Physical therapy can assist in patient’s fast recovery after breast surgery, by restoring muscle flexibility, improving joint mobility, improving quality of life, and wellbeing.
Recent researches found out that Physical therapy can be very effective in decreasing functional deficits related to the use of the arm, during activities of daily living, such as getting dress, brushing the teeths, using the bathroom, or combing the hair.
It is very important to mention that any breast surgery can increase the risk of developing functional deficits, which can get worse with pain, and with moving the arm. In addition, breast cancer patients who underwent armpit radiotherapy have a higher risk of having less arm mobility, and lymphedema due to skin and muscle retractions.
Researches have discovered that early physical therapy, including therapeutic exercises, assisted mobilization may improve the shoulder range of motion, reduce chronic pain, reduce scarring, and improve quality of life.
Types of Physical Therapy Treatments
- Myofascial Release
- Gentle Stretches.
- Self guided Exercises.
- Teaching Proper Body Mechanics with Sitting, Standing, and Moving Around.
- Teaching Good Posture.
- Therapeutic Exercises to Improve Strength, and Flexibility.
- Joint Movement.
- Functional Manual Therapy.
- Nerve Glide.
- Home Exercise Program
- Breathing Techniques
Exercise After Breast Surgery
It is very important to listen to the body and start any exercise gradual, keeping in mind the pain as the best sign to know how much is enough to do, and respecting the healing process.
Always consult with the surgeon about the right time to start exercising, the right exercise to do, any precautions to have and warning signs to keep in mind.
Some exercises should not be done after the drain and stitches are removed, and other exercises can be performed the day after breast surgery.
Early exercises have multiple benefits for the health, and wellbeing. Early exercise means starting exercise early after surgery between day one and day three.
The benefits of Early Exercises include:
- Prevent Shoulder Stiffness.
- Help the Scar to Heal.
- Reduce the Risk of Lymphedema.
- Improve Overhead Movements.
- Regain Arm Movement Faster.
- Prevent Compensatory Postures.
- Reduce Stress.
- Improve Sleep.
- Speed Up the Healing Time.
It is very important to talk with the doctor or physical therapist about the right exercise to do according to patient’s needs.
Tip to stay Active
Try to walk every day and increase the amount of walk daily.
Start walking at home, then in the backyard, or patio, until progressing outdoors.
Not performing Exercises at all could be detrimental for the whole body, and health, affecting quality of life and function.
Problems associated with not moving after surgery or sedentary life.
- Decrease Strength.
- Chronic and Persistent Pain.
- Weight Gain.
- Decrease Shoulder and Arm Mobility.
- Decrease Endurance.
- Anxiety and Depression.
- Poor Posture.
There is concern that early exercise will increase the chance of developing lymphedema in the arm. However, the Journal of Oncology Practice found that early progressive exercise of the surgically affected arm will prevent adverse effects related to breast cancer surgery and address risk factors without increasing the risk of lymphedema.
What is Lymphedema?
Lymphedema is a a swelling in the upper body, face, neck, trunk, or affected arm that occur after cancer treatment, surgery, or radiation therapy.
What are the First Signs of Lymphedema?
- Swelling of the Arm, Shoulder, Chest, Finger, or Hand.
- A feeling of Heaviness or tightness in Affected Area.
- Weakness in the Arm.
- Joint Stiffness in the Affected Area.
- Rings, Clothing Fit Tighter than Before.
- Pain in the Joints.
- Aching or Discomfort.
Can a Physical Therapist Treat Lymphedema?
Yes, a Physical therapist is a trained professional to treat lymphedema using decongestive therapy, combined with myofascial release, therapeutic exercises, advice in the use of compression bandage, self-bandaging, and education.
Is Physical Therapy Needed After Breast Surgery?
Yes, Physical therapy is vital for fast and safe recovery after breast surgery. Physical therapy can help the patient to restore movement faster, improve the shoulder strength, function, and reduce pain.
The physical therapist will teach the patient how to position the shoulder/arm in bed, during activities of daily living, and how to do exercises at home after discharge.
Physical Therapy Benefits:
- Maintain the Flexibility to the Muscles Surrounding the Shoulder.
- Improve Strength.
- Improve Pulmonary Function.
- Safely Return to Do what the Patient Loves to Do, with Less Pain or Discomfort.
How Can A Physical Therapist Help?
Physical therapy can maintain optimal health and improve lifestyle after breast surgery, especially in cancer patients by managing the side effects, such as cancer-related fatigue.
Cancer -Related Fatigue
Fatigue is one of the most common side effects in patients with cancer. Fatigue affects up to 90% of patients treated with radiation, and up to 80% of patient treated with chemotherapy, According to the Journal of the Advanced Practitioner In Oncology Research.
What Does Cancer Related Fatigue Feels Like?
- Unable to Sleep At Night.
- Feeling Very Weak and Drained.
- Feeling Exhausted.
A physical therapist can design an individualized exercise program according to patient’s needs to manage fatigue.
Regular exercises reduce fatigue, elevate mood, reduce pain, and reduce the need for medication.
Safe Tips to Reduce Fatigue
- Be Active.
- Start with a Warmup (Marching in Place).
- Continue with a 10-Minute Walk.
- The goal is to be able to walk at least 30 minutes or:
- Walk 10 Minutes, 3 Times a Day.
Be cautious and do not do too much, start always gradual.
- Cool Down with Gentle Stretches.
Tips to Sleep Better
Take short naps during the day, not longer than one hour to not interfere with the nighttime sleep.
- Exercise Regularly.
- Practice Deep Breathing.
- Take A warm Shower or Bath Before Sleep.
- Try not to Watch T.V, Cellphone, Tablets, Before Sleep.
- Try to Go to Bed Every Day at the Same Time.
What Exercises Can the Patient Do After Breast Surgery?
Physical therapy starts one day or two after surgery. The therapist will answer any questions or concerns the patient has regarding the surgery. The therapist will educate the patient about precautions, what to do and what not to do after the surgery. For instance, a home exercise program is given in most cases with previous demonstrations, to make sure the patient understands the exercise, and does the exercises right with proper form.
The physical therapist teaches the patient that any movement has to be done slowly to not interfere with the wound healing process or increase pain.
Physical Therapy Tips for Moving
From Stand to Sit
- Back of the legs touching the chair.
- Reach hands back to chair while hips and knees bend.
- Try to use more legs than arms when sitting down.
- Sit with an upright posture.
- Place a pillow behind the lower back.
- Feet should be touching the floor.
- Place a pillow on the lap to support arms.
- Do not sit too long (>30 minutes).
- Get up and move.
From Sit to Stand
- Reach hands back to chair (or arms across the chest).
- Lean Forward, Keeping the Back Straight.
- Nose over the toes.
- Use legs to stand up, instead of arms.
From Sitting to Lie Down
- Keep back straight.
- Place the elbow on the bed keeping back straight
- Slowly Raise legs.
- Until you are resting on your side.
From Resting on the Side to Resting on the Back
- Keep both knees bend.
- Roll like a log from the side to the back.
- Place the arm on a pillow when sleeping.
What Should I Wear After Breast Surgery?
- Comfortable, loose clothing (Sweatpants, Jackets with a Zipper in the front).
- Tops, shirts that can button or zipper in the front.
- A bra that is fasten in the front and is approved by the Doctor.
- Wear Shoes you can slip into.
Are you still dealing with pain after Breast Surgery? Make an appointment today. Doctor Alexandra can help you on you healing journey to meet your needs and goals.
The information in this blog is for educational and informational purpose only, its content is provided based upon evidence-based medicine, knowledge, and experience as a doctor of physical therapy.