Regardless of the surgery performed on the breast, having a good functional recovery and greater life quality for the women, early physiotherapy is highly recommended to avoid complications. It can be performed during all cancer phases, since pre-treatment until the post-surgery. In each phase, it is necessary to identify not only the patient’s needs, but also the impact in the everyday activities.
Physiotherapist action is aiming at identifying the factors to act also during the pre-surgery period. He/she must evaluate the presence of posture alteration and tension at the shoulder and neck regions, guiding the patient. This also is the moment when the patient can pour their heart out, show their fears, explain their difficulties and solve any doubts.
During this phase, the patient will face many limitations, and the physiotherapy treatment is essential. Those limitations are caused by pain and skin and muscles retraction in the armpit, thorax and arm. Their will face difficulties to: get dressed, brush the teeth, brush the hair, reach for the back of the neck, hook the bra. It is very important to use a supportive bra, because it helps the skin to adhere, avoiding breast and thorax swelling.
Physiotherapy aims at getting back the arm movement, decrease the pain, avoid breathing complications and prevent adherences, scars and fibrosis to form. In this phase, it is also identified neuro alterations which may occur during surgery. The physiotherapist shall guide light exercises for the arms, how to position the arm with pillows and how to train breathe, recovering lung function, and a self-massaging that the patient can give to themselves on their own, as the lymph drainage.
The patient will be discharged in some days in case there is not any post-surgery complication, and can go home with the stiches and drains. As during the first weeks is likely that the patient has a drain, he/she shall not rise their arm above 90º so the surgery wound is not opened.
The stiches will be removed within 15 days after the surgery, in case there are not complications, recovering the full movement of the arms. Stretching exercises and muscle power increase will be performed, as well as the lymph drainage techniques. The early rehab provides an increase in arm movements, avoiding adherences and dysfunctions.