Breast Cancer Rehabilitation For Physiotherapists

Updated October 2016. Written by Siobhan O’ Reilly Bracken MISCP PT MPA MSc CLT. Email questions and comments to

What has Physio to do with breast cancer?

What has physiotherapy to do with breast cancer?

Physiotherapists work closely with the patient’s oncology team and GPs to address the acute and chronic side effects of surgery, chemotherapy and radiation. Breast Cancer Rehabilitation aims to return each patient back to their pre diagnosis quality of life and beyond, towards living well.

Timely and effective Physiotherapy reduces the traumatic effects of the patient’s breast cancer experience. The skilled Physiotherapist may address pain, restriction, swelling, weakness and functional difficulties in a structured and professional manner. This care instills confidence and optimism and empowers patients to participate in their recovery and future well being, right from the beginning.

Breast cancer sometimes occurs later in life when a person may also have a significant co-morbidity. Physiotherapists are trained to safely address the common co-morbidities including, previous cancers, shoulder and spinal disorders, cardiac and lung pathology, diabetes, bone and joint pathology and neurological pathology affecting co-ordination, balance and endurance.

Cancer treatment is systemic and so affects the whole body not just the location of the tumor. Treatment side effects are therefore also whole body. Physiotherapists recognize that patients may have needs beyond their remit and often will refer patients to other members of the multi-disciplinary team, for example, for pain management, nutritional support and /or psychosexual counseling etc.

Specifically, Physio addresses:

• Pain and decreased shoulder flexion
• Cording and axillary web syndrome
• Adherent scarring, mastectomy, surgical drain and reconstruction scars
• Slow healing surgical wounds e.g. at the flap donor sites.
• Tissue stiffness after radiation therapy.
• Intercostobrachial neuralgia.
• CIPN neuropathies
• Bone density, joint pain and arthralgia.
• Capsular contractures after implant reconstruction
• Donor site rehab after reconstruction
• Cancer related fatigue
• Guidance with weigh lifting, aerobic and endurance training
• Prevention and management secondary lymphedema
• Cellulitis prevention, early ID and treatment.
• Education
• Meticulous skin care
• Self-manual lymph drainage (SMLD),
• Self-wrapping
• Compression sleeves when exercising and flying.
• Use of Antihistamine and antibacterial creams and antibiotics.

Exercise is medicine and Physios prescription is > 35 minutes daily

Our wellness experts all agree and recommend we all do more than 150 minutes per week of moderate exercise or 75 minutes per week of vigorous exercise to enjoy the benefits of exercise – which includes the reduced risk of many diseases.

Daily walking, aqua therapy, biking, cross trainer, tennis, basketball, skiing to name a few examples, helps breast cancer survivors achieve lean muscle mass and optimal body weight, which is also co-related with less cancer recurrence.

Physios can facilitate this by researching and recommending suitable groups in their patient’s neighbourhood. Research shows that the more fun and high quality it is, the more likely a person is to experience positive results and to commit to it longterm. One of our tasks as Physios is to remove as many barriers as we can to help survivors of all ages and income levels to suceed in integrating exercise into their everyday routine so they can stay well and enjoy their lives.

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