Physiotherapy After Mastectomy : 7 Things Every Breast Cancer Patient Should Know
A ProVital Physiotherapy Guide
Recovering from breast cancer surgery involves more than waiting for the wound to heal.
For some women, simple activities such as reaching for a cup on a high shelf, putting on a blouse, washing their hair or reaching behind their back suddenly become uncomfortable or difficult. The arm may feel tight, the shoulder may not move as freely as before, and even sleeping in a comfortable position can take some adjustment. These changes can be frustrating, especially for someone who was previously independent and active.
After a mastectomy, or other breast cancer surgery, the body needs time to recover. Physiotherapy can help patients regain movement, rebuild strength and gradually return to their usual daily activities.
Here are seven things worth knowing about recovery and rehabilitation after breast cancer surgery.
1. Why does my shoulder feel stiff?
Pain, swelling, healing tissues and muscle tension can restrict shoulder movement after surgery. Avoiding movement out of fear may also contribute to stiffness. Recovery varies depending on the surgery, lymph node procedures, reconstruction and additional cancer treatment.
2. Is it safe to move my arm?
Gentle movement is often encouraged when approved by your medical team. Early rehabilitation may include breathing exercises and gentle hand, elbow and shoulder movements. Avoid forcing movements or stretching aggressively, particularly if you have surgical drains, reconstruction or specific restrictions.
3. How can physiotherapy help?
An individualised rehabilitation programme may include:
Shoulder mobility: Improving reaching and lifting.
Strengthening: Gradually rebuilding arm and shoulder strength.
Posture and movement training: Improving movement confidence.
Scar management: Addressing scar tightness when appropriate.
Functional training: Practising dressing, reaching and household activities.
Your physiotherapist will tailor treatment to your symptoms, surgical restrictions and goals
4. What causes chest or armpit tightness?
Healing tissues, scar sensitivity and muscle tension may cause pulling around the chest or armpit. Some patients develop axillary web syndrome, which causes a tight, cord-like structure beneath the skin and may restrict arm movement. Appropriate exercises and, when indicated, manual techniques can help improve mobility.
5. Should I worry about lymphoedema?
Lymphoedema occurs when lymphatic fluid builds up, causing swelling in the arm, hand, breast or chest. Other symptoms include heaviness, tightness and reduced movement. It can develop after lymph node surgery or radiotherapy.
Seek medical assessment for new or increasing swelling. Sudden swelling, redness, warmth or pain requires prompt attention to rule out infection or a blood clot. Confirmed lymphoedema may require specialist care, including exercise, skin care and prescribed compression (Davies et al., 2020).
6. When should I start physiotherapy?
Timing depends on your surgery, wound healing, reconstruction and medical advice. Some patients begin gentle rehabilitation soon after surgery, while others need to wait. Physiotherapy can also help later if stiffness, weakness or difficulty with daily activities persists.
7. What should recovery look like?
Recovery is about more than achieving a particular shoulder angle. It means dressing comfortably, reaching everyday items, sleeping better and gradually returning to meaningful activities. Progress should reflect your individual needs rather than comparisons with others.
At ProVital Physiotherapy Centre, we believe rehabilitation starts with understanding the person, not just the condition. If you experience stiffness or difficulty using your arm after breast cancer surgery, speak to your medical team about whether physiotherapy is suitable for you.
References
American Cancer Society. (n.d.). Exercises after breast cancer surgery. https://www.cancer.org/cancer/types/breast-cancer/treatment/surgery-for-breast-cancer/exercises-after-breast-cancer-surgery.html
Davies, C., Levenhagen, K., Ryans, K., Perdomo, M., & Pfeifer, K. (2020). Interventions for breast cancer–related lymphedema: Clinical practice guideline from the Academy of Oncologic Physical Therapy of APTA. Physical Therapy, 100(7), 1163–1179. https://doi.org/10.1093/ptj/pzaa087
