Physical therapy is indicated in the postoperative period of breast cancer because after mastectomy there are complications such as decreased shoulder movements, lymphedema, fibrosis and decreased sensitivity at the site, and physical therapy helps to improve arm swelling, and even combat pain in the shoulder and increasing its degree of movement, it returns the normal sensitivity and fights the fibrosis.
The main benefits of physical therapy after breast cancer are improved body image, ability to perform daily activities, and promote satisfaction for work ability and self-satisfaction.
Physiotherapeutic treatment after mastectomy
The physiotherapist should evaluate the health and limitations that the woman presents, and indicate the physiotherapeutic treatment that can be done with, for example:
- Massage to remove the scar;
- Manual therapy techniques to increase the amplitude of the shoulder joint;
- Strategies to increase sensitivity in the pectoral region;
- Stretching exercises for the shoulder, arms and neck, with or without a stick;
- Strengthening exercises with 0.5 kg anchors, repeated for 12 times;
- Exercises that activate lymphatic circulation;
- Exercises to increase respiratory capacity;
- Mobilization of shoulder and scapula;
- Mobilization of the scar;
- TENS to decrease pain and swelling;
- Manual lymphatic drainage throughout the arm;
- Low elasticity bandage at night, and compression sleeve during the day;
- Application of compressive band that must be maintained for a few hours or days, depending on the case;
- Postural reeducation .;
- Pompadius of trapezius, pectoralis major and minor.
Some exercises that can be performed include those of Clinical Pilates and exercises that can be performed inside a pool with warm water in the hydrotherapy.
The woman does not have to be afraid of having a swollen arm after exercise because it is more common in women with a Body Mass Index (BMI) above 25 kg / m2, and practicing the exercises also does not make healing difficult, it does not facilitate the formation of seroma, nor increases the risk of scar complications, being a safe procedure.
When to do physiotherapy after breast cancer
Physiotherapy is indicated for all women who underwent breast-lift surgery, with or without complementary radiation therapy. However, women undergoing radiation therapy after mastectomy have greater complications and require more physical therapy.
Physiotherapy exercises can be started on the first postoperative day and should respect the limit of pain and discomfort, but it is important to gradually increase the range of movements.
Physical therapy should begin the day before surgery and should last from 1 to 2 years. Before the surgery the physiotherapist can clarify some doubts, evaluate the movement of the shoulders and perform some exercises that the woman will have to perform after being operated. After surgery to remove the breast it is indicated to perform sessions that are repeated 2 or 3 times a week.
Special recommendations after breast removal
How to care for the skin
The woman should bathe daily taking care to always apply moisturizing cream on the affected region to keep the skin properly elastic and moisturized. It is also important to be careful when cooking, trimming the nails and shaving to avoid burns, cuts and wounds, which can become infected more easily.
When to use the elastic sleeve in the arm
The elastic cuff should be used according to the recommendation of the doctor and / or physiotherapist, with compression of 30 to 60 mmHg during the day, and also during exercises, but it is not necessary to sleep with the sleeve.
How to reduce swelling of the arm
To reduce swelling of the arm after removing the breast, what can be done is to keep the arm raised because it facilitates the venous return, thus reducing the swelling and discomfort of feeling the arm heavy. It is recommended to avoid tight clothing, preferring light cotton fabrics.
How To Fight Shoulder Pain
A good way to fight shoulder pain after removing the breast is to place an ice pack on the pain site. The compress should be applied daily, 2 to 3 times a day, for about 15 minutes. To protect the skin you should wrap the ice pack on a sheet of kitchen paper.
How to Increase Pectoral Sensitivity
A good strategy to normalize the sensitivity in the scar region is to desensitize using different textures and temperatures. Thus, making circular movements with a cotton ball for a few minutes is indicated, and also with a pebble of ice, however the physiotherapist may indicate other ways to achieve results, according to the need of each.
Applying moisturizer throughout the region after daily bathing also helps to peel off the skin and improve sensitivity.
How To Fight Back and Neck Pain
To combat back and neck pain and just above the shoulders, taking a warm bath and doing an auto massage is a good strategy. Self massage can be done by applying grape seed oil; sweet almond oil, or moisturizing cream with circular motions throughout any sore area.
Stretching also helps relieve pain by reducing spasms. Check out some examples of stretches you can do to combat neck pain.
