Case 3: Status after breast amputation and removal of underarm lymph nodes.
Secretary, 53 years old, operated on 6 months ago for left mamma-amputation with removal of underarm lymph nodes. Increasing shoulder complaints on left side: stiffness, pain, difficulty working.
Examination shows: posture defect of thoracically strengthened kyphotic posture in elevated or protracted position of left shoulder girdle, slight restriction in movement, increasing pain when working.
A seated exercise is chosen because patient can do it behind her desk. See book English version: p. 75 D2 Shoulder protraction. Thoracic kyphosis.
Patient appears to have problems with the exercise. She cannot stabilise her spinal column and joints properly. The starting position is changed to a prone position where her back is supported by the couch and by using a small sandbag between her shoulder blades she is more able to feel the correct position for her shoulders.
See book English version: P. 34 A3: Relaxing tight M. Pectoralis Minor. After three weeks of daily exercises (ten times twice a day) she can stabilise and correct when sitting and standing. After six treatments divided over two months she complains less of pain and she can continue her office work without problem. She does pause now and again to correct her posture: Using the desk surface as a fixed handhold.
I was surprised that my symptoms had disappeared with only two exercises. I like being able to do the exercises during work. I came for the pain in my shoulders but the tiredness in my back has also lessened. I can present myself better and am no longer ashamed of my operation.