Physical therapy post BMX without reconstruction

eot28

Hi there,

Just curious to hear from anyone that had physical therapy post BMX without reconstruction. I'm curious if you found that the physical therapists used a 'firm touch' or if it was more gentle massage? Did they work on scar tissue? I have been trying PT and the exercises are helpful but I find the touch to be really firm when they are stretching scar tissue (e.g. pressing hard in the armpit area etc.) and I tend to swell after my appointments. I found an oncology massage therapist which uses a much more gentle touch and I think I prefer that - it's just gentle myofascial release.

But I'm not sure if I'm missing something about the benefits of a firmer touch of physical therapy? I'm thinking of just sticking with the massage therapist appointments and seeing how that works for me.

If you have any thoughts/experience with this, would love to hear from you. Thanks!!

tsoebbin

I had a double mastectomy without reconstruction also. I would suggest lighter touch. I developed lymphedema in my arms chest and trunk so I suggest being super careful about making any areas that are already swelling angry!

magiclight

My PT's did not use any massage, just exercise, but at that time did not know that massage was an option. Months after surgery I used myofascial release massage for post mastectomy pain.

Kicks

My suggestion would be to find a PT or OT who is also a LET (LymphEdema Therapist) - one who actually has the education about LE, not some PT who claims to 'know everything about LE' but can actually do harm. From what you wrote about your PT sessions, it sounds like the PT you are seeing knows nothing about LE.

Anyone who has had breast surgery (or surgery in any part of the body) can develope LE. It is important to see an LET for knowledge before LE develops (IF it does) to hopefully prevent it from happening. Also to get baseline measurements 'just in case'.

MLD (manual lymphatic drainage) massage should be gentle (almost like gently petting a pet bunny rabbit or kitty cat) and done in a specific order. (Part of the info you would be given by an LET.)

I had a UMX (no recon) and was never sent to a PT as it was not something that was needed as my ROM was not impaired. However, 9 weeks post UMX started having LE/swelling issues and my Dr got me in to my LET guy (he's an OT - Occupational Therapist) quickly.

Even if there are no potential LE signs - at least seeing an LET appt. is a good idea before issues develops.

Nulyte

Wow I'm glad I read this post. My BMX was Nov 14th and I have had constant pain. I finally see PT on Monday and I honestly didn't know what to look for

eot28

Thanks so much for your help, ladies!

tennischick888

I just finished 4 weeks of PT and it made a huge difference in my recovery. I was referred by my breast surgeon to a therapist who specializes in oncology rehabilitation. I developed some mild cording and went to PT early in my recovery. I have been to PT for shoulder and ankle injuries but this was very different and you need someone who specializes in treating patients like us. I learned a lot from my CLT and she really helped me. I will be diligent with the exercises she taught me. My therapist was very gentle with the massaging. She was adamant about letting me know that they didn't believe in "no pain, no gain."

Good luck.

eot28

Thanks so much tennischick. Good to know that your PT believed in gentle massage. It seems to feel the best to me too. Thanks again!

ksusan

Gentle, with the admonition, "If you get massage from anyone else, they're to stay out of your armpits!"

mustlovepoodles

Massage shouldn't hurt, especially over a scar. I had really bad cording after my BMX, so I found a massage therapist who was trained in myo-fascial release. Very gentle. I worked with her weekly for about 10 weeks until it was all gone. She wasn't a lymphedema specialist or a PT,but she did amazing work for me.

Luna52

After my BMX in September, I had some cording on the right (disease) side underarm and some range of motion issues. I have been in PT about 12 weeks. ( I had a 5 week setback when I tried to resume my former, aggressive exercise routine too soon.)

My physical therapist has been so incredible...working not only on the cording and ROM but also my persistent chest edema.

The myofacial massage has worked wonders in gradually opening up my lymphatic drainage.

Gentle is the key, for sure! Very different from other PT experiences I have had for different injuries. In those I was encouraged to keep pushing myself.. with this condition, pushing harder just rebounds my swelling.

Luna

ksusan

I've been getting PT and massage as they appeared to be needed for post-surgery, post-radiation issues. Both people are good but I wanted a consult to be sure the massage therapist didn't inadvertently cause LE rather than attempt to prevent it. Yesterday I saw a LANA-certified nurse who said that I have cording in both arms (I can't really feel this, but I believe her). I'm going to have 10 sessions of cording release with her. She wants me to stop getting my scar release massage for now, but I hope to induce her to keep working on that. My incisions and radiated areas have micro-adhesions that are grossly attended to but need periodic work to keep aligning the tissues correctly and releasing the adhesions. The good news about this is that she is covered by my insurance, unlike my massage therapist.

Luna52

ksusan raises an excellent point. You definitely need someone who is trained or certified in lymphedema.

eot28

Thanks so much everyone! All of your comments make me feel confident in my decision to just stick with the super gentle massage I am getting now. I am getting MLD once a week (mostly now just because it feels good and also very gentle massage at an Integrative Oncology Clinic. Both therapists are LANA certified. So I feel I'm in good hands now. Thanks again for all your help - I feel a lot less alone now and much more informed .

eot28

KSusan - I'm glad you found someone to help with the cording that is covered by insurance! That's my only issue now - both of my therapists aren't covered by insurance. But will take it week by week and see how it goes.

imisswine

trying to see if what's going on w/ me has happened to others.

I'd gone back to gym as soon as I could after surgery, doing my stretches, started slow on the strength training. I noticed arms feeling weaker as time went on. One year post L lumpectomy and SNB, then radiation, my L arm started swelling. Not a lot, but I wanted it checked. Referred to a physical therapy center specializing in BC.

Got a sleeve for the lymphedema, working well. And PT noticed ROM issues w/ arms, both arms. L side - the chemo, surgery, rads side there's cording. Doing my stretches and massage therapy, OK. The right arm - non cancer - side, also have bad ROM and pain issues. At first we thought it a shoulder injury- even went to ortho for cortizone shots. Now PT thinks it's also cording on the non cancer R side??

Everyone there is certified/trained in this, many are also BC survivors who have experienced this themselves. So I know they know what they're doing. She said it's rare but does happen.

Been reading some threads, hadn't seen much so I am curious if anyone else has heard of it. Thanks.

Momine

I saw a lymphedema specialist for about a year. I believe it saved my arm. I had light lymphedema and she got rid of it. I sometimes get light swelling near my armpit, but it goes away by itself