• Rehabilitation after Breast Surgery & measures to prevent a Frozen Shoulder

    Rehabilitation after Breast Surgery & measures to prevent a Frozen Shoulder

    Frozen shoulder, also known as adhesive capsulitis is a common complaint amongst women after Breast Surgery (unilateral or bilateral mastectomy, with or without breast implants). After a mastectomy, patients may experience tightness emanating from the surgery site as the result of scar tissue which can cause pain and restrict the range of motion in the arm and shoulder.

    Frozen shoulder is the inflammation of the capsule which surrounds the shoulder joint. This causes thickening in the joint which leads to stiffness of the shoulder. This syndrome can develop after Breast Surgery for various reasons such as trauma from the surgery, post‐operative pain (especially if not well managed), hyper vigilance, fear avoidance and underlying predisposing factors (perimenopausal, diabetes and certain medication e.g. Crestor)

    Symptoms that may be experienced are pain and a loss of range of motion of the shoulder joint. Although the normal sequelae of frozen shoulder can be long, prognosis appears to be better in most patients who develop frozen shoulder post breast surgery. The risk for developing frozen shoulder can be greatly reduced by gently mobilising the shoulder joint post operatively.

    Treatment options for the frozen shoulder includes exercises, physiotherapy, cortisone injections, NSAIDS (non steroidal anti‐inflammatory drugs), manipulation under anaesthetic and arthroscopic (keyhole) debridement.

    Post‐operative protocols vary depending on the surgery. For that reason it is of utmost importance that you communicate with your surgeon as to what she/he allows you to do. If you are experiencing severe pain in your shoulder, including at rest, at night or with sudden movements, inform your surgeon so that he can refer you to a physiotherapist with a special interest in frozen shoulder or post breast surgery patients.

    How to manage activities of daily living:
    Try using your arm for all normal activities of daily living e.g. washing, dressing and eating, but avoid strenuous activities such as picking up heavy objects, housework or intense exercise until the stitches are removed or your surgeon or physiotherapist, advises you otherwise.

    The exercises in the first few weeks are there to gently move the shoulder, in a pain free range of motion, to prevent complication. Strengthening exercises will only start from six weeks post breast surgery, once the drains and stitches are out. Often this decision may be made between the physiotherapist and the surgeon.

    It is normal to feel a gentle stretch while doing your exercises. All exercises must be pain free. If you develop any abnormal symptom such as dizziness, shortness of breath, contact your doctor.

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