Physical Therapy After Mastectomy or Lumpectomy: Restoring Mobility, Comfort, and Confidence After Breast Cancer Surgery
Breast cancer surgery is often described as lifesaving—and it is. But for many women, procedures such as mastectomy or lumpectomy also mark the beginning of a quieter, less discussed recovery process. One that can involve stiffness, pulling sensations, nerve sensitivity, swelling, discomfort and changes in how the body moves or feels.
If you’ve ever wondered, “Why does my shoulder feel tight months later?” or “Why does my chest feel restricted even though my incision has healed?”—you’re not imagining it. These experiences are common, and they’re rooted in how surgery affects the entire body.
A breast cancer diagnosis is lifechanging. Hopefully this blog helps you understand what’s happening in your body after breast cancer surgery—and why a thoughtful, hands-on physical therapy approach can play a meaningful role in recovery. You do not have to live with tightness, discomfort, restrictions and pain.
What Happens in the Body After Mastectomy or Lumpectomy?
During breast cancer surgery, layers of skin, connective tissue (fascia), lymphatic structures, nerves, and sometimes muscle are disrupted. While incisions may heal within weeks, deeper tissues often recover more slowly.
Common post-surgical changes include:
Myofascial tightness across the chest wall, shoulder and arm
Limited shoulder and thoracic mobility, especially with overhead or rotational movements
Altered nerve signaling, leading to numbness, hypersensitivity, or burning sensations
Lymphatic congestion or swelling, particularly if lymph nodes were involved
Protective movement patterns, where the body subconsciously avoids certain motions
Over time, these changes can affect posture, movement patterns, breathing mechanics, arm strength, and even how comfortable daily activities feel.
Common Symptoms Women Experience After Breast Surgery
Every recovery is unique, but many women report:
Tightness or pulling across the chest or incision area
Shoulder stiffness or reduced range of motion
Pain or discomfort with reaching, lifting or sleeping positions
Sensitivity around scars or the underarm
Swelling or heaviness in the arm or chest wall
Cording into the armpit and arm
A sense that the body feels “guarded” or asymmetrical
Restricted ribcage mobility
These symptoms may appear shortly after surgery—or emerge months later as activity levels increase.
Please note that women who choose to have DIEP flap reconstruction surgery often have significant tightness and restrictions in the abdominal region that will need to be addressed also.
Why These Issues Often Persist Without Targeted Care
One of the most common misconceptions is that rest alone will restore normal movement. While rest is essential early on, the body also needs guided input to reorganize tissue, restore glide between layers, and rebuild coordinated movement.
Without intentional intervention:
Fascia can stiffen and restrict motion, especially after radiation
Scar tissue may limit tissue glide
Muscles may weaken or compensate
Breathing patterns may shift due to chest wall restrictions
Over time, these adaptations can place stress on the neck, shoulders, ribcage and spine—creating new issues that feel unrelated to surgery.
A Holistic Lens: More Than Just the Chest or Shoulders
At Congruency, recovery after mastectomy or lumpectomy is viewed through a whole-person lens. Surgery affects interconnected systems, including:
Musculoskeletal system – mobility, strength, posture
Fascial system – tissue glide and tension distribution
Nervous system – sensation, pain modulation, movement confidence
Lymphatic system – fluid balance and immune support
Respiratory system – rib cage movement and breathing efficiency
Addressing only one piece often leaves progress incomplete and limited.
If you had lymph nodes removed, then an appointment with a Certified Lymphedema Therapist is essential. We can give you a referral if you need one.
The Role of Manual Therapy and Myofascial Release
Manual therapy—especially myofascial release—can be a powerful tool in post-surgical recovery. This hands-on approach focuses on gently restoring mobility to restricted tissues, improving circulation, and reducing protective guarding.
Myofascial release may help:
Improve chest wall and shoulder mobility
Reduce pulling or tight sensations
Desensitize tender or hypersensitive areas
Support lymphatic flow
Create a foundation for more comfortable movement
This work is always performed within your comfort level and guided by your body’s response.
Why Exercise Alone Isn’t Always Enough
Strength and mobility exercises are essential—but when layered on top of restricted tissue, they may feel frustrating or even painful.
Manual therapy prepares the body so that movement work becomes:
More comfortable
More effective
More integrated
The goal isn’t just to “stretch or strengthen,” but to restore how the body moves as a system.
Common Myths About Recovery After Breast Cancer Surgery
“Pain or tightness is just something I have to live with.”
Not true. While some changes are expected, many symptoms respond well to targeted care.
“If I didn’t get reconstruction, PT won’t help.”
Physical therapy can be beneficial regardless of reconstruction status. Everyone will have scar tissue and most likely posture and breathing restrictions that need to be addressed.
“It’s been too long since surgery to do anything.”
Tissue remains adaptable long after surgery. Improvement is possible even months or years later.
When It Makes Sense to Seek Physical Therapy
You may benefit from physical therapy if you:
Feel limited or uncomfortable with arm or shoulder movement
Notice ongoing tightness, swelling, or discomfort
Want to safely return to exercise or daily activities
Desire support navigating recovery with confidence and care
A Gentle Next Step
If you’re looking for a deeper understanding of how hands-on physical therapy may support recovery after mastectomy or lumpectomy, you can learn more about Congruency’s approach below. Care is never rushed—and always guided by listening, intention, and respect for where you are in your healing journey.
