Findings: Pain and activity limitation scores were elevated four weeks after surgery and returned almost to baseline at eight weeks. Abdominal pain was significantly higher for women with free versus pedicled TRAM flap surgery, and women with previous back pain reported more lower back pain after surgery. Opioids, followed by nonsteroidal antiinflammatory drugs, were the most common pain relief method. Active range of motion and muscle strength showed no significant limitations at eight weeks. Patients were very satisfied with the educational information provided by nurses and physical therapists.