“Help! I looked in the mirror and see tilts and bends that weren’t there before…”
If this sounds familiar, you are not alone. Many people notice changes in posture after cancer treatment– rounded shoulders, a forward stoop, or even a side tilt that looks a little like scoliosis. These changes can be surprising, unsettling, and sometimes worrying. The good news? There are ways to understnad them, and there is something you can do.
Why posture changes after breast cancer treatment (or any surgery area, especially in the early days)
Cancer treatment affects not only the tumour site but the way yiur whole body holds and moves. After breast surgery, particularly mastectomy, it’s common to adopt a protectective posture– rounding the shoulders forward, holding the arm close to the body, or leaning slightly to one side.
• Guarding habits: Studies show that 50-80% of women adopt to protective postures in the first 3-6 months after surgery. For some, these habits can persist for years if not addressed.
• Stooping and tilting: Research consistently reports rounded shoulders, forward head and trunk tilts as the most common postural changes after mastectomy and/or radiotherapy.
• Why it sticks: At forst, it’s a way to protect the healing area. But over time, scar tissue, radiation tightness and muscle imbalance can stick in these positions until they become your new “normal.”
When posture shifts into scoliosis
Scoliosis– when the spine curves sideways– can either appear for the first time or worsen after breast cancer treatment.
• Mastectomy without reconstruction: Removing tissue on one side alters the balance of the rib cage and shoulder girdle. Studies show measurable Cobb angle shifts (the way scoliosis is measured) after mastectomy, with greater changes when no reconstruction is performed.
• Scarring and radiation fibrosis: Tightness across the chest and under the arm can literally pull the rib cage forward and sideways.
• Shoulder weakness: When muscles like the serratus anterior or lower trapezius switch off, the trunk compensates with a tilt.
• Bone health changes: Menopause, hormone therapy (endocrine therapy) and inactivity increase the risk of osteoporosis, which can exaggerate the curves.
• Lympjoedema: Swelling and heaviness in one arm or chest area may tip the balance further.
In the UK, population studies suggest about 9% of adults over 40 have scoliosis, rising to over one-third of adults over 60. Breast cancer treatment can act as a “trigger” in someone already predisposed.
The good thing: Awareness. I am sure everyone reading this will have stood upright, repositioned their shoulders and probably pulled their tummy in. The first step is awareness. Change starts to happen even with the those little steps.
Can anything help if I’ve suddenly developed a tilt or curve?
As mentioned already, awareness is your first step. And yes– absolutely. It takes time and effort, but targeted exercise and awareness make a big difference.
• Balance and postural control improve with structured rehab programmes after breast cancer.
• Shoulder function recovers more fully in those who begin gentle exercise early, compared with those who avoid movement.
• Scoliosis specific exerciose show imoprovements in spinal alignment, trunk rotation and quality of life in adults.
A beginner-friendly movement toolkit
* Always check with your medical team first, especially if you have had recent surgery, radiotherapy, if you have bone health concerns or lymohoedema. *
1) Breathing for symmetry – Seated, place your hand on the hollow side of your ribs. Breathe deeply into this area, lengthening up through the crown of your head.
2) Scapula (shoulder blade) setting. This is great done against a wall if you have space, if not lie on the floor. I call this the W-T-Y exercise. Start with your hands resting on your hips as if in the pockets of your jeans (notice your shoulder blades and imagine gentling setting them in place and keeping them there), elbows are resting on the floor. Elbows stay where they are and you move your hand/forearm to rest the back of the hand towards the floor (may or may not get there. Do not force it), creating a W shape. You then progress to sliding the hands/arms out to the sides to form a T shape and back. The last shape is the Y, moving from the T to slide the arms to form a Y above the shoulder height (this is the most challenging and needs care not to overdo things). Start with 1 or 2 reps of W, when you feel 6-8 are comfortable add the T for 1-2 reps. Monitor how the shoulder, chest and arm feel over 24 hours.
3) Core control. Marching in front of a mirror, keepin the body upright, the pelvis level. You can hold onto poles to help keep you upright.
4) Hip and balance work. Again you can stand in front of a mirror and then lift one leg. Hold for 20-30 seconds. Again use poles to help you stay up right to begin and then progress to a hand on the wall and then free standing.
5) Keep up with the exercises given after your surgery, these are very specific to you and your surgical area.
6) Chest and scar mobility. Pregressing your chest stretches, side reaches and even some scar therapy will all help.
Consistency matters, not working hard– 10-15 minutes a day can start to change long-held postural patterns.
When to seek more help
. • If your lean or stoop is getting worse, or you notice pain, weakness or numbness
• If you feel “pulled” strongly to one side after mastectomy, especially without reconstruction.
• If you are unsure where to start– ask for a referral to a cancer-aware physiotherapist or cancer rehab movement specialist.
External breast protheses may help restore balance for some women, though research is mixed. For others, surgical reconstruction is an option to discuss with your care team.
Remember
– You didn’t cause this– protective posture is a natural response.
– Posture changes are common and often reversible or at least improvable.
– Small daily steps, supported by your medical team, can gradually bring your body back into better balance.
In many areas there are cancer rehab movment programmes.
Here in East Suffolk and North Essex we are very well catered for.
You can contact the cancer wellbeing centre in Colchester who may offer you a place on a funded cancer rehab programme.
You can speak to Maggie Parkes at Clacton Leisure Centre about the specialist and often subsidised programmes on offer there.
Please get in touch with me if you want information on scar therapy, movement programmes after breast cancer treatment or manual lymohatic drainage. fi@therapyinmotion.co