Oncological Program

We're Here To Help

When breast cancer is a part of your life, your body is under siege by both the disease and its treatments. At Premier we examine, evaluate, screen and establish a safe and effective plan of care for individuals who have been diagnosed with cancer.

Through our individualized Breast Cancer Rehabilitation Program, our Physical Therapists aim to help you:

  • Improve your quality of life
  • Helping you reach your goals and return to activities you enjoy
  • Identify and manage potential diagnosis of lymphedema, axillary cording and myofascial pain syndrome
  • Help mobilize scar tissue to allow improved upright posture
  • Assist with balance difficulties associated with peripheral neuropathy
  • Increase your strength, endurance and range of motion
  • Assist in reducing your pain whether it is related to your surgical site or elsewhere as a result of being less active

Meet our Lymphedema Specialist, Dr. Jessica Grochowsky


Jessica and her team have a passion for helping individuals affected by cancer recover and return to the activities they enjoy. Becoming a part of your cancer care team allows our therapists to manage the quality of life issues that so often arise. Whether it is tightness from scars preventing range of motion in the shoulder, low back pain from sitting in infusion chairs for long duration, tension headaches that arise from improper posture or use of the shoulder, to treatment of lymphedema, we are able to help.

Commonly Asked Questions About Lymphedema

Learn more about Lymphedema, treatments, its stages, and what to expect on your first visit.

What is Lymphedema?

Lymphedema is an accumulation of fluids and protein in the tissue that develops as a result of a malfunction of the lymphatic system. Lymphedema is a chronic condition that causes swelling in the leg(s), arm(s), face or trunk.

What is included in the treatment of Lymphedema?

Lymphedema treatment is targeted to reduce the current swelling, as well as, educate the patient to learn how to help manage symptoms in everyday life. We use a combination of treatment methods, including:

Complete Decongestive Therapy:

Phase one includes

  • Manual lymph drainage - a gentle technique that stimulates the lymphatic vessels in order to improve the vessel activity and assist with moving fluid out of the congested limb.
  • Compression wrapping - utilizing specific bandages to provide graded compression to decongest the limb. The wrapping will stay on consistently until the patient's next visit when they will be re-wrapped. This phase of treatment must be consistent in order to reduce the size of the limb, not make it smaller.
  • Exercises - designed to help the muscular system pump lymph fluid away from the affected area;
  • Training in a home management program.

Phase two includes

  • Transition to independent maintenance program
    • Includes recommendation on type of compression garment(s) in order to maintain size of decongested limb
      • May include daytime and/ or nighttime compression garments
    • Transition to independence with self-manual lymph drainage
    • Transition to independence with home exercise program

How do I know if I have Lymphedema?

It is important that you be screened for lymphedema if you suspect swelling into a limb has started. You may also notice a sensation of heaviness in your arm. The faster intervention occurs, the easier the treatment. If you have lymphedema you will present with one limb generally larger than the unaffected side. Your therapist will determine this by taking circumferential measurements up both arms to determine a total limb volume and will compare it to the unaffected side. If both limbs are involved, the measurements will be taken on both sides and used as a baseline before treatment. Evidence of pitting edema versus fibrotic edema will be assessed and skin integrity will also be assessed.

What can I expect in my first visit?

A comprehensive evaluation will be performed to collect objective information on the current status of the patient. This includes but is not limited to:

  • Range of motion measurements
  • Circumferential measurements of the involved and uninvolved limbs in order to objectively gain an understanding of the amount of fluid accumulation
  • Strength measurements
  • Functional movement analysis
  • Skin integrity check
  • Postural assessment

After the evaluation is completed the plan of care will be discussed with the patient based on the findings from the evaluation.

If it is decided that the patient will benefit from treatment of lymphedema with complete decongestive therapy, then there will be a list of supplies provided to the patient that they will need to purchase in order to participate in the compression bandaging portion of the treatment.

If compression bandaging is not necessary the patient may be recommended to participate in a less aggressive program that utilizes only manual lymph drainage, potential use of kinematic taping, use of compression garment and exercise.

Jacksonville Location

Taylor Place Shopping Center

(904) 996-6922
13947 Beach Blvd #109
Jacksonville, FL 32224

Ponte Vedra Location

Azalea Office Park

(904) 996-6922
6 Fairfield Blvd, Suite 6
Ponte Vedra Beach, FL 32082


We've had the pleasure of working with some incredible folks over the years. Here's what they had to say.

5 5 1
This was my second trip to Premier in 6 years. They healed my neck last time. This time they squeezed me in to their busy schedule the afternoon after twisting my knee. I thought, for sure, I would needed x-rays and surgery, but Chris gave me a deep tissue massage and stretched my knee. I immediately started feeling better and in 24 hours, I’m walking and without even a limp! Thanks!
5 5 1
These guys are the best - if you want results you can't do better than Chris and his team. During my post-op rehab, I've made more progress in two weeks with Premier than my previous PT big-system provider achieved in two months. I look forward to meeting my goals soon, thanks to Chris, Beverly, Kurtis and the rest of the Premier PT team. Thanks!
5 5 1
5 star experience here every time. Chris and his team (primarily Kurtis, in my case) rehabbed me through three separate injuries over the past couple years with great success each time. This group has a very knowledgeable staff that takes the time to do it right. I also love their Alterg and have used it with great success, even immediately after a stress fracture diagnosis.