Reclaiming Normal During and After Breast Cancer: How Therapy Helps Pain and Agility

by Kerry Andersen

The surgery is behind her. The last chemo appointment is done. And then she reaches for a book on the top shelf and finds her arm simply won’t go there anymore. 

That moment is usually when women start thinking about physical therapy. According to the team at Hope Therapy Center in Lake Charles, it’s a conversation that should happen months earlier. 

“Most women do not know they can begin their therapies before surgery or treatment,” says Reba Desonier, PT, DPT. “We highly recommend being proactive in your care and cancer journey.” 

A patient can start therapy at any point after diagnosis. Immediately following a lumpectomy or mastectomy, physical therapy most often addresses limited shoulder movement, tight scar tissue, swelling and joint stiffness. Owner Sonya Brooks, a speech-language pathologist, has built a multi-discipline practice with occupational therapists and other specialists on staff to handle the many symptoms that surface during cancer treatment. 

Pain is the part patients talk about most, and the clinic’s answer isn’t another prescription. Treatment can include manual therapy and scar tissue mobilization, therapeutic exercise, activity modification and the center’s aquatic facility, which offers a hydro-massage using warm water and controlled jets to ease pain and swelling. Dry needling is another option but is used selectively. “We often do not use dry needling local to the site if there has been removal of lymph nodes,” Desonier says, though it remains an option for referred pain from surgery or radiation. When lymphedema care is needed, the clinic connects patients directly with certified specialists in the area and coordinates the handoff so there’s no gap in treatment. 

Then there’s the fatigue, which arrives during chemo and radiation and makes exercise sound impossible. Desonier doesn’t dismiss it when a woman says she’s too tired to exercise, but still champions physical activity as therapy. “As movement specialists, we know the positive effects exercise can have on the body and the mind,” she says. For patients cleared to get in the water, the pool allows low-impact movement. For those who can’t, therapists recommend gentle strengthening, breathing and stretching. 

Realistic expectations matter during recovery. Rebuilding true strength can take six months to a year. Most patients start two to three times a week, working first on restoring full motion in the arm and shoulder before adding strengthening exercises. 

If you’re concerned about cost or insurance coverage, it’s less of a roadblock to care than you might expect. Louisiana’s Direct Access law allows a physical therapist to treat a patient for up to 30 days without a physician’s order, and clinic administrators can check individual insurance policies. For Medicare patients, a referral is preferred. 

Desonier says range-of-motion numbers aren’t the only measure of success. Therapists are more likely to remember when patients achieve milestones that improve their quality of life. “That may look like the first time she can fasten her bra, or perhaps the first time she can lift her grandchild, but it signals that although the road to recovery is long, there is hope.” 

Hope Therapy Center is located at 1727 Imperial Boulevard, Building #3 in Lake Charles. For more information, call 337-478-5880, visit hopetherapycenter.net, or follow Hope Therapy Center on Facebook, @hopetherapycenter on Instagram, and @hopetherapyctr on TikTok.