5 Tips for Overcoming Fitness Challenges After Breast Cancer Treatment

No one thinks that they are going to get cancer, especially when you’ve spent a good portion of your life doing everything right. Breast cancer is on the rise and continues to impact women of all ages every year. One in eight women will be diagnosed with this disease and everyone knows someone that has been impacted by cancer [1].

As both a breast cancer survivor and a Cancer Exercise Specialist, I want to share tips on overcoming challenges when rebuilding your strength and fitness during and after cancer treatment.

When I was diagnosed with breast cancer, it came as a huge shock: I was in the best physical shape of my life! I exercised 5-6 days a week and ate a well-balanced diet; cancer was not even on my radar at that time of my life.

In hindsight, there were a few key health considerations that I was neglecting in my wellness routine, like prioritizing sleep and proper stress management. Yet, I just didn’t fit the profile of a high-risk candidate. Even without family history of the disease, some of us can be at a genetic disadvantage based on our individual genome.

Cancer has taught me some valuable lessons and I’ve learned that even those of us who are health conscious are not without risk. I’ve made it a top priority to spread awareness and help other women battling this disease.

Don’t forget to feel your boobies and schedule your yearly mammogram!

How Exercise Comes in After Treatment

Exercise, soft tissue work, stress management and adequate rest are essential for healing and overall wellness during and after cancer treatment. Research shows that it’s not only safe to exercise after cancer, but also extremely beneficial during treatment [2]. There have been more than 80 studies evaluating the effects of exercise on cancer patients. Exercise has been shown to improve quality of life and tolerance of symptoms.

If you are currently undergoing cancer treatment, speak to your doctor about exercise recommendations. Every case is unique and each patient will have a period of recovery time where physical activity is prohibited or limited. Your doctor might advise you to avoid range of motion exercises for a specified time period for tissue healing.

Walking is a great low-impact exercise that you can do to help boost your mental health and energy levels. Walking is typically good for most patients throughout the treatment process, unless a patient is dealing with severe anemia.

Recommendations for exercise; frequency, type, duration and level of intensity should be individualized based on various personal factors and treatment protocol. Even survivors who are dealing with extreme fatigue from their therapy will benefit from short bouts of stretching exercises each day. Cancer-related fatigue occurs in 75 to 90 percent of survivors. Exercise has been shown to reduce daily fatigue in women with breast cancer receiving chemotherapy [3].

Typically, the rehabilitation program is divided into four phases. Each phase has a specific focus to help the client improve mobility, stability and rebuild strength. It’s normal to experience tightness in your chest and arm after cancer surgeries and radiation. This will improve over time with a good exercise program. Massage therapy is also an excellent adjunct treatment.

Seeking out a breast cancer exercise specialist, who is trained to design an exercise protocol after surgery and will work with your physician to build a personalized plan, can be a great way to orient your efforts.

My Top Tips for Regaining Your Fitness Groove After Cancer Treatment

1. Focus on the Fascia

Fascia mobility is important for normal functioning of the musculoskeletal system. Our fascia is made up of elastin, water and collagen and surrounds muscles, neurovascular bundles, organs and groups of muscles. Basically, our fascia surrounds every structure in the body. When this network of fascia is inhibited by trauma or repetitive movements, tension is transmitted along the fascial planes. When a cancer patient experiences chronic pain, it’s usually from a buildup of scar tissue and an accumulation of dense restricted fascia. When the fascia is free, our body moves more freely. Stretch fascia and muscles in all planes of motion. Massage therapy can also assist with fascial release.

2. Practice Diaphragmatic Breathing

Focusing on the breath during your exercises helps reduce tension. Deep breathing is also an excellent way to reduce anxiety and stress, since it signals the brain to relax.  When you are undergoing cancer treatment, stress reduction is helpful in your healing process.

3. Build Up To a Minimum of 30 Minutes of Exercise Five Days a Week

Pick an activity that you enjoy, so you’ll want to do it often. If you’re not having fun, you’re less inclined to make it a regular habit. Start with short sessions of 10-15 minutes, three to five days per week, of walking or another low-impact aerobic exercise. If this feels great, build up to 30-60 minutes of activity three to five days per week. While undergoing treatment, try to continue your usual physical activity. You can reduce the duration and intensity, if needed, depending on how you are feeling.

Cancer survivors are encouraged to follow the U.S. DHHS (U.S. Dept. of Health and Human Services) guidelines for aerobic activity of 150 minutes per week of moderate-intensity exercise or 75 minutes of vigorous-intensity exercise, or a combination of the two. If their health status doesn’t allow this level of activity, the ACSM (American College of Sports Medicine) and U.S. DHHS recommend that they “should be as active as their abilities and conditions allow” and “avoid inactivity. “ [4][5]. Find your fitness groove and rock it!

4. Focus on Exercises That Assist in Shoulder and Core Stabilization

Make sure that your programming includes a wide variety of exercises that help build shoulder and core strength and stability. Making these two things a top priority in my training has made a big difference in my recovery. Resistance bands are inexpensive and an invaluable tool during the rehab process.

5. Slowly Rebuild Strength

When your doctor has cleared you to resume all exercise modalities, start back slowly with resistance training and work your way up. Trust me, I know this firsthand: during my own recovery, I wanted to give a big middle finger to cancer and jump right back into my training. Keeping my insatiable appetite for intense training in check was a struggle, and I’ve had my share of roadblocks along the way, including a wicked bout of tendonitis.

Be patient with the process, and remember what your body has just endured. You have just fought — or are fighting — a difficult battle.

Try not to get discouraged if you can’t pick back up where you left off. Before you know it, you’ll be setting new personal records and amazed at how far you’ve come in your wellness journey!

Here are a few favorite rehabilitation exercises that I’ve incorporated in my own training.

Bilateral Shoulder Flexion

This exercise improves range of motion in the shoulders, and engages the mid-back:

  • Kneel and sit back on your heels.
  • Place your hands on top of the stability ball.
  • Keeping your arms straight, slowly roll the ball from side to side.

You can also do this exercise sitting in a chair, or standing with the ball against the wall.

Trunk Extension and Reach

This exercise works on core stabilization, as well as the shoulder girdle and lats:

  • Wrap a resistance band around a sturdy bar or have someone hold it for you.
  • Sit tall with legs straight, holding the band in the right hand and resting the left hand on top.
  • Exhale and reach back with the left hand, hinging at the hips. Keep the chest lifted.
  • Repeat with the opposite side.

Banded Push Through

This exercise works the lats, shoulder stabilization and strengthens the abdominals:

  • Sit tall with straight legs and feet flexed.
  • Anchor a resistance band to a sturdy bar or have someone hold it from behind and above.
  • Inhale to begin then exhale, scooping the belly in, rounding to form a C-curve from the base of the spine.
  • Relax the shoulders and push through with the core.
  • Return to a seated position, rolling up slowly.

Seated Banded Row

This exercise strengthens upper back and helps counter rounding of the shoulders:

  • Sit on the floor with your chest upright.
  • Loop the band around a bar or the soles of your feet.
  • Start with arms straight in front of your body, then pull back to meet your chest,
    squeezing the shoulder blades together.
  • Return to starting position and repeat.

Arms Over

This exercise improves shoulder range of motion:

  • Lie on your back with the band in each hand, knees bent, feet flat on the floor.
  • The closer your hands are to each other, the more resistance with the band.
  • Engage the mid-traps, inhale to begin then exhale and slowly move arms back towards the floor, widening the band as you lower, moving hands away from each other.
  • Slowly return to starting position and repeat.

References

  1. National Cancer Institute, Surveillance, Epidemiology, and End Results Program, Cancer Stat Facts: Female Breast Cancer. https://seer.cancer.gov/statfacts/html/breast.html
  2. Drouin JS, Armstrong H, Krause S, Orr J, Birk TJ, Hryniuk WM.  Effects of aerobic exercise training on peak aerobic capacity, fatigue and psychological factors during radiation for breast cancer. Rehab Oncol. 2005; 23(1):11-17
  3. Schwartz AL. Daily fatigue patterns and effect of exercise in women with breast cancer. Cancer Pract. 2000 Jan-Feb;8(1):16-24. https://www.ncbi.nlm.nih.gov/pubmed/10732535
  4. Schmitz KH, Courneya KS, Matthews C, Demark-Wahnefried W, Galvao DA, Pinto BM, et. al. American College of Sports Medicine roundtable on exercise guidelines for cancer survivors.  Med Sci Sports Exerc. 2010; 42(7): 1409-1426
  5. Committee. PAGA. Physical Activity Guidelines Advisory Committee Report. In: Services UDHHS, ed. Washington, DC; 2008

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