When finally done with the surgery for breast cancer and all that it entails, the last thing you want to deal with is injury to another body area. Unfortunately, it is pretty common to see rotator cuff pain after breast cancer surgery. There can be several reasons for this, and we’ll explore those and what you can do about them in this article. First off, do you know where your rotator cuff is? (Hint: it isn’t near your wrist.)
What is the rotator cuff?
The rotator cuff is the group of muscles and tendons that connects your shoulder blade to your arm bone. It keeps the head of your arm bone in the socket of your shoulder. Because it is a network of muscle and tendons, it is closely connected to the tissues of the breast, including the lymph nodes.
Injury to the rotor cuff can involve inflammation, impingement (something pressing on it that makes it painful and interferes with use) or tears. This shows itself as reduced range of motion (hard to raise your hand over your head), a deep, dull ache, and can make it difficult to sleep. It usually responds well to ice, physical therapy and time off from heavy duty lifting.
How is this related to breast cancer?
Those who have had breast cancer surgery are prone to rotator cuff problems. The more invasive the surgery, the more likely it is that they will have trouble. Some women experience lymphedema following surgery, which is a swelling of the lymph nodes that snake around the chest area and up to the arm pits. Some speculate that this contributes to rotator cuff pain after surgery.
According to BreastCancer.org, rotator cuff pain after breast cancer surgery is a fairly common problem:
- 85% of women have mild or worse shoulder problems six months after surgery
- 50% of women reported moderate to severe shoulder problems six months after surgery
- lymphedema, or swelling of the lymph nodes, was not the best indicator of shoulder problems, as 44% of women who did not havelymphedema still had shoulder problems six months after surgery
So while the lymph nodes may be related to the problem, it does not appear that lymphedema itself is the only cause. Some of the many possible contributing factors are protective posturing (holding your arm so you don’t hurt after surgery), scar tissue formation (causing impingement or interfering with proper movement), or radiation damage. Lymphedema may contribute by adding weight to an already overtaxed and underused muscle system around the time of surgery.
What can you do about it?
One of the first things to remember is that a high percentage of women get this kind of pain. While it may help to do some small amount of range of motion exercises while healing from surgery, never do an exercise after surgery unless your doctor has okayed it. You also don’t want to do exercise if you are still in pain from surgery, as that can have a deleterious effect on your healing.
It is not likely, but pain can be a potential sign of cancer spreading. Because cancer can form on the head of the humerus, it can interfere with movement and make it painful. Therefore, your first course of action should be to see your doctor to rule out any spreading of cancerous tumors. Don’t get too worried though. The odds of it being cancer are quite low as the development of these tumors generally takes years to develop, has the added symptom of arm weakness, and is becoming quite rare.
Once your doctor confirms that you are not dealing with any cancerous issues in your rotator cuff area, you can concentrate on healing. While time will help, physical therapy, anti-inflammatories, and gentle exercise can certainly be useful in shortening the time it takes to heal from this kind of problem. Before you throw yourself into a PT regime, however, make sure to check with your doctor. He or she will tell you how much you should be using or not using your arm for the best level of healing.
What should I be doing?
After surgery, it is important to begin moving as soon as you can. Under a doctor’s guidance, you should be able to take anti-inflammatories to reduce inflammation and pain. Once you are pain-free, you can start some gentle stretching and range of motion exercises.
When it comes time to do physical therapy, you’ll start working on muscle strengthening, stretching, and postural training. There are many muscle groups you will need to work on to achieve the closest level to normal you can.
You may also learn more about ergonomics and how to pick things up. While it is possible that you will get your full range of motion back, there is comfort in knowing that there are assistive devices that can help you temporarily while you re-gain your strength.
When you heard that you had breast cancer, you kept focusing on the next hurdle: surgery, then radiation and possibly chemotherapy. A rotator cuff injury was probably one of the farthest things from your mind. Add it to the collection of collateral damage you never expected on this journey.
The link between breast cancer surgery and rotator cuff injury is well-known in the medical world if not completely understood. Through your dedication in your physical therapy, you can get past this one-more-piece-to-the-puzzle.
FREE Rotator Cuff Health Check-Up Event
In celebration of National Physical Therapy Month and Breast Cancer Awareness Month (most breast cancer patients and survivors suffer from shoulder pain) in October, Orthopedic and Balance Therapy Specialists will host a FREE Rotator Cuff Health Check-Up Event on the following dates and locations:
- Monday October 17, 2016 at our Valparaiso office (3125 Calumet Ave., Suite 8)
- Tuesday October 18, 2016 at our Crown Point office (11055 Broadway, Suite B)
During the event, each attendee will receive:
- One on one FREE consultation time with one of our Rotator Cuff Specialist physical therapists.
- You will discover tips on how to:
- Know which rotator cuff muscle is affected and the grade of the tear
- Correct the cause of your pain and speed up the healing process
- Prevent your shoulder from getting worse
We have 24 FREE consultation spots available for each location. To hold your spot, please call 219-202-2500 in Valparaiso, or 219-203-3100 in Crown Point.