Case Study: Mastitis in Breastfeeding Woman

Connection of arm lines and mastitis in breastfeeding woman


A 37-year-old woman presented with h/o 4 episodes of mastitis in the last one year. She is 1 year postpartum and breastfeeding. The client has h/o natural birth with min tearing and she had only one episode of mastitis after her first born. The client is doing her PhD and she has to spend time in front of the computer for her thesis. The client is an active runner. Her menstrual cycle returned 9 month postpartum.

Client Characteristics

The client does not have any medical history. The client is under stress with her dissertation otherwise she is healthy. The client stated she gets slight breast pain/clogged duct every 3 months followed by fever next day and she gets mastitis. She had to be on antibiotics for that for 4 times in the last one year. She is breastfeeding her child mainly in the evening and at night on demand. Her child goes to daycare during the day. The client really wants to avoid the pattern of mastitis and antibiotics every 3 months.

Examination Findings

Posture: Slightly rounded shoulders and slouched while seated and while breastfeeding, she mostly carries her child on the right side with hips shifted on the right side. Breathing mechanics: Decreased rib mobility, upper back tightness present ROM: Thoracic spine mobility:extension: mod loss, rotation to R/L: mod loss tightness of rib cage/thoracic spine present. Muscle strength: Both UE and LE grossly graded: 5/5 The client presented with tight superficial and deep front arm lines. The arm lines are myofascial meridians that run from the axial skeleton through the four layers of the shoulder, to the four quadrants of the arm, and four sides of the hand. The arm lines provide more mobility and require more variable lines of control and stabilization through interline links (lateral, spiral and functional). These arm lines (deep) connect the shoulders contralaterally to the pelvic girdle. (Ref: Anatomy Trains). The posture can affect the arm lines. For example, slouch posture can lead to shortening of front arm line and lengthening of back arm line which creates compensatory patterns and muscle dysfunction. The client had to do work in front of the computer- typing (using fingers) along with posture affected her arm lines. Superficial front arm line consists of palmar muscles of hands and fingers, carpal tunnel, lower arm flexors, intermuscular septum, and pectoralis major/latissimus dorsi, and medial third of clavicle, costal cartilages, lower ribs, thoracolumbar fascia, and iliac crest. The deep front arm line consists of 3rd, 4th, 5th ribs with pectoralis minor muscles, subclavius, clavipectoral fascia, coracoid process, biceps brachii, coracobrachialis, brachialis, radial tuberosity, pronator teres, supinator, radial periosteum, styloid process of radius, radial collateral ligament, scaphoid, trapezium, thenar muscles, and outside of the thumb.

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