Tightness in back and side after lat flap reconstruction

nash

Tightness in back and side after lat flap reconstruction

nash

I'm four months out from unilateral lat flap done for a recurrence in a previously radiated lumpectomy breast. I've been reading people's "iron bra" stories, and I have that (it feels like I always have a tight sports bra on, with a brick strapped to my chest), but I also have excruciating tightness and pressure in my side and back on the surgery side. It feels like a combination of having duct tape on my ribs and someone pinching ribs with their fingers, plus the whole area being encased in cement.

These feelings started as soon as I woke up from the lat flap surgery, and have continued 24/7 with varying degrees of intensity. It was a 10 for the first few weeks after surgery and got down to a 7 about a month ago. The PS and pain clinic are mystified, and keep telling me it's PMPS and if I take gabapentin all will be fine. I don't want to take gabapentin, and I think it's all mechanical anyhow.

I self-referred to PT (PS didn't think I needed it), and PT found that my diaphragm, which is normally tight to begin with, is in spasm. Also, ribs and vertebrae are not moving properly. She has been doing release work on that and also some myofascia release. After four sessions over a few weeks, I am down to a 4/5 in the mornings, then things get worse as the day progresses. She said my back is tight on the surgery side from the neck all the way down to the top of the hip.

I had to ask for Flexiril right after the surgery, and it didn't help anyhow. Heating pads don't help. Ice doesn't help. Stretching makes things worse. So far the only relief comes from the PT manipulating things, but it is short lived. I've also been going for massages, but they don't do much.

Has anyone experienced anything like this? For reference, I am a competitive athlete and on the thinner side of things. No meat on my back, so I'm sure most of this tightness is from losing a big hunk of flesh off of my back, combined with surgical incision tightness, plus getting manhandled during the surgery (I had a bruise the shape of a handprint on my back after surgery, pretty much right where most of my problems have been.). But I'm just curious how common all this is, and what others have done about it. If it's permanent, I'm going to be really unhappy, b/c it affects my QOL in a big way.