A client once told me that right after her double mastectomy, she felt like she was tossed into the ocean without a lifeboat or any direction. The surgery was a success, but no one warned her of the extent of pain and tightness she would feel as the scars began to form across her chest. About how she wouldn’t be able to lift her arm high enough to take a glass from the shelf, let alone brush her own hair.
This tightness and limited range of motion in the shoulder and trunk following mastectomy surgery is normal, but there’s also something that can be done to help aid the healing process during those early weeks after the procedure, and your surgeon may not tell you, not because they don’t want to help, but because maybe it’s out of their range of care or they aren’t sure where to refer out to.
When scars form, they can sometimes lay down collagen fibers in crazy, mish-mash directions. I like to personify the body, and I imagine a crew of construction workers with very good intentions, but their work isn’t always the neatest. Instead they’re shouting, “Fill the hole! As quickly as possible!” The body wants to heal quickly by nature. In fact, if you puncture the skin with a needle, it takes just one second after that puncture for fibrin (a wound-healing protein) to start forming, ready to fill the hole.
But those hastily-laid collagen fibers can cause lumpiness, pulling, and puckering in the superficial tissues. Adhesions can form, “webbing” in the armpit (called “axillary cording”) can occur, and scar tissue likes to attract more scar tissue, which only exacerbates the sensations of pain and tightness.
Massage can help encourage the construction crew to lay fibers down in a more organized manner, keeping the tissue pliable as it is forming, which can reduce pull on the incision and the surrounding tissues. Massage can also help create space and alignment in surrounding muscle tissue, such as in the upper chest and shoulders, which may be very tight after surgery. And lymphatic drainage massage can aid in keeping lymph circulation flowing, which can help reduce swelling.
I’ve been lucky to see some incredible results in my treatment room with a combination of very gentle scar work (which can be incorporated as soon as the incisions have closed up), lymphatic drainage massage, and non-aggressive myofascial techniques to help mobilize the shoulder joint and trunk. This can happen as soon as 2-3 weeks post-surgery. In fact, earlier on is great. As scar tissue forms, it’s a little like concrete setting. The longer you wait, the more difficult it can be to encourage the tissue toward greater pliability, so you can really benefit from the work in those critical first few weeks after surgery.
The work is painless and relaxing and is really just about kindly “nudging” the body toward smoother recovery. People are able to get back to their daily activities sooner. They can drive. They can blow-dry their own hair. Recently a client of mine walked into my office after we’d been working together for a few weeks, raised her hands above her head, and cried tears of joy at regaining her range of motion.
Though some post-mastectomy patients can feel lost, there is direction. There is massage, there is physical therapy, and there is a body that wants to heal. You don’t have to be lost at sea, and with your range of motion back, you can swim to shore.
“I found my way to Megan’s massage therapy practice two weeks after my surgery for cancer. Although the surgery was very successful, I was feeling tense and uncertain about what to expect as I healed, and how best to support the healing process of muscles and skin impacted by the surgery. From the moment I walked into Megan’s peaceful treatment room, I was put at ease—treatment was always gentle, attuned, and ultimately very effective in preventing scar tissue as well as increasing range of motion. I feel grateful to have had this skilled care and support during what otherwise would have been a much more stressful period of my recovery.”
~ J. L., Middlesex County