Inclusion Criteria:  Patients with histologically proven cancers of the upper aero-digestive tract (oral cavity, oropharynx, nasopharynx or pharynx), skin, thyroid or salivary glands; Case has been indicated for surgical treatment and following adjuvant treatment in the multidisciplinary head and neck tumour board Age: 21 - 70 years ECOG 0 or 1 Able to give informed consent  Exclusion Criteria:  Patients who are not able to undergo primary resection of their HNC(not fit for general anesthesia) Patients with distant metastases or incurable recurrent disease Patients who are currently pregnant or breastfeeding Patients with a history of shoulder surgery or trauma, or any known joint pathology such as rheumatologic disorders, or prior neurological disease affecting the upper and or lower extremity such as stroke; Patients who are receiving a free fibular flap as part of their reconstruction Patients who are on a permanent tracheostomy e.g. after a total laryngectomy Patient with ischaemic heart disease or with current beta blocker medication