Breast and Shoulder Rehab

16/05/2023

Breast cancer rehab training for health professionals

Health professionals ready to add physical rehabilitation for upper body impairments to their patient services can now choose from various training options. This new course is designed for Physiotherapists, Occupational Therapists, and Lymphoedema Therapists with general skills in oncology care need...

01/10/2022

A new easy-to-follow guide for exercises to manage arm stiffness after breast cancer.

Forceful arm stretching after breast cancer surgery can cause micro-tears to tight tissues at the chest and shoulder. In this new online resource, you will be able to watch, listen and practice safe and gentle ways to achieve large arm movements. These arm exercises are specifically designed for peo...

09/09/2022

Following breast cancer treatments- most women should be able to reach their arm on the surgery side, easily up in the air- to beside their head.
But today, was another reminder that many women after breast cancer do not achieve this and have to initiate their own recovery action. Furthermore, referral to community-based oncology rehab care is not working in Brisbane, Australia.

Today, a new patient was referred to my rehab service by her friend Jan Hunter, a massage and lymphedema provider who is > 1000 km from Brisbane.
After surgery and completing radiotherapy some months ago, she did receive therapy services, yet was discharged with no further rehab - as her cording was deemed no longer problematic.

Yet, the patient still had cording, which restricted her ability to reach her arm up beside her ear (20 degrees short) and she was not able to stretch her arm behind her body.

One of the ah-ha moments for the woman today was that she has been massaging too hard and stretching too fiercely, especially when engaging in a big session of gardening. Overstretching in the first 12 months can cause rebound tightness, more inflammation and then extra scar tissue, and more shoulder pain.

Gentle hands-on treatments at the chest/ breast and shoulder will help regain an easier range of arm movement. Once full arm movement is achieved- then strengthening activities will work better.

There should be a general expectation that arm-to-ear movement is fully recovered, even after cording. The key is having a hands-on assessment by a therapist trained in breast cancer scar and adhesions at the very least before radiotherapy and then 2 months later and then at 3-6 monthly intervals over the first 2 years.

In Australia, women who experience pain for 3 months after their surgery can access Medicare subsidies for 5 allied health services per year in the community. This referral method can be made by the GP but should be initiated by the cancer care clinic.

If you need help finding a community-based trained service provider, then connect and I'll try and make the task a little easier for you.

Cording is sometimes hard to see but at a really big arm stretch, it can look like a thick band that extends from the breast cancer surgery site and into the arm. Overstretch will cause pain in the upper arm.

02/03/2022

Do you have persistent muscle tightness that doesn’t respond well to usual massage? Then there is a new approach that may explain this-neurovascular fascial method, where the local smaller blood vessels and nerves have got tight and can remain tight.
With recent advances in knowledge about fascial connections within the body, it has become apparent that the nerves and blood vessels also hold together within connective tissues and these tissues get tight. This tightness keeps the local muscles tight.
That’s a lot of tight!
The assessment is: ease of movement and locating places of old injuries. I can help you with this is a face to face appointment( online or in Brisbane).
The treatment is completely different to muscle release.
Check out This video from Kieran Schumaker - whom I learned these new methods from:

This Neurovascular Release™ self-treatment technique is a myofascial differentiation technique that frees up cranial nerve XI (the accessory nerve, which sup...

19/08/2021

Compression arm sleeves help to manage arm swelling during the day- but they need to be well fitted, feel comfortable at the elbow and be easy to put on and take off.
Check out the sizing chart for Second Skin readyfit ( off the shelf) range, as the weight of the fabric allows for airflow, the elbow is shaped for working at a bent elbow position and the zipper makes it easier to get the hand through.
Talk with your therapist about whether this is an option for you.

Extends from the axilla to the wrist providing effective skin contact up the arm and includes soft fabric in front of the elbow for increased comfort. Features a zipper for easy application and reduction of shearing and friction to the skin. Usable on either arm.

14/07/2021

If your family member or friend has had breast cancer, then they might want to know about how to manage tightness in their neck.

Most people I see in the first year, or longer, after breast cancer treatments will experience increased neck stiffness. Looking over their shoulder gets increasingly harder to do; rolling the head down becomes a physical impossibility; the bones in the neck just won’t bend individually anymore. T...

14/01/2021

Women (and men) after mastectomy rarely get help to manage the massive changes that occur to their body after a mastectomy.

I want to turn this around in 2021- so designed an online and live training program for WOMEN to build confidence in their self-care, for their new body.
The first 8 session program starts on March 6th.
Read more at my online training website:

Have you got less arm movement than before surgery? Does your chest feel tight? Have you had radiotherapy or nodes removed? Are you confident in your ability to care for these changes ove…

03/11/2020

People surviving breast cancer have additional support from the Oncology Nursing Society who recently published guidelines for specific care to minimize or prevent lymphedema, based on extensive research reviews.
To ensure early detection and treatment, they recommend monitoring the person's limbs for changes in swelling on a regular basis over the first 3 years ( surveillance model).
To delay or reduce the risk of lymphedema there are three guidelines:
1. Manage exercise in the first 7 days following surgery
2. Actively treat scar tissue that may impede lymphatic flow.
3. Compression garment for early signs of lymphoedema

If you feel that you are not receiving these services, use the PDF copy of these guidelines to present to your cancer health care professional:

10/10/2020

Does your lower front rib cage (one or both sides) stick out after mastectomy surgery?
Are you getting low back pain on that side as well?

This happened to the lady I treated yesterday- she had a change on one side only, where she noticed “a hollow “ where the mastectomy surgery was- where the breast tissue was removed.

She felt like there was muscle missing - because of this “sunken” appearance, and . even asked the surgeon whether he had removed more than the breast tissue as stronger . The doctor said “no”.

This is a common experience for women after mastectomy, especially following abdominal surgery( recon or removal of uterus).

Explanation: the chest skin and tissues below ( pec muscle) gets tight. The lower ribs are only connected by cartilage and so they can be drawn upward- causing a change in the shape of the rib cage.

When the lower rib bones are out of position, the abdo muscles just can’t work properly to draw these bones back into position. So things don’t and can’t get better by themselves.

ANSWER: gentle skin and pec muscle lengthening ( mastectomy scar release) - mid back pin on that sidecombined with gentle repositioning of ribs and retraining abdo muscles to engage will restore the shape of the rib cage. Change can be expected in one treatment / training session but extra at home practice is needed.

Connect for online training to regain better rib cage position and stronger abs after mastectomy.

21/08/2020

Today I helped a young lady who has severe and persistent shoulder and neck pain plus unusual writhing in the left arm and hand, when pain levels increase.

It was causing her great distress, because there seemed to be no obvious reason for the pain or the writhing.

The head seemed to be the place to start. I did a roof of mouth release and gentle massage release for really tight and painful skull bones. This resulted in instant changes to the freedom of movement at her left arm, neck turn, hip addiction and even the big toe moved more freely.

Next the ribs started to ache so bad- we both treated this, with gentle gentle hands on techniques and steady deep breathing.

I love sending people off with homework: was there a head trauma event from the past?

Homework completed: The story unfolded that she was kicked in the ribs and near the eye by a horse and ended up with concussion from her heavy fall backwards - and that was 7 years ago. Could this be the event?

Concussion events can easily be the root cause of delayed and serious pain and other unusual “nervy“ things. There are many bones in the skull with little holes that nerves and arteries pass through. If the bone angle becomes distorted-there has to be compression of soft structures, like nerves, against the bony edge of the “hole”.

Moral of the story- injuries, especially traumatic ones leading to concussion, benefit from careful rehab care- sooner rather than later.

I’m studying vagus nerve health, online,with Melanie Weller a USA physical therapist. We delve into how this nerve gets compromised from all sorts of injuries, especially concussion, poor posture and even as simple as below the surface worrying thoughts.
Just in case your worried- neurologist appointment next week. It’s always good to have a thorough medical workup for any persistent pain and unexplained symptoms.

25/07/2020

Axillary Web Syndrome was presented by Dr Emad Besher (Qatar) today to physiotherapy students in India. He described how AWS/cording, a painful side effect to surgery, exceeds the incidence of lymphedema, yet there is little research to offer assessment and treatment pathways for breast cancer survivors.

I am honoured that Dr Emad chose to describe how my Arm to Ear test and Reach-out- the Back Test, can be used for detecting cording.

Congratulations to the sponsors and organizer, Dr Mudasir Rachid from Yenepoya Physiotherapy College India, for conducting an International webinar series for students and learners during COVID travel restrictions.

Breast Cancer Rehab is important and training health professionals to recognize and treat common side effects is essential.

19/06/2020

Plan for a healthy mature or older age.
This delightful mature aged occupational therapist, Barbara Beskind, recommends regaining the body’s alternating arm/ leg patterns of our youth.
Barbara adapted her ski poles and uses them daily.
Take seven minutes to hear her inspiring story.
I use Nordic and Urban poles- no adaption required.
I have been walking with poles 3-6 days a week for the last year and recently returned to yoga sessions; my planks and slow pushups and downs are so much stronger.

As we increasingly rely on technology to problem solve, conceptual designer Barbara Beskind is a testament to the power of personal input. Using her experien...