Physiotherapeutic care can begin as early as the first postoperative day, focusing on pain relief and gentle mobilization. The primary goal of physiotherapy is to restore arm mobility on the affected side while preventing edema.
For patients, lymphatic drainage, alongside compression bandages or stockings, plays a vital role. This process helps the formation of alternative lymphatic pathways and prevents swelling in the hands, arms, and back. Respiratory therapy is also essential to improve lung ventilation and mobilize the entire body. The physiotherapist can ease discomfort through gentle stretching, relaxation techniques, and light massages.
Once the surgical wound has healed, scar treatment may begin. This approach helps restore tissue mobility, reduce pain, and improve overall well-being. Since the scar area may feel like a sensitive or taboo zone for many patients, it is crucial for the therapist to be mindful, providing care and responding to any anxieties the patient may have. For most women, this therapy improves both body image and self-confidence. If a woman feels more comfortable being treated by a female therapist, she can express this preference when scheduling her therapy.
Key Consideration: Pain Management
During the early stages of treatment, it is important to respect the patient's pain threshold. Pain relief should always be the top priority. This includes proper positioning of the arm, passive movement within a pain-free range, and breathing exercises that focus on the operated area. An important goal in physiotherapy is to promote venous and lymphatic flow to prevent swelling on the affected side. To achieve this, decongestant exercises are performed, and the patient is encouraged to continue these exercises at home. However, these exercises should never cause pain, and the patient should avoid overexertion.
Lymphatic reflux can also be supported through proper positioning. If chronic lymphedema develops, manual lymphatic drainage by a specially trained therapist will be necessary. To prevent swelling from recurring, patients should wear a compression arm stocking immediately after treatment and consistently follow the advice on wearing or bandaging the arm daily.
Improving Movement and Posture
Training Exercise therapy will gradually increase until full mobility is restored, with progress tailored to the individual patient's abilities. Often, devices such as rods, towels, or balls may be incorporated into the exercises. Posture training is also a key part of physiotherapy after breast surgery, as patients may develop asymmetric postures due to changes in body sensation. The physiotherapist will correct and raise awareness of these posture issues, especially after breast reconstruction, where the prosthesis may differ in weight from the natural breast, leading to further postural adjustments.
Practical Tips for Daily Life
The physiotherapist can teach patients exercises for independent practice at home and offer helpful tips to prevent edema. For example, patients should avoid wearing constricting bras, and blood pressure should be measured on the unaffected side. Heavy lifting should be avoided, and breaks should be taken before the onset of fatigue, both during work and exercise. Overheating and overcooling should also be avoided, meaning hot baths, ice packs, and similar treatments should not be used. Additionally, patients should stay alert to potential hazards that could cause injury or infection to the affected arm.
Post-Breast Reconstruction with Own Tissue
For patients who have undergone breast reconstruction using their own tissue, further treatment is necessary. Since breast or abdominal muscles are typically used in this type of reconstruction, there may be issues in these areas as well. The same principles for wound mobilization and scar treatment apply, and the muscle area used for reconstruction must be slowly rehabilitated. Because there are various methods of reconstruction, physiotherapists develop individualized treatment plans for each patient. Duration of Physiotherapy Treatment Patients should remember that even after the wound has healed, there may still be a tendency for scar tissue to contract and a risk of lymphedema for some time. To regain the best possible range of motion and prevent scar contraction, physiotherapy should continue for up to one year after surgery, with patients adhering to the recommended guidelines in their daily lives.
Psychological Support and Counseling
Psychological support is essential during such life-changing events. Patients often feel isolated from their social and family circles, and sometimes even their partners may struggle to offer the support needed. These situations can be incredibly difficult to navigate alone. Having someone to listen and provide a caring word can make a world of difference. The saying "Smile, and the world will smile back" is our guiding principle, even on challenging days.
