One in eight women in the United States will be diagnosed with breast cancer. Early identification and treatment of breast cancer have significantly improved survival rates. However, with improved survival we are now looking at quality of life – and one example of this is shoulder function. Statistics vary, but shoulder / arm pain and decreased shoulder flexibility / movement, are very common among patients that have had breast cancer, with some studies quoting as high as 50% prevalence. For some patients this is only short term, but for some it can last years.
What Does this Mean?
It means that the person may have difficulty reaching overhead to take clothes off and on, reaching in the back seat of the car, opening a jar, lifting a grocery bag, or combing their hair. It means that after treatment for breast cancer, when the person just wants to get back to their normal lives, that pain, pulling, weakness, or stiffness may prevent them from doing just that.
Everybody is different, and the purpose of this blog is not to say that everyone will have shoulder pain. However the purpose of this blog IS to say that if you have shoulder pain, or stiffness, or weakness – there are physical therapists who are trained to help.
Many physical therapists will receive special training to better understand breast cancer treatments: breast surgery, radiation, reconstruction, chemotherapy, etc. These therapists will understand better how the treatments may affect their posture, shoulder biomechanics (how the shoulder joint and surrounding tissues move) – and therefore how to better treat them.
Talk to your medical team about Physical Therapy if you have any questions or concerns about how your shoulder, arm, or chest feel during or after breast cancer treatment. It is our job and responsibility to take care of the whole you, and help you return to the activities that you love.
Resources (in addition to clinical experience)
Ebaugh D, Spinelli B, Schmitz KH. Shoulder impairments and their association with symptomatic rotator cuff disease in breast cancer survivors. Med Hypotheses. 2011;77(4):481–487.
Stubblefield MD, Keole N. Upper body pain and functional disorders in patients with breast cancer. PMR. 2014;6(2):170–183.
Cancer Rehabilitation: Use of evidence-based manual therapy and exercise to help return people to their prior level of function during and after cancer treatment. This includes evaluationprior to surgery as well as treatment through chemotherapy, radiation, initial and reconstructive therapies, and years afterwards if difficulties persist.
Lymphedema: education, risk reduction, and treatment.
Orthopaedic Rehabilitation (neck, back, shoulder, hip, knee, and other injuries): Minimize pain and function (flexibility, strength, daily movement patterns) to allow people to lead their daily lives without being limited by pain.
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