Shoulder Pain and Stiffness After Breast Cancer Surgery : How Physiotherapy Can Help
A Provital Physiotherapy Guide
Have you noticed that reaching for something on a high shelf is no longer as easy as it used to be? Perhaps you struggle to put on a blouse, wash your hair or reach behind your back. Your shoulder may feel tight, or you may notice a pulling sensation around your chest and armpit when you lift your arm.
For some women, these difficulties appear after breast cancer surgery. Even when the surgical wound is healing well, the shoulder and arm may not feel quite the same. This can be worrying. You may wonder if the discomfort is part of normal recovery, if you should keep moving your arm or if resting it would be safer.
Understanding the possible causes can help you take the next step.
Why does shoulder movement become difficult?
Several factors may contribute:
Pain and muscle tension: Protecting the surgical area by avoiding movement may contribute to stiffness.
Chest and armpit tightness: Healing tissues or axillary web syndrome, which causes cord-like structures under the skin, may restrict movement.
Lymph node surgery: This may increase the risk of lymphoedema, causing swelling, heaviness and tightness.
Fatigue and reduced activity: Lower activity levels can affect strength and endurance.
Recovery varies depending on the surgery, reconstruction, additional treatment and individual healing.
Is it safe to move your shoulder?
Gentle movement is often part of recovery, but the timing and exercises must follow your surgeon’s instructions. Avoid forcing stretches or pushing through pain, particularly if you have undergone reconstruction or have specific surgical restrictions.
How can physiotherapy help?
A physiotherapist can assess your shoulder mobility, pain, posture, strength and daily functional difficulties. Depending on your needs, treatment may include:
Gentle shoulder mobility exercises.
Progressive strengthening.
Posture and movement training.
Guidance on home exercises and returning to daily activities.
When should you seek help?
Consider a physiotherapy assessment if stiffness, weakness or difficulty with daily activities persists. Seek prompt medical assessment for new or rapidly increasing swelling, redness, warmth, fever or sudden worsening pain.
Take the next step towards comfortable movement
At ProVital Physiotherapy Centre in Taman Desa, we focus on understanding each patient’s difficulties and setting meaningful rehabilitation goals. If shoulder stiffness is affecting your recovery, speak with your medical team about whether physiotherapy is appropriate for you.
References
Ferrara, P. E., Gatto, D. M., Codazza, S., Zordan, P., Stefinlongo, G., Ariani, M., Coraci, D., & Ronconi, G. (2024). An update on rehabilitative treatment of shoulder disease after breast cancer care. Musculoskeletal Surgery, 108(1), 31–45. https://doi.org/10.1007/s12306-023-00806-w
National Institute for Health and Care Excellence. (2025). Early and locally advanced breast cancer: Diagnosis and management (NG101). https://www.nice.org.uk/guidance/ng101
Xu, Q., Liu, C., Jia, S., Wang, P., Liu, Q., Ding, F., Ren, Y., Ma, X., & Zhu, J. (2024). Effect of physical exercise on postoperative shoulder mobility and upper limb function in patients with breast cancer: A systematic review and meta-analysis. Gland Surgery, 13(8), 1494–1510. https://doi.org/10.21037/gs-24-255
González-Rubino, J. B., Vinolo-Gil, M. J., & Martín-Valero, R. (2023). Effectiveness of physical therapy in axillary web syndrome after breast cancer: A systematic review and meta-analysis. Supportive Care in Cancer, 31(5), Article 257. https://doi.org/10.1007/s00520-023-07666-x
