Susan A. Thomas, LMT, CLT
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SCAR TISSUE THERAPY -
Post Mastectomy -
"By breaking up those fibers, you can actually improve mobility, decrease pain and increase range of motion." Dr. Shelley Hwang, Chief of Breast Surgery at the Buck Breast Care Center, University of California San Francisco.
One of the many treatments for breast cancer involves removing the breast (mastectomy). Approximately 40% of those diagnosed with Breast Cancer will undergo a mastectomy. Although this procedure goes off without a hitch for the majority of women, a large percentage end up with chronic post-surgical pain. Procedures that may lead to post-mastectomy pain include total mastectomy, partial mastectomy, lumpectomy and even breast reconstruction.
Scarring is dependent on how much tissue needed to be removed, radiation involvement, how your body reacts to wounds and healing and how much information you’re given when you’re sent home. Scarring, however, is not only what you see. What goes on under the skin, involving muscle, fascia, tendons, ligaments, bones, is more problematic. The most common incision is oblique across the nipple line and continuing up into the axilla. It has varying lengths depending on how many lymph nodes are removed and how much lateral breast tissue is present and removed. The larger the incision the more structures can be involved with the scarring.
The healing of the breast area may be complicated by radiation. Radiation has many long-term effects on the tissue. The tissues become less elastic due to a diffuse scarring process, and changes to the skin post radiation can become problematic in areas with folds in the skin like the axilla or breast.
The shoulder, being a very complex and dynamic area can be affected by scarring post mastectomy. There are many muscle groups that attach to the shoulder girdle and have different directions of pull. As scars form they tend to pull and twist into themselves, pulling in the tissues around them to the central scar area. Post mastectomy this force will pull the fascia of the anterior shoulder and the bony shoulder girdle down and forward. Conversely the muscles on the back of the shoulder girdle will be stretched. At this point the patient will feel varying degrees of pain and dysfunction in their shoulder complex. They may feel a pull in the front of their shoulder in the scar tissue and even the pectoralis muscles may feel sore and tight. These mechanical changes may affect the range of motion and function of the shoulder complex.
The more scar tissue that has formed the more work will be required to release the internal scarring and adhesions that have developed. It is possible that there will always be some adhesions within the layers. Scar Tissue Therapy will help to restore the shoulder complex to a healthier balance, function, and manage the symptoms arising from this imbalance.
Post mastectomy health has many physical factors as well as many emotional factors. This is a sensitive area for most women and having a Massage Therapist who is compassionate, respectful and well trained in Scar Tissue Therapy can have a positive impact on quality of life.
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