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Breast Cancer and Rotator Cuff Pain: Why It Happens and What You Can Do About It

Breast Cancer and Rotator Cuff Pain

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, 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:

  1. One on one FREE consultation time with one of our Rotator Cuff Specialist physical therapists.
  2. 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.

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Barbara Serynek
Barbara Serynek
18:52 03 Oct 19
The entire staff has been very pleasant, professional and accommodating. Both Kristen and Joe have given me the best massages. Kate and Kollin made sure that I was doing my excercises and helped to move things along. Feeling better every visit. I'm so glad that I chose Orthopedic & Balance.
Heidi Richardson
Heidi Richardson
17:00 19 Sep 19
I went to physical therapy not expecting it to do very much to help because that’s the way I approach everything with low expectations. Noel and his team have made my neck feel so much better that it puts me in a more positive mood each day and I actually feel more positive and more productive on a day-to-day basis..
Christine O'Donnell
Christine O'Donnell
16:26 14 Aug 19
I could barely walk into OBTS six weeks ago. I had very bad lower back and hip pain. The progress has been life changing for me. I always walk out of there with little or no pain. The staff, Laura, Dr Diane, Angie and, of course, Peggy, have taught me so much to keep my pain at bay. I highly recommend this team.
Nancy Guenther
Nancy Guenther
15:28 12 Jul 19
Absolutely awesome! My walking has improved 110%. And my pain level is zero. I highly recommend them. will be amazed how much better you feel.
Tracie Baxter
Tracie Baxter
20:24 03 Jul 19
This was the only place that could help with my TMJ. If you’re suffering from TMJ go see Noel! He really understands the condition. I no long have to deal with constant pain! The whole staff at this office is amazing and very welcoming.
Cindy Standiford
Cindy Standiford
21:33 28 Jun 19
The whole team is great!! I’m getting great care! I recommend Orthopedic & Balance for any issues you might have.
Joseph Mulholland
Joseph Mulholland
19:53 09 May 19
Amazing staff and amazing care. I came in barely able to stand up straight due to a back injury. After 6 weeks, I feel like brand new. Everyone was extremely helpful and easy to work with. Highly recommended!
Trool u
Trool u
19:44 24 Apr 19
I am a PTA student that was required 16 hours of observation time. I had the pleasure of completing my hours at this Valpo location. The staff is incredibly friendly. They were quick to make me feel at home. In a way I was sad to leave, but happy to continue on. I hope to eventually work in this field with a work family this caring and knowledgeable about their profession.
sharon Kramer
sharon Kramer
16:23 18 Apr 19
My experience has been a very enjoyable and rewarding experience in getting me to feeling better. The staff does a remarkable job and are fully qualified in their respective areas. The staff made it fun coming here and they were very caring and helpful with their clients!!
Tim Nash
Tim Nash
15:32 27 Aug 18
My first experience with OBTS was very positive. During the course of my 13 therapy sessions I worked with many different therapists and all of them were professional and competent. They were able to help me effectively control my pain without medication using their therapy program. Unfortunately, they could not get my physical condition back to the same ability as before. However, this is due to the fact that it was later determined by my doctors that I required surgery. I plan on returning to OBTS for my post-op physical therapy and have already scheduled my evaluation appointment. Scheduling seems to be a challenge sometimes but that's probably an indication of their patient's satisfaction and good reviews. Thank you OBTS!
Arlene Gross
Arlene Gross
15:58 22 Jun 18
Everyone that worked with me was helpful. I enjoyed watching the staff interact as they worked as they laughed and smiled making me feel that it was fun to exercise. My knee pain is less and I look forward to having the same results with my back.
Jose Ico
Jose Ico
12:43 27 Apr 18
My wife and I have been coming here for a year. They have wonderful customer service and the treatments were great. I could say that since coming here for treatments, I am now able to walk properly and sleep well at nights. They help you in the best way possible. The people here are great and we definitely recommend it to everyone!
Paul Grant
Paul Grant
21:51 03 Apr 18
I have read lots of reviews that say "the entire staff of ..." is great, and you know that it is BS.. .. Butt at OBTS that statement is true. The person answering the phone, appointment setting they work around my schedule. It is truly a team concept. Everyone that has work with/on me keeps me focus on getting healthy to play golf.... Even those employees that haven't work with/on me are upbeat, positive and encouraging both their patients and me..... follow up phone calls, positive, hand written notes of encouragement, reminding me to do my homework so I can play golf this year. Great Employees, Great Business!.
Diane Burns
Diane Burns
02:30 16 Mar 18
I’ve had an incredible experience here at OBTS. In just two and half weeks I’ve seen and felt remarkable results. My hip mobility has improved by 30%. I credit the excellent physical therapists and the deep tissue laser therapy for my gains. I’ve gone from walking with a limp and pain everyday to walking normally and know that I’ll be back to running in the future. Every single person is warm and friendly here. Great place!
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