Mastitis: What is it? And How Can Physiotherapy Help?

Mastitis – What is it?

Mastitis is a common condition during breastfeeding that involves inflammation of the breast milk ducts.

This inflammation usually occurs as a result of milk ducts not being completely emptied, and can be infectious or non-infectious.

Blocked ducts present as a tender lump in the breast with or without local redness.


Risk Factors

• Incomplete emptying
• Engorgement from delayed feed or missed feed
• Tight, restrictive, and ill fitting bra or clothing
• Trauma to the breast tissue
• Maternal exhaustion
• Use of nipple creams which may harbour bacteria



Breast Anatomy
The breast contains connective tissue and fatty tissue as well as clusters of mammary glands/alveoli, which produces milk. The milk flows down the milk ducts to the nipples where it exits through many little ductal openings. The milk ducts transport the milk and do not store any milk.

How does mastitis or blocked ducts happen?
There are a few proposed mechanisms for how mastitis occurs. One is that the mechanical blockage of a milk duct forces the milk banking up behind the blockage into surrounding breast tissue. Such a build up and/or blockage causes tissue inflammation, which can feel like a hard lump.
Another recent clinical hypothesis is that engorgement and blocked duct presentation may be more of a lymphatic issue – that the connective tissues in the breast are tight, and therefore restrict the flow of lymphatics and venous drainage from the breast and back into the circulatory system.


How can physiotherapy help?

A women’s health physiotherapist can assess your symptoms as well as look into your risk factors for developing mastitis to provide general breastfeeding and self care advice.

Treatment generally also involves the use of therapeutic ultrasound.
A pulsating crystal within the head of the ultrasound probe causes ultrasound waves that pass through the skin to cause a cellular vibration and heating of the soft tissue.
Ultrasound therapy for mastitis has been shown to help soften hard breast tissue, break down infectious cell membranes to help better update of antibiotics and help to flush away inflammatory mediators.

Home exercises to help gently stretch the pectoral muscles and aid lymphatic drainage may also be prescribed.

If your symptoms include fever, malaise and chills, it is suggested that you also see your doctor for a medical assessment and potentially the prescription of antibiotics.

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