Mastitis and Physiotherapy

Mastitis is a common and painful condition that can occur during breastfeeding, often causing breast pain, swelling, redness, and flu-like symptoms. It can affect comfort, confidence, and feeding, and many women feel unsure where to seek support.

Physiotherapy can play an important role in recovery by helping to reduce pain and inflammation, support effective breast drainage, and address contributing factors such as feeding positions and muscle tension. At For Her Physiotherapy, care is gentle, evidence-based, and tailored to your individual needs.

What Is Mastitis?

Mastitis is an inflammatory condition of the breast tissue, most commonly affecting breastfeeding women, though it can occur in non-lactating women as well. It often develops when milk flow is blocked, leading to milk stasis and inflammation. In some cases, mastitis may be associated with infection.

Common Symptoms

Breast pain or tenderness
Swelling, warmth, or redness of the breast (often wedge-shaped)
A feeling of heaviness or tightness in the breast
Flu-like symptoms such as fever, chills, or fatigue
Pain or burning sensation during breastfeeding

Early recognition and management are important to prevent complications such as breast infection or abscess.

What Has Changed in Mastitis Care?

Our understanding of mastitis has evolved.
In the past, mastitis was commonly managed as a blocked duct that needed to be aggressively cleared. Current evidence recognises mastitis as an inflammatory condition of the breast. Treatment now focuses on calming inflammation, supporting gentle milk flow, and addressing contributing factors such as oversupply, stress, and mechanical strain. This shift helps reduce pain, tissue damage, and the risk of ongoing symptoms.

Mastitis is a simple "clog in a pipe" that needs to be forced out.

Milk ducts narrow due to inflammation and swelling, which traps milk.

Treatment: Apply heat, use deep tissue massage, feed more often/pump to "empty" the breast.

Treatment: Use cold compresses to reduce swelling, perform gentle lymphatic drainage massage, feed normally on demand (not excessively), and rest.

Antibiotics are a first-line treatment for most cases.

Antibiotics are reserved for confirmed bacterial infections or if symptoms worsen/don't improve within 12-24 hours.

Previous Understanding (Outdated)

Current Understanding (Evidence-Based)

Causes and Risk Factors

Blocked milk ducts or incomplete breast emptying
Poor latch or positioning during breastfeeding
Pressure on the breast from tight clothing or bras
Sudden changes in feeding patterns
Cracked or sore nipples, allowing bacteria to enter
Fatigue, stress, or lowered immunity

How Physiotherapy Helps in Mastitis

Physiotherapy plays a supportive role in pain management and reduction of inflammation.

Physiotherapy Interventions:

1. Therapeutic Ultrasound
Low-frequency therapeutic ultrasound may be used by trained physiotherapists to help clear blocked milk ducts, reduce inflammation, and improve milk flow.

2. Massage, Exercise & Taping
Lymphatic drainage massage and exercises support fluid movement, reduce swelling, and promote healing of inflamed tissue. Breast taping can also be taught to reduce swelling recurring.

3. Low Level Laser Therapy (LLLT)

Low Level Laser Therapy is highly effective for nipple trauma and pain relief. It stimulates cellular repair by increasing blood flow and reducing inflammation, with improvement often noted within one session – although, more commonly 2-3 sessions are required for robust healing.

When to Seek Medical Care

While physiotherapy can be very helpful, medical assessment is essential if:

Symptoms persist or worsen after 24–48 hours
Fever or flu-like symptoms are present
There is concern about infection or abscess
Mastitis occurs repeatedly

Antibiotics or further medical treatment may be required in some cases. If left untreated, mastitis can lead to a breast abscess which may require surgical drainage – so prompt and correct treatment is vital.