Pilot study of effective methods for measuring and stretching for pectoral muscle tightness in breast cancer patients

Abstract

[Purpose] To evaluate differences in pectoral muscle tightness according to arm abduction angle and to determine the best arm abduction angle for stretching of pectoral muscle tightness in breast cancer patients. [Subjects and Methods] Horizontal abduction differences of shoulders were measured bilaterally by arm abduction to 45°, 90°, and 135° to determine the best arm abduction angle for measuring pectoral muscle tightness. Thirty-two patients were divided into three pectoral muscle stretching groups (A: 45°, B: 90°, and C: 135°). We measured the shoulder range of motion, scores of the Disabilities of the Arm, Shoulder, and Hand, European Organization for Research and Treatment of Cancer Quality of Life Questionnaire and the Breast Module, and pain levels (using a visual analog scale) before and after therapy. [Results] The differences in degree of horizontal abduction between shoulders were significantly larger for arm abduction to 90° and 135° than that to 45°. Groups B and C showed greater improvements in horizontal abduction limitations than group A. [Conclusion] Horizontal abduction differences between shoulders are prominent when arms are abducted to 90° and 135°. The appropriate arm abduction angle for measuring horizontal abduction and effective stretching of pectoral muscle tightness may be >90°.

Effectiveness of Botulinum Toxin A for Persistent Upper Limb Pain After Breast Cancer Treatment: A Double-Blinded Randomized Controlled Trial

“…Several studies have indicated the possible contribution of the pectoral muscles to pain and upper limb dysfunctions after breast cancer treatment. 3,[8][9][10] In the acute treatment phase of the cancer, breast and axillary surgery and radiotherapy cause scar tissue formation, wound healing, fibrosis and shortening of soft tissues, such as the pectoral muscles. 3,[8][9][10] Initially, this may lead to an increase in muscle tone of the pectoral muscles and local postoperative or post-radiotherapy pain.…”

“…3,[8][9][10] In the acute treatment phase of the cancer, breast and axillary surgery and radiotherapy cause scar tissue formation, wound healing, fibrosis and shortening of soft tissues, such as the pectoral muscles. 3,[8][9][10] Initially, this may lead to an increase in muscle tone of the pectoral muscles and local postoperative or post-radiotherapy pain. 3,10 In a further postoperative stage, forward shoulder position, induced by the shortened, hypertonic pectoral muscles and narrowing of the subacromial space may lead to rotator cuff pathologies, which can be painful and contribute to upper limb dysfunctions as well.…”

The effectiveness of Botulinum Toxin A for treatment of upper limb impairments and dysfunctions in breast cancer survivors: A randomised controlled trial

“…The onset of upper limb impairments can be explained by changes in the pectoral muscles after treatment for breast cancer, among others. (Stubblefield and Keole, 2013, Hidding et al, 2014, De Groef et al, 2015, Lee et al, 2016 Several studies describe an increased muscle tone and shortening of the pectoralis major muscle after breast cancer treatment. (Shamley et al, 2009) (Hage et al, 2014) Both tissue removal during surgery and post-radiotherapy fibrosis may enhance this.…”