Research & Evidence
My practice is grounded in the latest research. Here's the evidence behind the treatments I offer — oncology rehabilitation, scar therapy and musculoskeletal care.
Oncology Evidence
Structured exercise before surgery or systemic treatment improves cardiorespiratory fitness, reduces post-operative complications and shortens hospital stays. Starting early gives your body more reserve to draw on.
Androgen deprivation therapy accelerates loss of lean muscle and bone density. Progressive resistance training offsets much of this loss and supports strength, balance and quality of life during treatment.
Graded range-of-motion and scar management work reduces shoulder stiffness and cording after breast surgery, supporting a faster return to everyday activity.
The evidence base for exercise during and after cancer treatment is particularly strong for breast, prostate, colorectal and gynaecological cancers. Across large trials and guidelines, structured exercise improves fatigue, fitness, strength, mood and quality of life — and in breast, prostate and colorectal cancer, being active after treatment is also associated with better long-term outcomes.
Cancer-related fatigue responds better to appropriately dosed exercise than to rest. Tailored aerobic and resistance work is one of the most effective interventions available.
Scar Therapy Evidence
Scar tissue lays down collagen in a disorganised way and can bind to the layers beneath it. Graded scar mobilisation, stretching and loading help that tissue remodel along lines of stress, which is why most people notice the pulling, tugging and tightness settle before anything looks different.
Restricted scars limit shoulder, trunk or hip movement. Studies of manual scar work combined with progressive range-of-motion exercise after breast and abdominal surgery report meaningful gains in movement and in the ability to return to daily tasks and exercise.
Massage and mobilisation increase local circulation and temporarily improve tissue extensibility, giving the scar a better environment to remodel in. Silicone therapy and consistent pressure also support hydration of the scar and can help with redness and raised tissue in some people.
Altered sensation, hypersensitivity and pins and needles around a scar are common. Desensitisation work and graded exposure retrain the nervous system, and are among the most consistently reported benefits of scar therapy.
After axillary surgery, tight cords can severely limit shoulder movement. Gentle stretching, manual therapy and exercise are the mainstay of treatment and typically resolve cording faster than waiting it out. Scar and soft-tissue work can also support lymphatic drainage where swelling is present.
Being touched, moved and given permission to use the area again matters. Patients consistently report feeling less protective of the scar and more confident using their body, even when the scar's appearance is largely unchanged.
Timelines
0–2 weeks
Wound healing. No scar work on the scar itself. Gentle breathing, posture and pain-free movement only, and always within your surgeon's advice.
From ~2–6 weeks
Once the wound is fully closed, dry and infection-free (typically 2–6 weeks, later if you've had radiotherapy or delayed healing), we can begin light scar massage, desensitisation and graded range of motion.
6 weeks – 12 months
The main remodelling window, when scar tissue is most responsive. Deeper mobilisation, stretching, silicone and strengthening are progressed here. Most people see the biggest change in this period.
Older scars (years on)
It is never too late. Mature scars — including C-sections from years ago — still respond with reduced tightness, better movement and less sensitivity, though change is usually slower.
How often
Typically a session every 1–2 weeks initially, with a short home routine of 5–10 minutes most days. Home consistency does more than clinic frequency.
How long overall
Many people need 3–6 sessions. Complex or extensive scarring (for example DIEP flap reconstruction with radiotherapy) may take several months of intermittent input.
MSK Evidence
Guidelines consistently favour staying active, education and progressive loading over rest and passive treatment alone. Hands-on therapy is used to make movement more comfortable, not as the whole plan.
Most rotator cuff and neck presentations improve with a structured exercise programme, supported by manual therapy and clear advice on load management.
Hands-on treatment and sports massage to reduce symptoms, exercise therapy to create lasting change, and education so you understand what's happening and why.
Evidence-based care tailored to your individual needs.