Will a massage "undo" all the work your surgeons have done for your mastectomy? How to know when it is safe to put yourself in someone else's hands

It can be scary trusting another person with your most painful parts! I get it.  You need to know you are helping yourself by going for a massage after your mastectomy, not making things worse.  

A question I get a lot with new patients is, "How soon after my surgery can I come in for treatment?"

There are many factors that influence how soon you can come in, not the least of which is your type of mastectomy surgery.  For example: surgery on one breast, both breasts, expanders or immediate reconstruction, as well as TRAM or DIEP procedures all influence how much your body has been affected, and thus your healing time afterwards.   

Assuming, before cancer and associated medical treatments like chemo & radiation, you are a person in average or above health, there are some commonalities with healing we can rely on:  

Healing During the First 2 Weeks Post-Mastectomy:

This is often a time when you will be resting the most.  The first two weeks can be the most vulnerable, carry the most discomfort and you may want to just stay put at home.  

During this phase, not much massage therapy will be performed and instead your focus will likely be sleeping, letting the tissues start to knit back together and you may feel very protective over your surgical sites.  Pillowing your arms, shoulders, chest and neck are really important here, so you can rest comfortably and not worry about children, pets (or others!) leaping on you unexpectedly.

At this phase, starting small movements and deep breaths to increase your range of motion in arms, shoulders, chest, diaphragm and possibly pelvis/hips is a good idea.  It helps to get the fluids moving in your lymphatic and circulatory systems, as well as your joints, and stimulates your nerves to reactivate your muscles.  

If you meditate, or always wanted to start, this is a great time to be still and go inwards.  You can talk to your body, to let it know it is safe, you are in this together and you will do everything you can to help it heal.  If it sounds funny to think about talking to your body, that's ok.  It may be a new concept for you but trust me, it works.  Your body responds to your thoughts, so if you are caring and nurturing towards it, it will hear you and it will help your healing process. 

Healing during 2 - 6 Weeks Post-Mastectomy:

This is when it is ideal to start smart registered massage therapy.  

I preface RMT with the word "smart" here for a reason!  Mastectomy surgery is complex, your mind and body have been taxed and the surgical sites are fragile.  We do not want to undo any of the work your surgeons have done!  Therefore, seeing an RMT (registered massage therapist, or LMT if you are in the States) with training and knowledge in post-mastectomy massage is highly recommended.  And yes, yours truly is one of those people!

In terms of timing, I find the best results come with the women who start seeing me sometime between 2 - 4 weeks after surgery, or if you have had a TRAM or DIEP you may be more in the 4 - 6 week window as ideal for starting massage therapy .  This way your body has healed enough you can get out of the house (assistance with driving is recommended during this period) but not so much that your body has taken off on a wild trajectory of it's own; rogue healing, so to speak.

Getting smart RMT will quickly reduce swelling, bruising and pain, get your range of motion coming back and start to teach the scar tissue how to form properly so it doesn't inhibit future movement patterns. Additionally, your nerves will start to get the signal to repair themselves, so numbness can eventually become a thing of the past. 

Not to mention, the act of choosing to actively participate in your healing process is very empowering.  It brings back a feeling of control into your life, an aspect which can be sorely tested through a cancer diagnosis and associated medical treatments. 

Healing 6 weeks - 3 months post-mastectomy:

If you didn't come in during your first 6 weeks for treatment, I would definitely start within this window.  Your body is very pliable and there is much we can do.

This can be the "getting comfortable" phase, where you start to live in your body again and feel like you are acclimating to your "new normal".  

Receiving massages here will focus on scar tissue and nerve repair, circulation improvements, getting your strength and range of motion back and continuing to reduce any swelling.  

It can also help to strengthen your mind-body connection, so you can get in touch with what you are actually feeling.  From what I have seen, disassociation from parts or all of your body after cancer and mastectomy surgery is common.  Massages help bring your mind back to inhabiting your body, so it feels safe and like it is a place you would want to be.  

If you have had lymph nodes removed, a very important component during this time is to practice preventative care against lymphedema starting.  As they say, preventative medicine is the best medicine, so ideal is to keep lymphedema from forming in the first place. Once it starts, sadly it will always be a case of managing it.  Practicing preventative lymph drainage keeps your body's safety mechanisms in tact and operating more effectively, which leads to better outcomes. 

Is there ever a time when it is too late?

Short answer?  No.  Never.  

However, saying that, it can become very hard to undo stubborn scar tissue if many years have passed since your mastectomy surgery, or if lymphedema has had a chance to develop into something long lasting.  But anytime is better than no time, and there are always things we can do to improve your quality of life and comfort in your body. 

So, what did we learn in this article?

Ideal time to start getting intelligent massage therapy is 2 - 6 weeks post-mastectomy surgery, but up to 3 months post-op is good too, and treatments continue on from there.

But really, anytime is the right time and you are definitely better late than never!  I've had good success with women who have started more than a year after their surgery, so change is always possible. 

If you are in the Vancouver area, look me up so we can work together to bring you comfort, strength and empowerment.  If you are out of the Vancouver area, find someone who has some training in post-mastectomy massages and get in there! You will be glad you did.  It is not a luxury, it is legitimate support for your healing process.  You are worth it! 

Next article: One woman’s story: how lymphatic massage improved her post-mastectomy healing

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