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Carol Michaels

Oncology Exercise - Breast Cancer



The best exercises for someone recovering from breast cancer include aerobic exercise, strength training, stretching using relaxation breathing, and balance and posture work. The particular surgery, treatments, fitness level and healing speed will guide the progression of the exercises. The recovery process is always changing and it will will be important to regularly monitor  blood count, muscle and joint pain, nausea, and fatigue.

Precautions for Stretching and Strengthening

1. Your immune system may be compromised, which places you at risk for infection. Gyms carry a high risk for infection. 

2. If you have poor balance, you may want to start with the exercises that are safer for those who have balance problems. Poor balance may be due to the chemotherapy, weak muscles, neurological issues, or normal aging. A common side effect of chemotherapy is peripheral neuropathy, which changes the sensation in the legs or arms. It can last a short time or be long lasting. This can affect the way you walk, your balance, and your general movement. If you have peripheral neuropathy, you should select activities that decrease your risk of falling. For example, we recommend avoiding uneven surfaces and exercising with a stationary bike instead of a treadmill without handles. Strengthening your core will help your balance. It is also a good idea to keep all the muscles strong to compensate for the ones that are affected by the neuropathy.

3. Be smart and safe by doing the exercises that are right for you at this particular time. You are exercising to get healthy, not to get hurt. This is an important point to keep in mind, particularly for those who were physically active before cancer. You will not be able to immediately resume the same level of pre-cancer activity.

4. Exercise in a temperature controlled environment. Cold temperature can crack your skin, while extreme heat can cause swelling or light-headedness.

5. At the start of your exercise program, you should warm up with deep breathing techniques and shoulder rolls. We recommend that you warm up before you stretch by walking, marching in place or using a stationary bike. You can also exercise after a warm shower, which may relax the muscles.

6. Never hold your breath during an activity. People often hold their breath during exercise, so remember to breathe deeply.

7. Drink plenty of water, especially when sweating.

8. If your blood counts or the mineral levels (potassium and sodium) are low, check with your oncologist before resuming exercise.

9. Some medications affect the heart rate, so your pulse rate is not a good indicator of the level of your exercise exertion.

10. Learn to move slowly and smoothly without jerky movements. Do not continue an activity if it causes pain or unusual fatigue. You should feel a gentle stretch, not pain.

11. Know your limits. You should be able to differentiate between discomfort and unusual pain. Stop if you feel pain.  Listen to your body and use common sense. If something does not feel right, do not do it. You should consult with your doctor if you are experiencing pain, swelling, or unusual fatigue.

12. Wear comfortable and loose clothing and appropriate footwear. For those with peripheral neuropathy affecting the feet, supportive footwear is particularly important.

Precautions for Strength Training

1. Add strength training after you have achieved almost full range of motion. If you are able to touch your opposite ear by placing your arm over your head without feeling a stretch, you can start to slowly add strength training exercises. If you take a few days off from exercising, decrease the amount of weight used when you return to strength training.

2. We recommend that you warm up before strength training by walking, marching in place, or using a stationary bike.

3. Good form is important. Focus on quality over quantity of repetitions.

4. Rotate your muscle groups so that you don’t overwork the muscles in one area.

5. Avoid the natural tendency to use heavier weights on your stronger side. Your weaker side will set the limits on the amount of weight used. This is determined by the amount of weight that you can lift for 10 repetitions in perfect form, feeling some fatigue by the eighth repetition.

6. Aim for slow gradual improvement and gradually increase the weight that you use. We suggest that you increase the amount of weight used in 1-pound increments. Having patience will prevent you from using a heavy weight and causing a problem. Being patient and consistent will help you achieve your goals. Remember: quality over quantity.

7. Wait 48 hours between strength training sessions. Use the day in between strength training sessions for aerobic exercise and stretching.

8. Cool down after you exercise by walking or stretching,

Understand your lymphedema risk. Although lymphedema may not be evident, your lymphatic system may function below normal. A gradual, progressive strength-training program may actually minimize the chance of developing lymphedema by widening the remaining lymphatic channels. Wide channels can handle the increase in the flow of lymph created by vigorous exercise. Stretches can ease tightness and scarring that block lymphatic flow. 

Contact us at CarolMichaelsFitness.com for our oncology exercise schedule.


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