1) Shoulder range of motion: Most patients following a mastectomy will have reduced ability to move their arm. The lack of shoulder range of motion could be caused by:
- Scar tissue: most people do not realize that scar tissue can cause tightness and deficits of arm movement. Think about it like this, if your skin cannot move how are your joints and muscles able to move? After the mastectomy typically there is a scar across the anterior chest. This scar tissue needs to be addressed via a technique called scar tissue massage. Scar tissue massage is well researched in the medical community. It was found that after scar tissue massage the cells are able to “reassemble” into a more organized pattern to allow for improvement in skin elasticity and mobility.
- Posture: After a mastectomy your first instinct is to round your shoulders to protect the surgical scar. What happens when we assume poor posture? Pectoral muscles shorten, thoracic (mid back) becomes tight, neck problems occur and the scar tissue heals with more restriction. With physical therapy we can screen you for your own deficits to restore proper alignment and posture.
- Muscle strength: We have well documented literature about the knee, describing that if we have as little as 5 cc’s (.17 oz) of inflammation in the knee joint the surrounding muscles will atrophy, meaning the muscle will waste or degenerate. We do not have the same research for the shoulder, however you can imagine that with a surgery in which you are removing the breast tissue there is extensive healing and inflammation that goes along with it. As physical therapists we are able to assess and address the strength deficits you have in the arm, core, back, etc. to allow you to resume your normal activities and hobbies you enjoyed!
2) Lymphedema: If you have had lymph nodes removed or radiation to your armpit you could be at risk for developing lymphedema. Your risk factors should be discussed with your physician and medical providers. However, if you feel that you are developing some swelling in your arm, breast or back it is important that you speak up and tell your health care professional. As certified lymphedema therapists we can help address your lymphedema. The treatment for lymphedema does depend on the extent of your swelling. At the time of the evaluation with a physical therapist we can walk you through how your treatment will go and what should be done to achieve the best results.
3) Fatigue: Cancer related fatigue is fatigue related to chemotherapy and cancer treatments. Fatigue is one of the longest lasting side effects of cancer treatment and what most cancer survivors complain about 5 years after their treatment. When looking at current literature, cardiovascular exercise is one of the best ways to combat cancer related fatigue. Getting on a regular, appropriate, cardiovascular exercise regimen with correct education can help you combat this side effect.
Physical deficits after your cancer treatment can be debilitating. Your quality of life is SO important. You went through your cancer treatment to have a better life, a life filled with activities you enjoy! It is never too early to contact a physical therapist. We are great resources as soon as you learn of your diagnosis and beyond.
-Kristin Anderson, PT, DPT
This blog is here for your help. It is the opinion of a Licensed Physical Therapist. If you experience the symptoms addressed you should seek the help of a medical professional who can diagnose and develop a treatment plan that is individualized for you. If you enjoyed this blog, check out our website at foundationalconcepts.net for more blog entries and to learn more about our specialty PT practice, Foundational Concepts. Follow us on Twitter @SarahpelvicPT or @Jenn_pelvic_PT and like us on Facebook/Foundational Concepts for updates.