Great question Drayton. I agree that secondary complications following RT
are becoming increasingly more common. We have been following the
surveillance model at my clinic, so we see most patients at pre-op, and on.
However, even with "prehab", a lot of these women still experience a lot of
shoulder issues. The only real pattern I've seen is that it is FAR more
common in post-menopausal women, those with a lower BMI, and those who have
a h/o thoracic kyphosis. The worse the posture is coming into therapy, the
harder it is to avoid these issues. So... one thing I have been doing for
every breast cancer patient is doing not just a posture assessment, but a
tragus to wall (or occiput to wall) assessment, as well as flexicurve to
assess spinal alignment. It gives me a good idea (and shows the patient)
what they can do to try and reverse some of those abnormalities.
I hope you find that helpful! Good luck,
Marisa Gough
On Mon, Apr 4, 2022 at 1:11 PM Perkins, Drayton <
Drayton.Perkins@xxxxxxxxxxxxx> wrote:
Good afternoon, all –
I am seeking any information from the therapists on this list serve,
whether in the form of research articles or from clinical experience,
related to post-breast surgery patients who, through the course of
radiation, have developed impingement syndrome or other
musculoskeletal-related shoulder impairments (e.g. impingement, rotator
cuff tendonitis, bursitis, adhesive capsulitis, etc.). Our patients are
typically supine with the shoulder on the affected lifted overhead in full
shoulder flexion for prolonged periods of time, for many weeks on end
throughout the course of treatment.
I am noticing an increase in diagnoses of impingement syndrome, rotator
cuff tendonitis, bursitis, etc. in patients who are undergoing breast
radiation or who have recently completed radiation. Does anyone else see
these diagnoses for their patients receiving radiation? If so, how are you
addressing them, not only from a treatment perspective, but also from a
pre-radiation or early stages of radiation to reduce the incidence of or
severity of these diagnoses? Currently we’re addressing impairments as they
arise, but I would love any insight into how we can help these patients
*before* these diagnoses are present.
Thanks in advance for your consideration and responses.
*Drayton Perkins, PT, DPT, CLT*
Doctor of Physical Therapy / Certified Lymphedema Therapist
Oncology Rehabilitation
Comprehensive Care and Research Center, Atlanta
600 Celebrate Life Parkway, Newnan, GA 30265
*O:* (770) 400-6493 *F:* (770) 400-6978
*E:* drayton.perkins@xxxxxxxxxxxxx *W:* cancercenter.com
<https://www.cancercenter.com/>
Hospitals <https://www.cancercenter.com/locations?loc=hospitals> | Outpatient
Care Centers <https://www.cancercenter.com/locations?loc=clinics>
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