Post-mastectomy aqua-therapy and rehabilitation.
Exercise is medicine, and the prescribed dose is more than 35 minutes per day… I read this in an article recently and it got me thinking. Exercise, whether it is water based or land based, has many physiological as well psychological benefits. It is an essential part of any rehabilitation program and finding the right medium for you will determine the success of your post-mastectomy rehab program.
What is aqua-therapy?
Aqua-therapy is a rehabilitation option that allows people to exercise in a water environment. You do not need to be able to swim to enjoy the benefits of aqua-therapy, you just need to be comfortable in the water. Some people are more comfortable using a flotation device or having the therapist in the water with them, you just need to find what works for you. Ideally the water temperature should be between 32⁰ and 34⁰ as this will suite most diagnoses. For general aqua-aerobics, the recommended temperature is anything from 23⁰ – 30⁰. There are a great many physiological benefits of exercising in the water. These include decreased load on the joint, increased range of motion, pain reduction, reduction in muscle tension and spasm, strength is improved due to the waters resistance, as well as increased blood flow due to the hydrostatic pressure (the pressure of the water on the body).
Apart from these physiological benefits, the water also has psychological benefits. So many of my patients come to the water because they call it their “happy space”. From conception, we are cocooned in the warmth and protection of amniotic fluid, which is largely made up of water. Its function is to protect and cushion the fetus from any harm. It’s no wonder then that we often get a feeling of calm and protection when immersed in a body of warm water, finding our “Happy Space”.
Many women, post-mastectomy, experience some form of numbness and swelling post surgery. Other complications can include pain, tingling, weakness, stiffness and a loss in range of motion in the upper limbs. Starting with a gentle exercise program, with your doctor’s approval of course, can help to alleviate many of these symptoms. Being able to take the weight off the joint, allows one to move more freely and find some relief.
This is where getting into a warm pool to start your rehabilitation program comes in. Water offers buoyancy as well as constant resistance to muscles, allowing you to start strengthening very gently. Sometimes, due to the surgery and associated pain as well as our natural instinct to protect ourselves when we are hurt or threatened, we tend to adopt a “closed” posture and try make ourselves smaller, by hunching our shoulders forward and up towards our ears. However, being in the water where we feel warm and safe, we can “let go” and try to correct these negative postural habits by doing big functional opening movements like breaststroke, backstroke and crawl which also help to stretch the scarred and radiated skin.
Another condition that women, post-mastectomy, are at high risk of developing is Lymphoedema (swelling in the limb). This can occur if there have been lymph nodes removed. As mentioned previously, the water provides hydrostatic pressure causing the soft tissue to be compressed, greatly enhancing lymphatic return. Just by having the arm vertical in the water, the pressure gradually decreases from the fingers to the shoulder, which promotes lymphatic return from the peripheral areas to the trunk, thereby reducing the swelling in the limb.
Exercise and Rehabilitation
So what are you waiting for? If you were unsure of what exercises to do post mastectomy, why not try the pool. You won’t only enjoy the physical benefits of moving freely, but also the psychological benefits of being cocooned in the warmth of the water.