Breast Cancer Rehabilitation focuses on the unique needs of the breast cancer patient. Surgical interventions such as lymph node biopsies, lumpectomies, and mastectomies can result in muscular imbalances, postural distortions, and nerve pain. Radiation and chemotherapy treatments can further damage delicate tissue. Adhesive capsulitis, scapular dysfunction, axillary web syndrome, iron bra syndrome, seromas, swelling, edema, and lymphedema are a few of the issues faced by the breast cancer patient. Breast Cancer Rehabilitation is both restorative and preventative in nature and includes a variety of interventions including massage, manual therapy, stretching, exercise, and education. Rehabilitation is performed in a discreet and collaborative manner.
Axillary Web Syndrome
Axillary Web Syndrome is a complication of breast cancer treatment that forms after lymph node resection. A hard fibrous cord-like structure forms in the axilla (arm pit) and travels down the arm causing tension, pain, stiffness, and loss of function. Patients often have difficulty extending their arm or reaching overhead. Shoulder function may be significantly altered. Axillary Web (or Cord) Syndrome is caused by lymphatic thrombosis. It typically occurs due to inflammation after injury to the lymphatic vessels which causes clotting and scarring in the lymph vessels. Cording may develop within the first 8 weeks following surgery or several years later and it can be self-limiting or last for years. Frequently there is an acute phase, which is more painful, and a chronic phase, where the cords soften and the pain begins to resolve. Treatment of axillary web syndrome consists of soft tissue manipulation, myofascial release, scar release techniques, and active and passive stretching. This condition, if not properly treated, can result in significant pain and disability. The development of cord formation is correlated to a higher risk of developing lymphedema.
Scapular dysfunction is difficulty with shoulder movement. Surgical removal of muscle, lymph nodes, or connective tissue can change the way the shoulder is able to function. Radiation can make the situation much worse. Muscles become weak Adhesions can form binding down tissues and restricting movement making reaching overhead or simple activities such as getting dressed almost impossible. Studies have suggested that roughly 60% of breast cancer patients experience shoulder pain and 67% have decreased strength.
Adhesive Capsulitis or Frozen Shoulder is a loss of range of motion and inability to move the shoulder. Pain following surgery, damage from radiation, scarring, tightening of connective tissue, and protective posturing cause shortening of pectoral muscles, protraction of the shoulder and narrowing of the space in the shoulder joint where the rotator cuff tendons go through. This leads to impingement, inflammation, and pain when moving the arm. The common reaction to painful movements is to stop moving. Unfortunately our bodies are designed to move. When movement is reduced inflammation and contraction results in thickening of the shoulder capsule leading to severe tightening, stiffening, and a shoulder that is frozen in place.
Iron Bra Syndrome
Iron Bra Syndrome is a fairly rare phenomenon, but occurs more frequently in mastectomy patients who have had reconstructive surgery with implants. The post mastectomy pain of Iron bra syndrome is a feeling of extreme tightness across the across the ribs and chest. It is often described as feeling like an incredibly tight underwire bra pushing in on the ribs - thus the colloquial Iron Bra name. Pain, spasms, tightness, throbbing, burning sensations, and restricted movement can contribute to a feeling of difficulty breathing and trouble participating in normal activities like walking up a flight of stairs. Iron Bra Syndrome is most likely Post Mastectomy Pain Syndrome (PMPS) which is chronic neuropathic pain after a lumpectomy or mastectomy. It is thought to be a result of damaged nerves in the armpit or chest during surgery. Massage and soft tissue mobilization can help with pain control and restore function.
Seroma formation is a collection of serous fluid that builds up in an area of the body where tissue has been removed following surgery. Mastectomies, lumpectomies, and lymph node removal frequently result in a pocket of fluid in the space that was created. This is part of the healing process and the body typically will reabsorb the fluid over time. Sometimes the fluid causes inflammation and is painful. Occasionally the seroma persists and does not reabsorb. It must be drained and if it continues to fill then it may require surgical removal. At times an abscess may form and must be treated with antibiotics. Compression bandages and manual lymph drainage can help prevent seroma formation.
Edema & Lymphedema
Edema is swelling from excess fluid that builds up in body tissue. Capillaries leak fluid into the interstitium resulting in swelling most often in dependent areas such the feet or lower legs, but can be anywhere in the body. Prolonged sitting or standing can cause accumulation and retention of fluid especially in hot weather. Edema often goes away on its own. Edema in the legs may be resolved in the morning from the legs being raised in bed. Edema can be uncomfortable and if it persists long enough it may affect blood flow to the tissues such as the skin. This results in tight stretched and shiny skin with hair loss.
Lymphedema is the accumulation of lymph fluid within the tissues resulting from damaged, obstructed, or missing lymphatic vessels and nodes. Lymph fluid is part of the immune system carrying and filtering waste. It is protein rich and can cause damage to tissues, skin changes, and infections if it stays too long. Lymphedema does not resolve on its own and there is no cure for it, however it can be managed with lymphedema therapy especially if caught early. Prevention and early treatment are essential to minimize problems. Complete decongestive therapy along with manual lymph drainage can reduce the swelling and restore function.
What Our Clients Are Saying
"Melissa at Nurture Massage is quite simply the best! Not only does she give an amazing massage but she takes the time to get to know you and listen to your needs. I never feel rushed and I always look forward to my appointments with her. She brings joy. and makes me feel relaxed and at peace" ~ B. G., Brunswick, ME Breast Cancer Survivor
"I use to have terrible headaches and neck pain so bad I couldn't sleep but after a session with Melissa I was so relaxed I slept like a baby. If you're in pain she is the one to see - you won't regret it! ~ G. S., Bath, ME