A referral for therapy was created for a 29 year old female with complaints of generalized shoulder dysfunction. This dysfunction includes difficulty with everyday activities, muscle weakness with numbness and tenderness, paresthesia to right upper extremity down to the hand and shoulder pain.
The problems affecting the right side began February 2012, when she was diagnosed with right breast cancer with a protruding tumor. The patient soon after underwent chemotherapy to treat the cancer and tumor. Mets were still found in the lymph nodes and chest wall due to chemo resistive cells. Axillary damage resulted by the surgery complications to lymph and axillary nodes. A radical mastectomy was performed July 2012 followed by a second tissue removal August 2012. A hysterectomy was performed September 2012 due to a cancer caused by hormones. She had breast reconstruction with port removal surgery done in August 2013. As a result of the breast reconstruction surgery the patient developed Adhesive capsulitis of the shoulder, also known as “Frozen Shoulder”. Shoulder impairment is sometimes reported as a consequence after post mastectomy surgery.
The patient has three children at home and finds it difficult to keep up with the recreation and play activities. She also expresses concern of bed mobility, flexibility, grasping objects lifting, and performing home management skills. On her best day pain from her shoulder is at a two out of ten scale. Her worst day the pain is at a nine out of ten scale. The use of the right upper extremity, movement and pressure makes the pain worse. The pain is relieved with avoidance. She was told that with avoidance will come dystrophy of the right arm.
Adhesive Capsulitis is the stiffening of the shoulders due to scar tissue, which results in the painful movement and loss of motion. Kelley MJ. (2009). It affects women more than men and typically occurs in people who are over the age of 45. Of the people who have had Adhesive Capsulitis in one shoulder 20% to 30% will get it in the other shoulder. Some believe it’s caused by inflammation, or by an autoimmune reaction, which include reactions after an injury or surgery. Pain from other conditions-such as arthritis, a rotator cuff tear, bursitis, or tendinitis- that has caused you to stop moving your shoulder. Kelley MJ. (2009). Immobilization of your arm, after surgery or fracture can cause Frozen Shoulder. Often, however, there is no known reason why Adhesive Capsulitis starts. After mastectomy, patterns of scapular movement are altered, particularly on the operated side, despite the absence of mechanical restriction. This...