Exercise for pelvic radiation fibrosis

Lora Packel MS, PT
Last Modified: May 26, 2002


Dear OncoLink "Ask The Experts,"
One of the physiotherapists in our Agency has been asked to develop an exercise program for a lady who has radiation fibrosis in her abdominal & pelvis. She had her radiation treatments about 4-5 months ago.

Thank you for any help you are able to provide. 


Lora Packel MS, PT, Coordinator of Cancer Therapy Services for the Hospital of the University of Pennsylvania, responds:

Radiation changes the pliability of muscles, fascia and skin. These changes often occur weeks to months after radiation has ended. It is beneficial to provide patients with a prophylactic stretching programs while undergoing radiation and after radiation has ended to help avoid fibrosis.

Once fibrosis occurs, you can use many of the deep techniques used in the general population. Ideas include massage, stretching and joint mobilization. In addition, many therapists have found myofascial release techniques to be quite effective. It is also important to address any issues of pelvic pain, lymphedema, incontinence and pain with intercourse, as these may also be side effects of radiation to the pelvic region.

There are some relative contraindications to deep techniques after radiation.

  • Do not use deep techniques over acutely irradiated skin
  • Do not use deep techniques over any open wounds or fragile skin
  • Do not use electrotherapies without discussing with physician