Following breast cancer treatment, complaints of upper body pain and dysfunction are common, especially in the early period following surgery, radiation or chemotherapy can cause damage to healthy muscle fibres, breast tissue, lymphatic vessels and the shoulder joint. We are now learning from research that resting the affected side following breast cancer treatment helps to promote healing, but avoiding movement altogether may contribute to the development of further complications. With studies suggesting that 60% of women will experience shoulder pain following breast cancer treatment, a safe and appropriately prescribed exercise program is imperative for the healing and rehabilitation of the upper body..
After surgery, it is important to give the body the best chance to heal by resting and avoiding excessive movements. Being mindful of posture is very important during this first phase of recovery to ensure proper healing. Poor posture causes the muscles of the chest and upper back to become imbalanced and restricts full range of motion of the shoulder. This can lead to shoulder issues such as frozen shoulder or thoracic outlet syndrome (the entrapment of blood vessels and nerves that supply the arm). While excessive activity is to be avoided, light gentle movement of the upper body is encouraged to maintain range of motion of the shoulder joint. This will speed the recovery time following surgery and reduce the long-term impacts of treatment. Gentle shoulder rolls, deep breathing and practicing good posture are great examples of exercises that can be done during the first few weeks following surgery.
Once proper movement is restored and healing is well under way, exercise to increase the endurance (how long a muscle can hold a contraction) and strength (how much force a muscle can produce) of muscle can begin. Adding strength exercises will not only correct poor posture and improve range of motion further, but will also contribute to increasing bone mineral density and muscle mass. Increasing bone mineral density is important because one of the long-term side effects of chemotherapy includes osteoporosis. An individualized exercise program emphasizing movements that mimic daily living activities will support a full recovery. Proper pushing, pulling and lifting techniques should be emphasized in a program as these are common movements that occur day-to-day.
While exercise for overall health can be quite straightforward, exercise for breast cancer rehabilitation is more complex. An individualized exercise program is important for regaining range of motion, strength and allowing for a return to normal activity in the safest and most efficient way possible. Understanding what recovery means to you is important and working with a kinesiologist one-on-one can help you determine this. Recovery won’t happen overnight, but being patient and mindful of your goals during the process will ensure greater success for a pain-free, full recovery.
By Kelly Wanless, InspireHealth Exercise Therapist