Breast Cancer | Donna Sarna

Breast Cancer Rehabilitation

Physiotherapy can play an important role in the post-operative management of women whom have undergone a partial or total mastectomy. Pain in the neck, shoulder complex, and arm can occur for a variety of reasons and is often associated with adhesions and scarring that develops around the incision as a result of the surgery and/or radiation. It can also be a result of irritation of one or more of the nerves in the chest wall, which may be entrapped by scar tissue or which may have been cut during surgery. When this occurs, the arm is often held in a guarded position which may initially ease the pain, but ultimately causes tight musculature, particularly in the front of the chest and into the neck leading to restricted range of motion and poor postural habits.

If reconstruction surgery is performed, tension may be felt through the abdominals, low back as well as the hips. These areas of the body can also become weak post surgery. The pelvic floor muscles may also be involved resulting in discomfort with intercourse, incontinence, and weakness in this area of the body.

Lymphedema, or swelling in the arm, is a common concern. Swelling in the arm can range from mild to severe and can be temporary or permanent. It may occur with the removal of lymph nodes during the surgical procedure (lumpectomy, modified radical/radical mastectomy), and/or from radiation therapy, which can lead to the formation of scar tissue in the underarm. The lymphatic vessels can become blocked and the lymph fluid won’t drain as readily, resulting in arm swelling. Lymphedema may be present immediately after the procedure or may not occur until several years after.

What Symptoms Can We Treat?

Lymphedema (swelling into the arm and hand)

Decreased range of motion in the neck and shoulder complex

Decreased range of motion in the low back and hips (if reconstruction has been done)

Decreased strength of the muscles in the shoulder complex and arm

Decreased core strength

Pelvic floor pain and tension (if reconstruction has been done)

Constipation

Urinary incontinence or retention (if reconstruction has been done)

Decreased soft tissue mobility due to the presence of scar tissue build up at the incision and radiation sites

Pain and/or altered sensation that may be experienced at the surgical site and or in the site of radiation, but also may be experienced in the neck, shoulder blade, arm, and hand

How Can Donna Sarna Physiotherapy Help?

At Donna Sarna Physiotherapy & Rehabilitation, the physiotherapist will perform an assessment to evaluate range of motion of the upper extremities and neck as well as strength, posture, scar mobility, and soft tissue restrictions. They will also assess for signs of lymphedema, and test sensation.

An individualized treatment program will be developed based on assessment findings and may include myofascial release, visceral manipulation, education in self-release techniques, and stretches for the muscle and fascial system, postural education, scapular/core stabilization exercises, upper and lower extremity strengthening exercises, and cardiovascular conditioning exercises to increase circulation and stimulate lymphatic flow.