 October is both Breast Cancer Awareness Month and National Physical Therapy Month. The articles this month will focus on general breast health as well as physical therapy's role in caring for the breast cancer patient. As always, we try to bring you relevant health information from a physical therapist's perspective. If you have any suggestions for future topics that you would like to learn more about, please feel free to email us at info@legacytherapystl.com
Breast Health During Exercise
Several studies have shown that exercise can decrease a woman's risk of developing breast cancer, and it can contribute to better quality of life and psychological well-being in those women who already have breast cancer. For any woman considering starting an exercise program, there are some facts about breast health that you may not have considered.
When starting a workout program many women might be worried about getting dehydrated, straining a hamstring, or spraining an ankle. I doubt too many women are thinking about how exercise may affect their breasts.
 Jogger's nipple is a common condition that occurs from the rubbing of the nipple against clothing. This may result in soreness, irritation, chafing, or bleeding. Jogger's nipple commonly occurs in colder weather when the nipple rubs against cold sweat-soaked clothing. Wearing a properly fitting sports bra is the best prevention for this condition. (Bra fit will be discussed in the next article) If you experience this condition you can minimize symptoms by applying pure lanolin around the affected area before exercising. You may also find it more comfortable to put small bandages over the nipples to limit rubbing.
Bruising, swelling, or contusions are all possible breast injuries for women who play racket or contact sports. The first line of treatment for an injury of this nature is ice and anti-inflammatories. If these conditions do not resolve, you should seek medical care from you doctor. Aspiration, or removal, of excess blood from the bruise may be needed to resolve the condition.
Proper Bra Fit
.Approximately 75% of women are wearing the wrong size bra. Proper bra fit is important not only for breast health but also for reducing risk of upper back, neck, or shoulder pain. A review of proper bra fit is a part of all of my physical therapy interventions for patients with the above-mentioned conditions.
A properly fitted bra is comfortable to wear and, ultimately, will feel as if you are not wearing a bra. If your favorite bra is hanging on by mere threads you are way past the point of it providing you with any support. A woman should visit her favorite lingerie store at least twice a year and, ideally, each quarter to ensure her bra fits properly. My favorite place to send patients who are in need of a proper fitting are:
The back strap (band) and cups should provide most of the support, rather than the shoulder straps. When viewed from the side, the strap that runs around the body should  be horizontal, should not ride up the back, and should be firm but comfortable. The underwires at the front should lie flat against the rib cage (not the breast), along the infra-mammary fold, and should not dig in to the chest or breast, rub or poke out at the front. The breasts should be enclosed by the cups and there should be a smooth line where the fabric at the top of the cup ends. There should not be a ridge or any bulging over the top or sides of the cups, even with a low-cut style such as the balconette bra.
Common Bra Fit Problems and Solutions
Problem: – The band at the back of the bra rides up.
Explanation: – The band of the bra is too big
Solution: – You need a bra with a smaller back size.
Problem: – Under wire digging in under the armpit.
Explanation: – Your cup is too small, the underwire should encase the breast not dig into it.
Solution: – You need a bra with a bigger cup size.
Problem: – Indents in the shoulder where the straps have dug in.
Explanation: – Your bra is too big in the back and not big enough in the cup, this is causing you to pull the straps up too tight for support.
Solution: – You need a bra, which is smaller in the back & bigger in the cup.
Problem: – Breasts falling out of the bottom of under wire.
Explanation: – The band of your bra is too big and the Cup is too small.
Solution: – You need a bra which is smaller in the back and bigger in the cup.
Problem: – Bumpy silhouette under clothes
Explanation: – Cup encasing breast is too small and so causes breast to overspill.
Solution: – You need to increase your cup size, until you have a smooth silhouette.
Physical Therapy for the Breast Cancer Patient
The diagnosis of breast cancer carries with it not only the treatment for the disease, but also the dysfunction and pain that occurs as a result of treatment. When musculoskeletal abnormalities occur as a result breast cancer interventions, physical therapy is indicated as part of a multi-disciplinary medical approach. Surgical interventions for breast cancer, such as a mastectomy or reconstructive surgery, can leave a woman with scars and soft tissue restrictions that can cause pain and limit upper body mobility and strength. Surgical intervention and adjuvant therapies, such as radiation and chemotherapy, can cause lymphedema (swelling) in the arm, breast, and trunk.
All of these changes can lead to a loss of function and decreased quality of life. It is the job of physical therapists to help people regain function and movement due to
effects of various conditions. Specialized physical therapy can successfully treat these impairments with manual treatment, compression bandaging and pumps, and an individualized home exercise program. Proper treatment can eliminate pain, restore mobility and strength, decrease or eliminate lymphedema, and restore vocational and recreational activity.
Potential conditions/symptoms that physical therapy may be beneficial for include:
- Lymphedema (swelling) in arm, breast, and/or trunk
- Impaired Range of Motion including the inability to raise arm over head, difficulty with arm positioning for radiation, or problems with upper body dressing
- Pain and Dysfunction in arm, breast, and/or trunk
- Cording (sensation of “pulling” in tissue )
- Impaired Strength
- Impaired Exercise Tolerance
The qualified therapists at Legacy Physical Therapy would be happy to answer any questions you may have about physical therapy treatment for the breast cancer patient. We offer a free 15-minute screening to see if physical therapy is right for you. Just call 636-225-3649. |
