Anyone who has ever been diagnosed with Breast Cancer realizes that the cancer experience does not end the day that treatment ends. People want to get back to their normal lives and put cancer behind them but at that same time, they’re dealing with all kinds of post-Cancer Treatment effects that affect them physically, emotionally and spiritually. Be the personal trainer that helps them get back to their normal lives!
The Effects of Breast Cancer Surgery & Treatment
Breast Cancer Surgery will typically result in:
- Pain to the affected areas
- Tightness in the chest, underarms, sides, and abdominals
- Reduced range of motion in the shoulder
- Postural deviations such as internal shoulder rotation and hunched shoulders and upper back
- Weakness in the affected muscles such as pecs and lats
- Muscle imbalances
- Internal Shoulder rotation, postural deviations, weakness & muscle imbalance in pecs/lats/seratus
- Decreased Bone Mineral Density and loss of muscle as a result of Chemotherapy and Radiation. The loss in Bone and Muscle one year after chemo and radiation is the same as 10 year losses in women!
Goals of a Post-Breast Cancer Rehab Program
When starting an exercise program after Breast Cancer surgery and treatment, your clients goals will be to reverse the negative affects of killing cancer…which can cause other secondary issues. These goals include:
- To restore strength and flexibility to particular joints and muscle groups that have become weak, stiff and inflexible as a result of surgery.
- Depending on type of surgery, nerve damage may be present causing muscular dysfunction (lats, serates). Strengthening surrounding muscle groups will be critical.
- To minimize the development of scar tissue
- To Re-train postural muscles
- To Reduce risk of lymphedemia for those cancer survivors who have had Lymph nodes removed. This results in chronic or sometimes permanent, abnormal swelling in the arm or hand, often accompanied by tightness, pain, or heaviness around the surgical area.
- To improve cardiovascular fitness
- To minimize weight gain and maintain body composition
- To maintain muscle mass and maximize body strength
- To improve bone mineral density
Post-Breast Cancer Rehab:
The type of Breast Cancer treatment and surgery will determine a woman’s recovery, how her body is affected and the post rehab process so you will need to work closely with your client and your client’s therapist who specializes in post-Breast Cancer rehab.
You will want to get the go-ahead from your client’s physician to begin an exercise program but typically clients can begin a light post-rehab program a few weeks after surgery and a more aggressive protocol an average of 10 weeks post surgery. Work closely with your client’s physician and therapist to determine effective and safe protocol.
Range of Motion:
Initially, you will want to focus on ROM at the shoulder. You can have your client start with holding each stretch for 15 seconds x 3-4 sets. Most women are very protective of the affected shoulder so ease into the stretches avoiding pain and gradually progress the stretch as the tissues allow. As the range of motion improves, your client will be able to go deeper into the stretches. Here is a variety of stretches to start with:
- Supine Single Arm Shoulder Stretch – Lie on your back with your arms at your side. Slowly lift the affected arm up and back over your head until you feel the stretch. Return to the starting position. You can assist with your unaffected arm or use a pillow beside your head to control the range of motion at the deepest stretch.
- Butterfly stretch – Lie on your back with your hands at your neck and elbows pointed towards the ceiling. Slowly let the elbows drop to the side. You can use a pillow under the affected arm to control range of motion.
- Wall Climb – Stand in front of a wall and slowly walk your affected arm up the wall until you feel the stretch. You can use your unaffected arm to assist.
- Perform this wall climb from a variety of angles – front and side and in between
- Single arm chest/doorway stretch – Stand within a doorway. Place your affected arm at shoulder height and move forward into the chest and shoulder stretch. You can perform this stretch with arm bent and straight. Perform the stretch at various angles – shoulder height, above shoulder height and below shoulder height to involve all the tissue fibers.
- Seated Side Stretch – Sit with your body tall and spine extended. Slowly reach the affected arm up and over to the other side while maintaining good posture.
- Towel Stretch – Take a towel behind your back and hold each end in one hand. Slowly straighten and bend your arms back and forth as you stretch through your shoulders.
- Overhead Tricep Stretch – Lift one arm up and bend at the elbow placing the hand on your upper back area as if you are trying to scratch your upper back. Take the other arm and apply light pressure downwards on the elbow to assist the stretch.
Cardio:
Aerobic exercise is very important for physical and emotional well-being. It will help a woman deal with the negative effects to her self esteem and giver her a natural high. Walking or hiking is the perfect post-surgery exercise because she can do it pain-free with very little negative implications to the affected areas. She can start with 20-30 minutes (continuous or intermittent) at a moderate Intensity, three times per week. She can gradually increase her frequency, duration and intensity as her body allows and she can begin implementing other activities as her body heals.
Muscle Conditioning:
As her range of motion improves and pain subsides, it is very important that she start a strength training program to minimize muscle atrophy, improve strength, enhance bone density and prevent posture deviations and muscle imbalances.
She can start with little or no resistance and then slowly add resistance as her body manages the load. Start with1 set of 8-12 reps of a variety of exercises for the lower body, upper body and core. She can increase to 2-3 sets or increase the number of exercises she performs. It’s a good idea to rotate between Lower & Upper Body exercises to allow for recovery in between sets and to help prevent lymphedema.
Since certain muscles and joints will be more affected from Breast Cancer surgery and treatment, exercises to strengthen the Lower and Middle Trapezius, Rotator Cuff, Rhomboids, Lats, Chest, Shoulders, and Core will be very important for the Breast Cancer Survivor.
A list of good specific Post-Breast Cancer Strength Training Exercises include:
- Lower/Mid Trap Floor Presses
- Lower/Mid Trap Wall Presses
- Prone Lower/Mid Trap Arm Lifts
- Shoulder Tubing Exercises
- Variety of angles
- Back Rows
- Back Flies
- External Rotation – Side Lying/Standing
- Chest Press/Flies
- Pullovers
- Standing Torso rotation
- Oblique Crunch
- Prone/Quad Opposite Arm/Leg
Although women are never the same after Breast Cancer, we have many clients who have gone on to living incredibly healthy, fit, rich and adventurous lives post Breast Cancer – and some are actually in even better shape now because they’ve taken a very active role in their overall health and well being. Here’s to helping your clients reach their Personal Best!
Yours in Health, Fitness & Business,
Sherri McMillan
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