(By Amy Tinetti, Women’s Health Physiotherapist)

Blocked Ducts

A blocked duct is a blockage of the milk duct in the breast that can result in pain and tenderness of the area and a palpable lump.

There may also be a white spot on your nipple which can be a sign of a blocked duct. The skin around this area may feel warm to touch and look visibly red. Generally, there is no fever and you feel well.

These blocked ducts can be treated with therapeutic ultrasound to resolve them more quickly.

Mastitis/Breast Abscess

Mastitis is an infection within the breast where bacteria has entered, causing pain, swelling, a firm mass, and a fever.

This type of infection needs to be treated with antibiotics. If mastitis is ignored a breast abscess may form. An abscess is a pocket of pus which forms in the infected area and should be discussed with your doctor on appropriate management.

It is possible that a blocked duct can go onto mastitis, therefore it is important to manage a blocked duct as soon as you notice.

What is Therapeutic Ultrasound?

Therapeutic Ultrasound transmits soundwaves from a machine through a coupling gel medium into the body. Due to the movement of sound waves, it can cause thermal and nonthermal effects.

Thermal Effects

  • Increase connective tissue extensibility
  • Increase the blood flow into the area

Nonthermal Effects

  • Forced movement of liquid
  • Waves (movement) through an area
  • Cavitation (the formation of empty space within a solid object or body)

All of these effects assist in loosening the blocked duct within the breast. Therapeutic ultrasound is not painful, you may just feel the area slightly heat up.

What to do if you have a blocked duct (painful red lump or swollen spot on the breast) whilst breastfeeding

As explained from the Department of Health WA:

  1. Feed frequently from the affected side first.
  2. Gently stroke your breast towards the nipple during the feed. This may assist the let-down reflex.
  3. For the comfort and to reduce swelling from excess fluid apply a cold cloth or cool gel pack.
  4. Express after feeding.
  5. If there is a white spot on your nipple – soak the nipple with a warm moist cloth and rub or scratch off the spot with a sterile needle to allow the duct to open and the milk to flow again.
  6. Use paracetamol or anti-inflammatory tablets according to directions until the lump clears.
  7. If the lump has not cleared after the next breastfeed, therapeutic ultrasound treatment (by a physiotherapist) of the affected breast may help clear blocked ducts – contact Wisdom Physiotherapy to arrange asap.
  8. It is important the breast is well drained within 20 minutes of having the ultrasound treatment. This may be either by breastfeeding or expressing the breast.

What does a session with a Women’s Health Physiotherapist for a blocked duct include?

  1. Applying Therapeutic Ultrasound to the area required
  2. Thorough subjective assessment of your breastfeeding (current and past history)
  3. Education on the use of breastfeeding holds and other management strategies you can do at home to assist in the drainage
  4. Discuss and investigate the possible causes of your blocked duct
  5. Liaising with health professionals you may need in your care (for example GP or lactation consultant)


If you are experiencing pain during breastfeeding, our Women’s Health Physiotherapist Amy Tinetti can help. Call us on (08) 6389 2947 for more information or click here to make an appointment online today.


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