TL;DR
(because I love bodies and this post is going to get a little long and a little nerdy)

Here’s what I’m working on in PT:

• Preventing frozen shoulder and lymphedema
• Re-establishing range of motion
• Breaking up scar tissue
• Eventually adding weight and re-gaining strength

We do this mostly on the left side (mastectomy side), but also the right—because a mastopexy is still a surgery. I have four comparatively small scars on the right side (they are not small) and then they threw my port in on that side (because it’s too risky to put it on the mastectomy side due to infection risk—a small “dual primary” cancer management detail given the short time between surgery and chemo), which jacked things up physically on the right side for about ten days.

Also: I got into PT fast.
Like, cleared by my surgeon and on the table within three weeks post-op fast.
Which matters. A lot. More on that later.

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My friend Jen, another trained yoga therapist, asked me about PT and I was like:
gurl, lemme write a whole-ass thing about it so we—and anyone else who loves bodies—can get into it.

P.S. No one knows what yoga therapists do. (Jen’s really good at explaining it. Better than I.) But, I will tell you yoga therapists have hundreds and hundreds of hours of anatomy and physiology training–especially those of us (like Jen and I!) who are also trained in adaptive yoga.

 

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Anyway.
I. Love. Physical. Therapy.

I’d go every day of my life if I could.

I love working on myself.
I love learning about my body.
I love eavesdropping on PTs working on other people.
I love watching someone move and guessing what their injury is.

Like—the most riveting thing to me about the Winter Olympics (aside from the men’s hockey final, obviously) was when I found the channel where they live-stream the figure skaters doing their pre-ice warmups.

I sat on my couch, fully riveted, for 45 minutes watching Amber Glenn go through her routine while my brain was just logging:
that’s core activation
that’s balance
that’s glute activation
that’s for rotation
that’s for power
cool cool cool

My mom just stared at me and said,
“Are you getting gym envy?”

…yes.

I tried her lunge series in my living room.
It was absolutely exhausting.
I was also 10 days post-op—probably still on oxy.

Go, Amber.

 

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I’ve been to PT before—mostly for my neck and right shoulder.

But I’ve never been for surgical rehab, because I’ve never had a surgery before.

And let me tell you:

Surgical rehab is a humbling experience.

See, I’m really smart.
Also, I’m an idiot.

I was like:
“Oh, a mastectomy, with reconstruction. Cool. They just take out the breast tissue and put in a tissue expander. Big deal, but also not a big deal. I know bodies. I’ve been doing strength training. I got this.”

Well.

As I said to my PT last week—when I was finally able to lay flat on my back for more than 10 minutes for the first time in five weeks…and got upgraded to “snow angels” on a half foam roller (big fucking deal):

“What in the actual hell did they do to me in there???”

I now have a much deeper respect for:

• pec muscles
• my rib cage
• and my personal favorite: fascia.

They’re involved in nearly everything.

I actually emailed a co-worker who pulled his pec a few months ago and was like,
bruh.

(This is the same co-worker who bought me the resistance bands off my “cancer registry.” So on brand.)

 

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What the Surgeries Were

• Left breast skin-sparing mastectomy
  • sentinel node biopsy (they took three)
  • immediate reconstruction with expander
• Right breast mastopexy
  

I’ll focus on the mastectomy, since that’s the bigger surgery and where most of my PT work is focused.

Here’s what was removed:

• nipple, areola, fascia (covering of the pec major), and skin
• Plus three lymph nodes from my left underarm.

Then:

• Tissue expander + alloderm were stitched into my pec and fascia
• Two drains inserted (one of which ran from my side ribs up to the top center of my breast—cool cool cool. That drain lived in me for 2.5 weeks and then my plastic surgeon just…pulled it out.)

I now have three sets of scars on the left side:

• One big one across my entire inframammary fold (where the underboob–a technical term?–meets the torso)
• One vertical from that fold about ¾ up my breast
• Two small ones from the drains

I also have the four scars on the right but they’re far less intense.

So yes—they removed tissue.

But also:

• They cut fascia.
• They impacted muscle—a big one.
• They disrupted entire fascial chains.

Case in point: my right hip hurt for several days after surgery, which resulted in me lying in bed, pissed off, doing figure fours.

Because everything is connected—cosmically, physically, and fascially.

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What I Couldn’t Do 

• Carry more than 5 lbs
• Walk my dog
• Wash my hair
• Put on a shirt overhead
• Open a jar
• Drive (turn a steering wheel)
• Do dishes / any repetitive movement
• Take deep breaths
• Twist or side bend
• Reach… literally anywhere
• Lift my elbow above shoulder height
• Sleep on my side or stomach
• Prop myself up on my side

And here’s the thing:

The body wants to move.
The body needs to move.

So the goal isn’t to stop moving.

It’s to move within the smallest possible ranges.

But fuck it hurts.

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And here’s another bonus:

I had a foreign object (tissue expander) stitched into my pec—and fascia. 

So, too much movement = pulling on sutures + alloderm (human cadaver tissue used in reconstruction–welcome, new friend!) = risk of rejection, tearing, infection.

I actually asked my plastic surgeon during our second post-op to explicitly tell me where and how she stitched it into me so I could understand why it feels nearly impossible to move.

I got it.

Also:

Swelling.

Not like “oh my right shoulder has bursitis.”

Like:

Fluid is moving into and around my entire chest and upper back and there’s so much pressure. 

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And yet…

ISN’T THAT SO COOL?!?!

Because this body—

that was strength training 4x/week for months—

suddenly couldn’t wash its own hair
and couldn’t put on a shirt overhead until this past weekend
and even then it had to be V-neck. And baggy.

Humbling.

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So What Do We Do?

The most boring shit ever.

That is everything.

Because if I don’t do this…
I don’t get my life back.

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What PT Actually Looks Like

(My PT is oncology rehab trained!)

Manual work:

• Pec, lats, delts, traps (chest, back, shoulders)
• Scar tissue release (yes, digging into ribs and sternum right under and around my boobs… delightful)

Assisted movement (reclined):

• Arm guided overhead extension (reaches)
• Arm guided lateral extension (side reaches)
• Elbow bend + hand presses → gentle external rotation

Self-guided (no gravity):

• Towel slides on wall, forward and lateral→ up to a 3/10 pain
• Shoulder rolls, forward and back
• “No monies” (external rotation)

With resistance / gravity:

• Swimmers, reclined then standing
• Snow angels (NEW LEVEL UNLOCKED. My angel has a broken wing but it’s cool. She’s working on it.)
• Banded external rotation and lat work (also a new addition!)

Advanced (aka: humbling AF):

• All of the above… on a half foam roller

→ Yay! Also, my ribs + sternum were sore for two days.

By the way, Lindsey Vonn and I are basically on the same rehab timeline.
Her recent injury was the day before my surgery.
She’s crushing her rehab.

Makes me feel kinda bad.

But I’m not an Olympian.
…or maybe I am.

Just a different kind.

If biathlon-style endurance cancer were a sport.
There’d be a pretty elite group of qualifiers.

It is, however, a sport I hope does not gain in popularity.

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The Mental Game

Here’s the kicker: the body part of all of this is the “easy” stuff.
The mind?
She’ll get you every time.

Because if you zoom out, this is depressing.
This whole fucking thing is really depressing.

So you don’t zoom out.
(Or, you try really, really hard not to.)

You zoom in.

This is what we call at O2X:
1% changes.

What is the smallest thing I can do to move forward?

Or, as we say:
1% better every day.

(Shoutout to Dave Brailsford + James Clear’s Atomic Habits for the concept and application.)

Here’s an example of how it looks in real life:

Right now, I literally cannot move my left arm overhead.
PTs measure range of motion in degrees.

So my goal?

One degree at a time.

Because I want:

• To put on shirt
• To wash my hair standing up
• To reach a top shelf
• To lounge with my hands behind my head
• To sleep on my side
• And, to thrive, not just survive

So I:

• roll my shoulders
• slide my hand up a wall
• repeat, repeat, repeat—1% after 1% after 1%

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Here’s the Kicker

Going to PT:

• The day after getting a port → sucks and hurts like hell
• The day after getting unplugged from chemo → also sucks because you feel like you’re gonna barf all the time
• On your worst mental health day so far when you see everyone else’s life moving forward in directions you want to go and you can’t move your arm → sucks the most

But, as my PT said on day one:

“If you can get here, we’ll make it work. You just need to show up.”

That’s the thing—the super secret thing to all of life, I believe: just keep showing up.

Showing up is the real 1%.

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So what did I do?

On days I could barely:

• get out of bed without being so lightheaded I thought I’d pass out
• eat without crying because it hurt that much to open my mouth bite into a sandwich
• dress myself
• not throw up
• stop myself from sobbing

I had:

• my dad & stepmom
• then my mom

drive me to the building, walk me into the room, to the table, and hand me off to my PT.

I showed up.

She modified everything.

I left.

And I felt at least 1% better.

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One Last Note on Going Early

Starting PT early matters.

Because scar tissue, stiffness, and compensation patterns start forming fast.

I’m really grateful to myself for knowing this and for asking my plastic surgeon about it before I officially hired her—back when we weren’t exactly sure what surgery I’d need.

She had a PT script in my hands at my first post-op appointment, and I was on the table exactly three weeks after surgery—one drain still intact.

Because the work doesn’t start when you feel ready.
It starts when you start showing up.

One degree.
One rep.
One percent at a time.