My day becomes extra special when the partner comes into the treatment session, to learn how to provide hand-on relief of pain and discomfort for their loved one. This is a beautiful act of love, that with some training can become special moments at home, for both the giver and receiver.
I am talking about non- cancer pain and the kind of persistent pain/discomfort that can plague 40-60% of people after their breast cancer treatments.
Recent sessions from my clinical practice will help describe my experiences in partner training in hands-on care and I will also give my top three tips.
The lady in the image above, now referred to as loved one, came to my office last week complaining about shoulder /arm pain that did not get better over time. She reported feeling fear, uncertainty, and frustration every time there was a niggle or pain.
Fear is a common experience for breast cancer survivors: " as soon as I feel a new ache or pain, I immediately think cancer has come back"
Fear was completely understandable, especially when your oncologist has performed more tests and they say "no abnormalities detected". Yet, you still feel the pain.
The brain is relentless when the pain is not defined or understood. You know the monkey chatter- "have they done the right test?", are they "missing something?". The brain likes to know why and then how.
This is where having your chest and shoulder assessed to find the reasons for soft tissue related pain, is important. Developing a treatment strategy around doing your best to manage any tight scars and adhesions is next on the list.
At the first appointment, the soft tissues of the chest wall and shoulder were evaluated..
My main findings were:
Significant tightness of the new scar which was causing continuous tension at the shoulder- pulling it forward
The shoulder blade was not sitting flat on the rib cage at the back
The muscle at the top of the shoulder was huge and tight, not al all relaxed
There had been surgery and radiotherapy to the area many years before.
I find this type of clinical presentation can not be resolved by arm stretches and strengthening program alone. I use a program of release, release, release and retrain, of which the bulk of work needs to be done daily (initially) and at home.
Understanding body mechanics and using safe and effective soft tissue methods are important for people who want to use scar/adhesion self-treatment at home. In this case, the scar was in a difficult place for loved one to self-treat. She knew that her partner would be keen to assist in the home program and so invited him to the next appointment.
TIP 1: You will know whether partner will be interested in hands-on care.
Enter partner (his hands are in the photo above) to session 2 this week, with loved one.
TIP 2: Know what partner's occupation is, as this might be a guide to their handling skills.
Partner's occupation: "Classer of live sheep's meat/fat quality". He demonstrated his hands-on skill of pushing through the wool, past the skin and into the superficial layers of the sheep, while in the pen.
Hmmm? The good part of this skill was partner was used to feeling soft tissue. The problem was loved one had no wool, no visible fat and was not ready to run away; so his normal palpation method was potentially going to be a bit heavy and way too quick.
Re-training in this instance was required. Partner required training in gentle skin and superficial soft tissue evaluation of barriers to stretch and then simple and measurable release methods. Loved one required training in providing feedback to partner about the location and degree of "ok" stretch and when the release occurred.
We practiced a variety of home programs together:
TIP 3: Have a range of short treatment programs, so you can book in sessions to suit both of you over the week.
The full 5-10 minute treatment program finished with two simple shoulder posture retraining methods. I guided partner's hands on his loved one and then finished up the session by demonstrating the methods on partner.
Purring sounds demonstrated to me that he fully appreciated that this was a comfortable and delightful method. Partner reported feeling confident that he could offer this to loved one at home- knowing that he wouldn't cause damage, it only required a short period of time, that he could make a difference, and that it would feel great! A potential win-win for this team.
Value of partner scar and adhesion care at home:
I believe the following can be considered as reasonable goals:
Potential to build team spirit
Developing a sense of mastery when things may feel not so mastered (for both)
Create improved stretch in tight scars and adhesions
Reduce soft tissue pain linked to tight scars/adhesions and secondary soft tissue changes associated with shoulder changes.
Breast cancer survivors and partners require training for home-based scar/adhesion care
I love providing training to people who believe that they are an integral part of the treatment team and am available to consult with loved-ones, with or without partner, looking for a home program (Brisbane, Australia or video conference).
Connect by email to book your first evaluation appointment and then a partner session.
If you are unsure- email to book a 15 min complimentary session.