- Chest or upper arm numbness
- Limited movement in the arm or shoulder
- Shooting or burning nerve pain in the chest wall, armpit, or arm
- Lymphedema, or swelling of the arm on the side of surgery
“Exercise generally contributes to holistic wellness, and studies also show that exercise improves survival and reduces recurrence of cancer risk,” says Monique Gary, DO, a breast surgical oncologist and the medical director of the Grand View Health Cancer Program in Sellersville, Pennsylvania.
Getting Physical Therapy Before Your Mastectomy
You can meet with a physical therapist before your surgery to help them understand your range of motion, level of strength, and any postural issues, all of which may be affected by your mastectomy, says Christine Hudacek, a physical therapist and certified lymphedema therapist with the outpatient rehabilitation institute at the University of Maryland St. Joseph Medical Center in Towson. This time also gives your therapist the opportunity to take pre-op measurements, so that any lymphedema that may develop after surgery can be spotted, she says.
Physical Benefits
Muscle Strength Physical therapy exercises can strengthen weak areas to prepare for faster recovery after surgery, according to Rebecca Viscusi, MD, a breast surgical oncologist in Tucson, Arizona.
In particular, prehabilitation helps increase strength and flexibility in your upper trunk and shoulders, which enhances postsurgical healing, says Nicki Evans, DPT , a physical therapist based in Millville, Delaware. These exercises may include shoulder rolls, arm circles, and stretches — anything that gets your shoulder and chest moving, Dr. Gary says.
Getting Physical Therapy After Your Mastectomy
Physical Benefits
Improved Range of Motion After a mastectomy, some people may experience tightness under their arms or along their chest wall, Dr. Viscusi says. Some may even experience frozen shoulder — pain and stiffness that may occur in the shoulder after surgery. “PT can help patients regain their full range of motion, and can help lessen some of the tightness, which in turn can help reduce pain.”
Lymphedema Prevention and Treatment If you had lymph nodes removed during your mastectomy, there’s a chance you may develop lymphedema. Some physical therapists are trained in lymphedema treatment, and can help decrease or prevent swelling, Viscusi says.
Nonphysical Benefits of Physical Therapy Before and After Mastectomy
“Similar to PT prior to surgery, PT can also benefit a patient psychologically after mastectomy by helping them to feel better, stronger, and more in control of their recovery,” Viscusi says.
Education While preparing for surgery, the amount of information thrown at you can feel overwhelming. But speaking with a physical therapist, particularly one who specializes in breast cancer surgery recovery, can offer insights on lymphedema prevention, Evans says. Your physical therapist can also teach you how to do each exercise correctly, and adjust your position as you do them.
After breast cancer surgery, your doctor should provide you with information on what was done during the procedure and what you should expect as you recover. Even so, the time after surgery can feel like a whirlwind, and it can be easy to forget some of your doctor’s instructions. Your physical therapist, who you’re likely to visit a couple times a week post surgery, can answer your questions about your level of movement and any physical limitations that may follow surgery.
Psychological Support Working side by side with a physical therapist, someone dedicated to making you stronger and who understands what you’re going through, can be uplifting, both before and after your mastectomy, Hudacek says. During your PT appointment, you’ll also get the opportunity to ask questions, share your concerns, and actively participate in your treatment. “All of which can contribute to a stronger sense of healing and fuller recovery,” she notes.
Adaptation Assistance Once you get home, you may not be able to do everything you could do prior to surgery. Not only can your physical therapist help you regain your strength, but they can also teach you tips and tricks for daily activities, like showering or cooking, so you can carry out these tasks independently as you heal.
What to Expect From Your Physical Therapy Appointment
During your first visit, your therapist will likely ask a series of questions to gauge your current pain level and mobility, and make a plan for your recovery. If you are seeing your therapist prior to your procedure, your PT will use this time to establish a baseline of activity and range of motion, especially in your arm and shoulder.
Exercises
After a detailed evaluation, your therapist will walk you through a few light stretches and exercises. They should give you specific instructions on how exactly to move and how many repetitions to do.
As you move through these exercises, your therapist will ask about your pain level and adjust your movement as needed. If you feel any sudden, sharp pain, stop the movement and let your therapist know right away.
Exercises to Do at Home
After you’re finished with the session, your physical therapist will give you instructions on exercises you can do at home. Your therapist may also send you home with printed instructions, featuring pictures, for you to reference.
“It is important to talk to your doctor or therapist about which of these are right for you, and when you should start doing them. Also, you should not do any heavy lifting, housework, or driving until your surgeon gives a nod,” Gary adds.
How to Find a Physical Therapist
Any physical therapist can assess your range of motion, strength, balance, and gait following surgery, Hudacek says. A certified lymphedema therapist (CLT) may be able to offer more specialized care post-mastectomy.
“These therapists possess specific knowledge of the rehabilitation protocol, use a more personalized approach, and stay up-to-date on the latest best practice guidelines,” Evans says.
Provider Recommendation As you prepare for your mastectomy, you will probably have a visit or two with your surgeon. During your visit, you can request a few recommendations for a physical therapist who specializes in both pre- and post-mastectomy care. Your doctor’s office can also send a referral to a physical therapy group of your choice, so you can get started as soon as possible.
Personal Referral If you are part of a breast cancer support group of any kind, you can ask around for personal referrals. People may be able to recommend a therapist they have been to, and tell you about their PT experience.
Insurance Provider List Not sure which physical therapists are covered under your insurance? Most insurance companies offer a provider list or search engine on their website so you can find the right therapist for you.
