and surgeon’s clearance.
Recovery rates vary a lot from person to person and between procedure types, so the recommendations below lean conservative and cautious. This is general education, not medical advice, and it doesn’t replace your surgeon’s post-op instructions. Your surgeon’s clearance always overrides anything in this article. If you notice increased swelling, warmth, fluid, an incision opening, or pain that gets worse instead of better, contact your surgical team.
Weeks 1–3: Very gentle mobility and walking as tolerated.
Your priority in this time window is healing. I’d encourage starting gentle daily walks to get movement and blood flow going and to enjoy some fresh air. Mobility movements should be easy and within a comfortable range of motion. Absolutely no overhead reaching in this time!
A few movements to do in order, 3-4x a week include:
Shoulder rolls. Inhale while bringing your shoulders up, back and then exhale as you move them down.
Scap retractions. Roll your shoulder blades down and back, gently squeeze your shoulder blades together each rep.
Upper trap stretch. Bring your right ear towards your right shoulder while keeping your shoulders depressed downward (prevent them from shrugging up) and hold for 10-20 seconds, repeat on the left side.
Shoulder external rotation, active range of motion. Start with shoulders blades down and back, elbows at side and bent to 90°, palms facing up. Rotate your arms away from your torso within pain free range.
Wall climbs forward (less than 90°). Facing a wall, climb fingers up the wall. Stop before you feel significant pulling at the chest/incisions. Climb them back down. At this stage you won’t be going very high -- keep your hands below shoulder height.
Weeks 4–6: Moderate mobility, restoring shoulder range of motion, continued walking.
At around weeks 4-6, your shoulder range of motion begins to return. You might be able to lift your arms to a T or even overhead within this window.
Around week 4, some surgeons clear folks for light cardio like easy jogging or cycling, and sometimes machine-based leg training. This varies a lot, so treat it as a conversation to have at your post-op appointment rather than a green light. Keep in mind too that cycling positions that involve gripping handlebars and leaning forward can pull at the chest.
A few movements to do in order, 3-4x a week include:
Wall Climbs (forward and side facing). Just like you did in the previous phase, face the wall and climb fingers up the wall. At 4 to 6 weeks, you can go past 90° or past shoulder height if your mobility allows. Turn so your right side is facing the wall, and repeat the wall climb laterally. Repeat on left side.
Standing Shoulder W’s. With elbows bent and arms up in the shape of a W, squeeze your shoulder blades together and hold that squeeze.
Butterfly Hands Behind Head Stretch. Sitting upright in a chair, put your hands behind your head, gently bring elbows backward and forward.
Weeks 6–9: Returning to lifting after top surgery
At week 6, mobility continues to increase and progressed mobility exercises should follow.
Week 6 is also when many surgeons will clear you for gradual return to resistance training, given there were no complications with recovery.
If you’ve been consistent with your mobility work these last few weeks, you’ve already been restoring shoulder motion and scapular stability. However, because you haven’t been training those patterns under meaningful resistance, load should still be reintroduced slowly.
Here are the progressed mobility exercises you can add 1-2x per week if you are strength training, and 3-4x per week if you’re not strength training yet:
90-90 Shoulder Switches. Start with shoulders at 90° with one arm pointed up and one pointing down. Alternate your arm positions to alternate your shoulder’s active internal and external rotation range of motion.
Gentle Doorway Pec Stretch. Bring your forearm to a door frame or wall edge at 90 degrees or less (whatever mobility allows). Gently lean forward and turn your head and chest away from the door frame to stretch your pec.
If these are too easy and comfortable, you can also add:
Open Book Stretch. Lie on your side with knees bent and arms extended straight in front of you and on top of each other. Begin to open your arm and rotate your body following the path with your head and neck while keeping the bottom arm on the ground and keeping your pelvis forward. Feel a nice opening of the chest and shoulder and a relieving twist of the spine.
Thread the Needle. In a quadruped position (hands and knees on floor) - “thread” your arm under the opposite arm/chest then rotate the same arm up towards the ceiling following with your neck.
Workouts
For returning to strength training, muscle groups such as arms and legs are fair game as long as restrictions in shoulder stability or mobility don’t interfere (ex: leg presses vs a barbell squat). Feel free to go HAM! One caveat! Heavy leg work means heavy bracing, and that pressure travels through your torso. If bracing hard makes your chest feel tight or pull, back the weight off and build up more gradually.
But for shoulders, chest, and back, we want to ease in.
For shoulders, overhead movements may feel extra challenging or unstable right now, so go light and slow. You can use a machine instead of free weights to take the stability element out of the movement while you reacclimate to loading the movement.
For chest, start light and slow. You can use a machine to take the stability element out of the exercise while you get used to loading your pecs again.
For back, scars might feel uncomfortable when overstretched. Vertical pulling movements that involve reaching overhead, like lat pulldowns, might be too uncomfortable and can be swapped for horizontal pulling for now. Hanging exercises like pull-ups can put a lot of tension on the chest and incision sites, so hold off or substitute until those feel comfortable.
The sample program in our guide to training before top surgery alternates two full-body workouts, A and B, three times a week. Here is how to modify each movement for your first few weeks back:
Returning to lifting, weeks 6 to 9
| Original exercise | Post-op modification |
|---|---|
| Workout A | |
| Bench press | Switch to a machine press, lighter weight |
| Chest fly | Machine fly, shorter range of motion if needed |
| Squat | Leg press or hack squat if holding a barbell feels uncomfortable |
| Close grip machine row | No change needed |
| Cable face pull | No change needed |
| Plank variation | No change needed |
| Workout B | |
| Lat pulldown | Light weight, or swap for a machine row if scars feel tight when stretched |
| Romanian deadlift | No change needed |
| Shoulder press | Light weight if mobility allows, or swap for a side lateral raise |
| Lunge | No change needed |
| Rear delt fly | No change needed |
| Hanging leg raise | Captain's chair leg raise or lying leg raise |
Keep weight moderate to moderately heavy as opposed to maximally heavy, meaning you should feel the movement challenging your muscles, but you shouldn’t feel like pushing to your absolute max. A rep range of 8-12 is a good place to start, while leaving a few reps left in the tank rather than training to failure.
Weeks 9 and beyond: Returning to full range of motion and heavy lifting
If you’ve been diligent about your mobility and training up until this point, chances are you have most or all of your overhead range of motion back and you’ve gotten used to challenging your chest, back and shoulders under load.
At weeks 9-12 is when you can begin pushing to failure and pushing your ranges of motion after you’ve done a few weeks of ramp up. Full range of motion should feel comfortable and controlled, and increasing load shouldn't cause pain, pulling, or significant discomfort around the surgical area. Though slight discomfort is expected as you’re pushing yourself a bit more each week.
It’s normal for a full return to your previous training capacity to take 16 weeks or more. That’s not a setback. That’s just how long it takes.
There’s also other types of care that can support top surgery recovery, such as professional scar massages and acupuncture.
In my experience working with trans men, trans masc and nonbinary folks through top surgery, folks who’ve been training consistently for a significant amount of time before top surgery tend to return to training faster than those who weren’t. Having an existing foundation of strength, mobility, and stamina makes a huge difference.
Be patient and listen to your body. Everyone moves at a different pace!
And if you are reading this before your surgery date, the training you do now pays off later. Our guide to working out before top surgery covers what to prioritize in the months leading up.