Breast reconstruction after mastectomy often involves two main procedures, the TRAMS (transverse rectus abdominis muscle) and the latissimus dorsi flap. They both consist of either using muscle tissue cut from an area or moving the muscle tissue.
The TRAM procedure may be done as either a pedicle flap (which means the tissue is pulled under the skin and attached in the chest area without cutting its blood supply) or a free flap (which means the tissue and blood vessels are cut and reattached in the chest area).
In the latissimus dorsi flap procedure, an oval flap of skin, fat, muscle, and blood vessels from your upper back is used to reconstruct the breast. This flap is moved under your skin around to your chest to rebuild your breast. The blood vessels (artery and vein) of the flap are left attached to their original blood supply in your back. Because the flap contains a significant amount of muscle, a latissimus dorsi flap is considered a muscle-transfer type of flap.
These procedures involve the transferring, pulling, cutting, and relocation of tissue, which often leave the patients with some side effects such as pain, bulging, hernia, strength loss, and some postural changes due to the relocation or transference of this tissue. It could also lead to decreased AROM in the shoulder of the side involved or both if a double mastectomy. Adhesive capsulitis (frozen shoulder) could possibly occur as a result of this, with “cord” development in the axilla or armpit, which could prevent the patient from moving their shoulder normally and could become progressively worse.
Other postural changes can also occur, such as thoracic or scapula pain from the latissimus procedure, as well as pain in the pectoral region from forward shoulder development.
At Excel Spine and Sports Rehab PC, we have created a post-op mastectomy therapy in Rowlett, Texas to help the patient alleviate physical signs that may arise from surgical or medical treatment for breast cancer. Through hands-on interventions and therapeutic exercise prescription, therapists help patients reduce pain, improve flexibility, strength, endurance, and range of motion following cancer treatment, thus improving their function and quality of life.
Our physical therapists can perform pain management using various modalities such as cold laser, interferential, high voltage electrical stimulation, and ultrasound. Our therapists are also trained in manual therapy, such as joint mobilization, stretching, and myofascial release, to help assist in reducing the chance of the patient developing frozen shoulder and help the patient to maintain flexibility in areas where the soft tissue was removed or pulled to make ready for a breast implant. It can also help to reduce the chance of scar tissue development.
After surgery, most patients may often experience weakness and fatigue, and it can take time to recover. As with any abdominal surgery, you may find that it’s difficult or painful to sit down or get up from a sitting position. It also might be hard to get in and out of bed. Your physical therapist can show you how to use other muscles to compensate until your abdominal muscles heal.
Everyday Strength Return
Regaining strength after a mastectomy is not only about exercise but also about relearning how to move through daily life with comfort, ease, and confidence. A rehab company helps guide this process by supporting safe movement in simple activities like standing, reaching, and lifting light objects while keeping progress gradual to avoid strain or setbacks. This stage of recovery also includes learning how to manage energy levels and fatigue, staying within safe movement ranges, and understanding that emotional reassurance matters just as much as physical progress, so recovery feels more steady and achievable over time.
- Gentle movement retraining helps reintroduce safe upper body motion into daily routines so patients can gradually return to activities like dressing, grooming, and light household tasks without discomfort or hesitation.
- Postural rebuilding support encourages better alignment during sitting, standing, and walking, which helps reduce unnecessary strain on the neck, shoulders, and upper back throughout the day.
- Functional strength reactivation focuses on restoring basic muscle coordination needed for real-life movements such as lifting groceries, reaching shelves, or getting in and out of chairs with more confidence.
- Fatigue management strategies are introduced to help patients understand energy pacing, allowing them to balance activity and rest in a way that supports steady recovery without feeling overwhelmed.
- Safe independence training gradually encourages patients to perform everyday tasks with less assistance while still maintaining proper movement control and avoiding sudden strain or overuse.
Frequently Asked Questions
How soon can movement start after breast surgery recovery?
What therapy is usually done after breast reconstruction?
Can arm weakness happen after breast surgery rehab?
What exercises are often used after breast reconstruction surgery?
What signs show a need for rehab after breast surgery?
Let’s Help You Move Better Again
Ready to start your recovery? Call Excel Spine and Sports Rehab PC today to schedule an assessment. You may reach us at 469-443-0458.