Written By: SportsCare Waldwick
When it comes to physical therapy for women following breast cancer treatment and/or reconstructive surgery, there are many factors to consider.
It’s important to first understand the effects that breast cancer has on a woman’s body.
In this blog, we highlight those impacts, then dive into how physical therapy can help before, during, and after treatment or surgery, and what specifically it can treat.
Effects of Breast Cancer Treatment
Local treatments, including surgery and radiation, can have extensive side effects, including physical and functional limitations.
Individuals treated with radiation for breast cancer will experience short-term and long-term effects.
Research states these effects could appear months to years after radiation and persist for years.
With your doctor, you can decide which surgical treatment is right for you. There are two main types of breast cancer surgery: breast-conserving (lumpectomy) and mastectomy.
Following surgery to remove breast cancer, many individuals choose to have reconstructive procedures. The most common types of reconstruction are implants or a tissue flap procedure.
A tissue flap reconstruction uses your own tissue from a different site to rebuild breast shape following surgery. Common donor sites include the latissimus dorsi, abdominals, or the thighs and buttocks.
Tissue flap procedures leave two surgical sites, and can leave muscle damage or weakness at the donor site.
Effects associated with these procedures include:
- Pain and/or tenderness in the chest, armpit, or neck
- Arm and shoulder weakness
- Restricted movement of shoulder or neck shoulder and neck stiffness
- Poor posture
- Scar tissue formation swelling or edema
The Role of Physical Therapy Before, During, & After
In the past, many surgical protocols recommended a period of immobilization following breast cancer-related surgeries. However, more recent evidence-based research demonstrates a need for early rehabilitation to reduce post-operative functional impairments.
Research has been heavily focused on the surgical technique to ensure minimal functional decline after breast cancer surgery. However, post-operative rehabilitation has proven to be critical in patients’ return to optimal quality of life.
Early rehabilitation, including assisted mobilization and therapeutic exercise, can improve shoulder range of motion, reduce chronic pain and reduce scarring.
Physical therapy can be utilized in the time between diagnosis and treatment to: assess baseline strength and range of motion, identify impairments, and set goals
PT will facilitate safe physical activity and address functional deficits including, getting dressed, brushing teeth, using the bathroom, or combing your hair.
After surgery, PT can reduce the lasting side effects of cancer treatment and related surgeries, speed up the recovery process, and restore normal function.
How Can Physical Therapy Help?
Physical therapists are an important part of the recovery and rehabilitation process following breast cancer treatments and/or reconstructive surgery.
Physical therapy treatment can alleviate symptoms and decrease functional impairments through:
Individualized Exercise Programs
Previous research had concerns that early exercise would increase the risk of developing lymphedema.
The Journal of Oncology Practice has found that early progressive exercise will address risk factors related to lymphedema and prevent adverse effects.
This technique uses manual stretching combined with mindful breathing to release tension in the fascia to help restore normal movement.
Even when a superficial scar appears smooth and healed, the deeper fascia often remains tight.
Tight fascia can result in chronic fatigue and an inflammatory response, causing pain with movement.
Massage & Soft Tissue Mobilization
Hands-on therapy can help reduce pain, decrease scar tissue formation, and improve motion by increasing blood flow and relaxing the surrounding muscles.
Both manual and self-stretching reduce muscle tension and pain that may be preventing normal movement.
Utilizing posture correction exercises to reduce compensation and misalignment related to post-treatment postural impairments.
Physical therapists can teach energy conservation techniques and home exercise programs to improve daily activity
What Do Physical Therapists Treat?
Shoulder dysfunction is common among patients who undergo breast cancer treatment or surgery.
Muscle tightness and postural changes can cause inflammation of the rotator cuff tendons and contribute to the development of tendinitis.
Radiation and breast surgery/reconstruction can cause damage to the nerves in the area, resulting in weakness, numbness, or tingling in the upper extremity.
20-30% of patients who undergo breast surgery experience Post-Mastectomy Pain Syndrome PMPS, a chronic nerve pain along the armpit, chest, and arm.
Patients who experience peripheral neuropathy, a common side effect of chemotherapy, would benefit from neuromuscular retraining and balance therapy to improve safety during daily activities.
Neck, Shoulder, & Back Pain Or Stiffness
Pain and/or stiffness are common after breast cancer treatments or reconstructive surgery.
Many individuals have difficulty reaching overhead or behind their backs following breast radiation or surgery.
Axillary Web Syndrome
Axillary Web Syndrome occurs in 86% of patients who undergo breast cancer surgery that involves the removal of axillary lymph nodes. A fibrous cord or scar tissue forms from the armpit into the arm.
Patients experience sensations of tightness or pulling when straightening their elbow fully, lifting their arm overhead, or reaching to shoulder height with a straight arm.
Fatigue is one of the most common symptoms related to cancer and cancer treatments. Regular exercise has proven to reduce fatigue and elevate mood.
The American Cancer Society recommends physical activity for patients both during and after cancer treatment.
Physical therapy is an important and necessary way for people to recover.
The key to success for every therapy program is individualization, and at SportsCare Physical Therapy, we see each of our patients as individuals.
With over 65 clinics across NJ, NY, and FL, our therapists are able to address all of their patient’s specific needs!