Edema Prevention | Physiotherapy for breast cancer in the early postoperative phase

Edema Prevention

Approximately every 5th woman develops a chronic progressive lymphatic problem after the procedure. For this reason oedema prevention should be started immediately after the operation. Possible signs of developing lymphedema can be a slight pulling pain on the inside of the upper arm or a feeling of tension in the armpit.

Swelling of the lower and upper arm, as well as of the hand due to the leakage of fluid into the space between the cells leads to pain and functional limitations. Lymphedema most often occurs after mastectomy, lymph node removal and radiotherapy. The risk of developing lymphedema is highest in the first 3 years after surgery, the severity of which depends primarily on the number of lymph nodes removed.

Excessive immobilization of the arm due to fear and pain also promotes the development of lymphedema. The following measures can have a preventive effect and can be started immediately postoperatively. Avoid incorrect and relieving posture Promoting the elasticity of the tissue around the surgical site

• Positioning of the arm in a slightly raised position on a cushion
• Fist closure exercises combined with forearm movement in lying position
• Fist closing exercises combined with upper arm movements in a lying position,
• Since the lymphatic fluid drains off very slowly, the raised position is held for 2-3 deep breaths
• Fist closing exercises in raised shoulder position while sitting, final position again over 2-3 deep breaths
• Lymphatic drainage
• Observing a symmetrical posture in bed
• Shoulder blade movement in back and side position
• Careful passive mobilization of the shoulder joint by the physiotherapist downwards towards the foot to support the freedom of movement of the shoulder joint
• Stretching of the neck muscles initiated from the head
• Correction of the sitting and standing position in the direction of symmetry
• Consistent storage
• Stretching of the neck muscles
• Depending on the condition of the surgical scar and the pain sensation, careful stretching of the skin over the large pectoral muscle and the actual scar tissue, as well as special massage techniques of the scar depending on the wound healing and pain tolerance.