Tag Archives: Frozen Shoulder

post mastectomy physical therapy

Post-Mastectomy Physical Therapy

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The word cancer is a scary one. Even though we all hope that it never becomes part of our lifetime of trials, more often than not, we know someone that has had, or is currently dealing with cancer. It is a testament to the medical community that so many women are able to wear the pink ribbon as a sign of triumph and pride, but we still mourn with those that wear it as a sign of remembrance and loss. More than once, while talking with women that have begun treatment for breast cancer, the topic of whether or not to have a mastectomy has come up. It’s not a decision taken lightly, often one with multiple concerns about what happens after surgery. Will the cancer be gone for good? Will it hurt? How long will it take to recover? A physical therapy post mastectomy program can help address these issues.

Physical Therapy can’t answer all of those questions, but one thing a physical therapy post mastectomy program can do is aid in the overall recovery process by focusing on regaining strength and increasing the range of motion in your shoulder and arm. Early intervention by a physical therapist can help women regain full function following mastectomy surgery, regardless of whether or not a woman has had reconstruction. Rehabilitation is always tailored to each patient’s specific needs. Not every patient experiences the same recovery, and as such physical therapists are prepared to help patients experiencing a multitude of symptoms – some have been highlighted below.

Size, location and the type of mastectomy are important considerations when choosing a type of treatment. Exercises to maintain shoulder range of motion and arm mobility may be prescribed as early as 24 hours after surgery.  These exercises are important in restoring strength and promoting good circulation. As rehabilitation progresses these exercises may be modified to meet new goals.

After mastectomy surgery, patients may experience tightness around the surgical site. This is caused by scar tissue formation. The result can be very dense tissue under the incision, which is painful and can restrict range of motion.  The restricted range of motion puts a woman at risk for a painful condition known as frozen shoulder. Early treatment by a physical therapist can help reduce the pain and help regain functional range of motion and strength.

Numbness and/or nerve sensitivity at the surgical site can develop post-mastectomy. Manual therapy can help restore sensation and relieve nerve pain. In severe cases, a chronic condition known as post-mastectomy pain syndrome may develop.  This is caused by scar tissue impinging on nerves. Physical therapy can be very effective at releasing scar tissue and reducing this nerve related pain.

Axillary node dissection can lead to a condition known as cording or axillary web syndrome.  Cording presents as a moderate to painful tightening, which appears as “cords” emanating from the armpit and extending down the arm. Cording significantly restricts range of motion and arm function. Manual therapy and therapeutic stretching helps to resolve this condition quickly.

Radiation treatment after mastectomy surgery can exacerbate posture and range of motion problems, causing fibrosis and skin tightness. Manual therapy can remediate these issues and may prevent them from ever becoming a problem.

The Benefits of Exercise and Physical Therapy post mastectomy treatment programs can differ greatly as seen above, but there are a few benefits that all patients can benefit from:

  • Improved shoulder range of motion
  • Improved shoulder strength
  • Improved functional mobility
  • Improved posture
  • Decreased pain at the surgical site
  • Decreased edema on the affected side
  • Improved sensation at the surgical site

Meeting with a physical therapist before surgery can help you feel more at ease and more confident in your overall recovery goals. It’s never too early to ask questions! To find a physical therapy clinic near you click here.

For more information on cancer related physical therapy programs click here:

    

 

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Frozen Shoulder

Physical Therapy can Help Patients Experiencing Frozen Shoulder Regain Movement Faster

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Physical therapy can help patients experiencing frozen shoulder regain movement faster. If your initial pain doesn’t go away with usual pain relievers, it’s probably time to check with a physical therapist. That’s because it can take up to TWO YEARS to go away on it’s own! This is definitely not something to be ignored.

Adhesive capsulitis is more commonly known as frozen shoulder, and with good reason: It can render your shoulder so stiff, it’s almost impossible to button your shirt — that is, if you aren’t in too much pain to get dressed in the first place.

Where does Frozen Shoulder Come From?
In general it comes on after an injury to your shoulder or a bout with another musculo-skeletal condition such as tendinitis or bursitis. Quite often its cause can’t be pinpointed. Nonetheless, any condition that causes you to refrain from moving your arm and using your shoulder joint can put you at risk for developing frozen shoulder.
Frozen shoulder affects 10-20 percent of people with diabetes according to the American Academy of Orthopedic Surgeons. Women are more likely to develop frozen shoulder than men and it occurs most frequently in people between the ages of 40 and 60.

Where does the diabetes come in?
Well, doctors still aren’t exactly sure. But they believe that excess glucose impacts the collagen in the shoulder. Collagen is a major building block in the ligaments that hold the bones together in a joint. When sugar molecules attach to the collagen, it can make the collagen sticky. The buildup then causes the affected shoulder to stiffen, and the pain prevents you from moving your arm. Ouch!

Frozen Shoulder has Three Stages:
FREEZING
Pain slowly becomes worse until range of motion is lost.
(Lasts 6 weeks to 9 months)

FROZEN
Pain improves, but the shoulder is still stiff.
(Lasts 4 to 6 months)

THAWING
Ability to move the shoulder improves until normal or close to normal.
(Lasts 6 months to 2 years)

Physical therapy is often very effective in treating frozen shoulder. If your initial pain doesn’t go away with the usual pain relievers, it’s probably time to check with a doctor. That’s because frozen shoulder can take up to two years to go away on its own! This is definitely not something to be ignored.

shoulder

TREATMENT
Treatment of frozen shoulder focuses on controlling pain and getting movement back to normal through physical therapy. Sometimes surgery is also considered. Talk to your doctor about treatment options that are right for you.

PREVENTION
Because doctors don’t really understand the causes of frozen shoulder, it can be difficult to prevent it in most cases. Keeping your blood sugars under control is always key to avoiding all complications. Doctors have also found that people who’ve suffered an injury to their shoulder or stroke are also at an increased risk of frozen shoulder, because of the immobility the other condition has caused. If you have diabetes and have had a shoulder injury, talk to your doctor or a physical therapist about what kind of exercises you can do to make sure frozen shoulder doesn’t happen to you.

Written by the Therapy Team at Advanced Physical Therapy