The physiotherapeutic measures can begin on the first postoperative day with measures for pain relief and easy mobilization. The main task of physiotherapy is to promote the mobility of the arm of the affected side and to prevent edema.
For patients, lymphatic drainage and the associated supply of compression bandages or stockings is elemental. In this way, diversionary tracts of the lymphatic system can form and there are no thick jammed hands, arms and backwater in the back.
Respiratory therapy for better ventilation of the lungs and mobilization of the whole body should be done.
The physiotherapist can relieve discomfort with gentle stretching, relaxation exercises and light massages. Once the surgical wound has healed, a scar treatment may take place to restore tissue mobility, alleviate pain, and thus enhance the patient's well-being. For this purpose, the patient should be treated sensitively, as the scar area for many initially represents a taboo zone. The therapist should cautiously approach the patient and respond to any anxiety. In most women, the therapy improves the body and strengthens self-confidence. Women who would rather be treated by a woman in this situation can indicate this when registering for therapy.
Most important limit is the pain
During treatment in the early phase, the pain threshold of the patient must be taken into account in all measures. Freedom from pain should always be the top priority. This includes correct positioning of the arm, passive movement in a pain-free area and breathing exercises, whereby the breathing can be targeted to the operated area. An equally important goal in the treatment is to promote venous and lymphatic reflux to prevent edema on the affected side. For this purpose, decongestant exercises are performed and the patient is instructed to continue these exercises at home. However, the exercises should not lead to pain on the affected side. Also, the patient should not overexert. The reflux of the lymph can also be supported by appropriate storage. If chronic lymphedema develops, the treatment requires manual lymphatic drainage by a specially trained therapist. So that the arm does not swell again after the treatment, the affected women should wear a suitable compression arm stocking immediately after the treatment and consistently wear or bandage the arm daily.
Movement improvement and posture training
The exercise treatment is slowly increased until freedom of movement is restored. The increases are based on the individual patient and her abilities. Often can with devices such. As rods, towels or balls are worked. A posture training is also very important in physiotherapeutic post-treatment, as the body sensation is initially disturbed and many patients take an asymmetric posture. A posture is counteracted here by being made aware and corrected. This is particularly important after a prosthetic restoration, since the prosthesis has a different weight than the natural breast and the patient's posture changes frequently.
Important tips for everyday life
The physiotherapist can instruct the patient on exercises that she can perform independently at home and give her helpful tips on preventing edema. So should for example, no constricting bras should be worn and blood pressure should be measured on the unaffected side. Also, the arm must not be overworked by heavy work. At work and during sports breaks should be taken before the onset of fatigue. Overheating and overcooling should be avoided. This means that hot baths, ice packs and the like should not be used. Sources of danger that could cause injury and inflammation to the affected arm should be avoided.
Treatment after breast reconstruction with own tissue
If reconstructive breast surgery has been performed with self-tissue, further treatment becomes necessary. As breast or abdominal muscles are usually used for reconstruction, disorders also occur in these areas. For the entire wound areas, the measures for mobilization and scar treatment apply. In addition, the muscle area taken from the tissue has to be slowly restored. There is no specific scheme for physiotherapists, as there are numerous procedures and each patient is treated individually.
Duration of physiotherapeutic treatment
Every patient should always bear in mind that, even after wound healing has been completed, there is a tendency to shrink in the scar area for a long time as well as a risk of lymphedema. In order to regain the best possible freedom of movement and to prevent scar contraction, the physiotherapy exercises should be carried out up to one year after the operation and the mentioned rules of conduct should be observed in everyday life.
Psychological counseling and care
Especially in such life crises psychological support is elementary. The affected person is often left alone by their society and familiar environment. Sometimes even the partner turns blank. These are situations that you can handle really hard on your own. It often helps an open ear, so many a loving tip. Then the world looks much rosier again. The wise saying: "Smile and the world smiles back" is our motto. Even if it's hard sometimes.
