Breast cancer treatment can be of various types, including chemotherapy, radiotherapy, medication or surgery. Surgery can include lymph node removal, lumpectomy, mastectomy and reconstructive surgery. Each type of treatment option will have different follow up care in terms of physiotherapy, and guidance from your therapist must always be followed. For example, reconstructive surgery may have used a muscle called Latisimus Dorsi, and therefore the patient may have specific strengthening exercises to help recover from this.
Physiotherapy falls into several key areas following treatment, and these include exercise, skin care, posture correction and lymphoedema treatment/ prevention. Simple steps can be taken to minimise long term problems after treatment.
Exercise helps in several areas. Mainly after breast surgery it involves regaining the shoulder range of movement. This helps prevent stiffness and pain in the shoulder area, and will enable normal function to return quickly. By stretching scar tissue, the shoulder can regain flexibility and prevent adhesions forming.
If the lymph nodes have been removed, exercise can help prevent cording in the upper arm. These are bands within the muscle tissue.
Exercise also helps prevent swelling by maintaining a healthy circulation.
Simple mobility exercises may include shoulder shrugs, assisted stretching with the ‘good’ side, and pendular swinging. These exercises should all be done within pain limits and following advice. Regular short sets seem most beneficial.
As mentioned previously, strengthening exercises may also be needed, and these are particularly required after reconstructive surgery, as the muscle tissue may have been used.
Looking after the skin around the treatment site is important to maintain a good circulation and encourage healing. Scar massages can be used to prevent adhesions forming, which can cause scar pain. By touching the scar site, this can help desensitize the area and increase the patient’s confidence in the scar.
If any lymph nodes have been removed, it is important to prevent any potential infections, so wearing gardening gloves and protection when doing jobs is important. Also preventing insect bites is important too.
After surgery you may feel that your posture is not as good as before. You may feel a little off balance. It is important to work on good symmetry and alignment in order to return to a healthy self. This is particularly important as it has been shown that poor posture can lead to conditions such as neck and back pain, which are conditions that should be prevented as much as possible.
Try today sitting up better like someone is pulling a piece of string from your head.
Whilst you are sitting reading this, think about your desk position and the support on your chair. We all spend a great deal of time sitting, so think of the places we do this and what can be improved. Driving is a key time to think of, so adjust your seat and mirrors so that you can sit correctly.
This may be an issue for you, and if that is the case seek help from a specialist physio or nurse, as they may be able to teach you some self massage techniques to help.
The local NHS service may be able to help you with the above issues, and your consultant or GP may be able to direct you. Alternatively, you can look for a HCPC registered Physiotherapist in your area.
By Andrea Hemingway