Dedicated to: Deborah Schwarcz Friedmann, sister of Audrey Chernofsky

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2 The OsteoBall Workout for Breast Cancer Survivors is a unique, new concept in exercise designed by a leading medical authority, Dr. Robert L. Swezey, M.D., FACP, MACR, FAAMPR, internationally recognized author and lecturer on back pain, arthritis, osteoporosis and other musculoskeletal disorders; Annette M. Swezey, MSPH, Health Educator, noted author and lecturer; co-developed by Audrey Chernofsky, PT OsteoBall and Wellness Community exercise instructor. Special Appreciation to Karen Hunt, Wendy Hirsch and Kim Brown for assistance on making this OsteoBall Workout for Breast Cancer Survivors. Dedicated to: Deborah Schwarcz Friedmann, sister of Audrey Chernofsky Disclaimer The advice and methods contained herein may not be suitable for each individual. It is always a good idea to check with your physician before starting any new exercise program. The information and programs in this Manual cannot take the place of personalized medical treatment. Any new and/or persistent ache or pain should be checked by your health professional.

3 The OsteoBall Workout for Breast Cancer Survivors STANDING EXERCISE SERIES

4 INTRODUCTION The goals of this easy-to-learn OsteoBall Workout for Breast Cancer Survivors are to help you rapidly regain and maintain strength and flexibility. The pleasant reality is that survivors can and do return to the lifestyle they had before cancer. There s no waiting with the OsteoBall you can start these simple exercises the day after surgery (of course, check with your physician before starting any exercise program). The American Cancer Society recommends that all women with any surgery for breast cancer do stretching and strengthening exercises after surgery. The OsteoBall uses little space. It is inexpensive. It is lightweight and compact. It can travel with you anywhere. It is the essence of convenience. Your OsteoBall Workout builds muscle & bone, and helps reduce body fat. The OsteoBall works on the principle of isometric resistive exercises one of the fastest workouts around just 10 minutes every other day is all that is required. OsteoBall exercises stretch you too. When your muscles are gradually stretched through a full range of motion, you gain flexibility. The softness of the OsteoBall allows you to comfortably stretch you move better and feel better. For added fitness, you can augment your OsteoBall Workout with cardio aerobic exercises. Turn the page and let s start..

5 --- WHAT S AHEAD--- BREATHING POSTURE CHECK 1. Chin-In 2. Pelvic Pinch WARM-UPS 1. Beginning Shoulder Circles 2. Shoulder Shrugs 3. Overhead Reach 4. Marching 5. Side to Side STRETCHES STANDING UPPER EXTREMITIES 1. Upper Back and Shoulder 2. Wall Roll-Up 3. Chest (Pect) 4. Lats Side 5. Maybe 6. Yes 7. No STRETCHES LYING DOWN LOWER EXTREMITIES 1. Hamstring (Knee Bent) 2. Hamstring (Knee Straight) 3. Calf Stretch 4. Figure 4

6 --- WHAT S AHEAD--- (CON T) STRENGTHENING EXERCISES UPPER EXTREMITIES 1. Posture Toner 2. Upper Back Strengthener 3. Arm Puller 4. Pect Squeeze 5. Internal Rotation 6. External Rotation 7. Lateral Shoulder Press 8. Shoulder Punch 9. Shoulder Push Back 10. Wall Push Up 11. Shoulder Roll 12. Side Shoulder Roll STRENGTHENING EXERCISES LOWER EXTREMITIES 1. Heel Raises 2. Outer Thigh Toner 3. Inner Thigh Toner 4. Inner Thigh Toner Wall Slide 5. Wall Slide with OsteoBall

7 TO START, pick a few exercises from each section (warm-ups, stretches--upper extremities; stretches--lower extremities; strengthening exercises--upper extremities and strengthening--lower extremities) that work easily for you. PROGRESS with the more challenging exercises as you build your flexibility and strength.

8 BREATHING IMPORTANT! During each strengthening exercise, say OUT LOUD, Push-1, Push-2, Push-3, Push-4, Push-5. WHY? This is to ensure that you exhale (breathe out) properly as you gradually increase the pushing or pulling effort required. Failing to exhale as you exert a strong force may stress your heart. With each PUSH or PULL, try to increase the intensity of the push or pull a little more each time. (Avoid pumping action.) After completion of each exercise, relax and count, 1001 to 1005, slowly breathing in and out. Rest as needed before you repeat the exercise or move on to the next exercise. On some exercises you will say, Push, to properly exhale while you are actually pulling on the straps of the OsteoBall. 1

9 POSTURE CHECK (Starting Positions) To ensure that the OsteoBall exercises are done in correct alignment there are two basic postural exercises. These key stabilization movements help prevent strain on the neck and back are the basis of all OsteoBall exercises. CHIN-IN Keeping your eyes level, glide your chin back until you feel a gentle stretch at the back of your neck. Now relax slightly. This places your head in a balanced alignment. (Hint: Look in the mirror and check if your earlobes are aligned with the edge of your shoulders). continue for Pelvic Pinch 2

10 PELVIC PINCH Gently tighten your lower abdominal muscles and at the same time squeeze your buttocks muscles together. This is a very subtle movement, which causes a stabilization of your lower back. 3

11 OSTEOBALL WARM-UPS 1 BEGINNING SHOULDER CIRCLES 2. SHOULDER SHRUGS 3. OVERHEAD REACH 4. MARCHING 5. SIDE TO SIDE 4

12 BEGINNING SHOULDER CIRCLES 1. Stand in a chin-in, pelvic pinch position. 2. Hold the OsteoBall waist height with the palms of your hands on either side of the OsteoBall. 3. Move the Osteoball slowly in a gentle, circular, forward motion - up and forward, down and back. 3 times. 4. Then move the Osteoball gently in a backward motion - back and down, forward and up. 3 times. 5. Between each repetition, relax a few seconds as you maintain chin-in, pelvic pinch. 5

13 SHOULDER SHRUGS 1. Stand in a chin-in, pelvic pinch position. 2. Hold the OsteoBall waist height with the palms of your hands on either side of the OsteoBall. 3. Shrug your shoulders gently up toward your ears. 4. Hold and slowly count out loud, 1001, 1002, to Relax and lower your shoulders. 6. Repeat this exercise 2-3 times. 6

14 OVERHEAD REACH 1. Stand in a chin-in, pelvic pinch position. 2. Hold the OsteoBall at waist height with the palms of your hands on either side of the OsteoBall. 3. Lift the OsteoBall up overhead as high as you can comfortably reach. 4. Bring the OsteoBall back down to your waist. 5. Repeat 3 times. 6. Relax. 7

15 MARCHING 1. Stand in a chin-in, pelvic pinch position. 2. Hold the OsteoBall at waist height with the palms of your hands on either side of the OsteoBall. 3. As if you are marching, raise your right knee up to the OsteoBall and then lower it to starting position. 4. Raise your left knee up to the OsteoBall and then lower it to starting position. 5. Repeat at least 5 times in a marching motion. 6. Relax. 8

16 SIDE-TO-SIDE 1. Stand in a chin-in, pelvic pinch position. 2. Hold the OsteoBall at chest level. 3. Move the OsteoBall across your chest to the left and then to the right. 4. Repeat 3 times. 5. Bring the OsteoBall back to your waist. 6. Relax. 9

17 STANDING UPPER EXTREMITIES STRETCH 1. UPPER BACK AND SHOULDER 2. WALL ROLL-UP 3. CHEST (PECT) 4. LATS SIDE 5. MAYBE 6. YES 7. NO 10

18 UPPER BACK AND SHOULDER 1. Stand with your back to the wall. Assume the chin-in, pelvic pinch position with your eyes level. 2. Place the OsteoBall at your mid-back below your shoulder blades. 3. With your arms at your sides and your palms facing forward, roll your shoulders back. 4. Hold for the count of Relax 6. Repeat 3 times. Target Areas: Pectorals, Anterior Deltoids 11

19 WALL ROLL-UP 1. Stand facing the wall with the OsteoBall in your hand. 2. Put the OsteoBall against the wall at chest height. 3. Stand 2 feet from the wall with your feet hip width apart. 4. Assume the chin-in, pelvic pinch position. 5. Place your palms flat against the OsteoBall. 6. Put one hand in front of the other as you roll the OsteoBall up the wall as far as is comfortable; feel a stretch in your arms. Hold for a count of Maintain chin-in, pelvic pinch as you roll the OsteoBall back down the wall to starting position. 8. Relax. 9. Repeat 3 times. Target areas: Latissimus Dorsi, Serratus Anterior 12

20 CHEST (PECT) 1. Stand with your back to the wall with the OsteoBall in your hand. 2. Place the OsteoBall behind your mid-back and against the wall. 3. Maintain chin-in, pelvic pinch as you lean back into the OsteoBall. 4. Bend your arms at your elbows to right angles (shoulder height) with the palms of your hands facing forward. 5. Bring your elbows back and pinch your shoulder blades towards each other. 6. Inhale as you keep your abdominals drawn in. 7. Exhale as you hold this stretch for 5 seconds. 8. Repeat 3 times. Target Areas: Pectorals, Anterior Deltoids 13

21 LATS SIDE 1. Stand with your left side next to the wall with the OsteoBall in your right hand. 2. Assume the chin-in, pelvic pinch position. 3. Place your left hand on the wall at shoulder height. 4. Place the OsteoBall under your left armpit. 5. Slowly lift and stretch your right arm up and over your head. 6. Hold the stretch for 5 seconds. 7. Slowly return to the starting position. 8. Repeat 3 times. 9. Repeat exercise on the right side 3 times. Target Areas: Latissimus Dorsi, Subscapularis 14

22 MAYBE 1. Stand with the OsteoBall at waist level and with your hands on either side of the OsteoBall. 2. Assume the chin-in, pelvic pinch position. 3. Keeping your shoulders down, look straight ahead. 4. Drop your right ear down toward your right shoulder until you feel a stretch. 5. Breathe comfortably and hold stretch for a count of Return to the starting position. 7. Looking straight ahead, move your left ear toward your left shoulder. 8. Breathe comfortably and hold stretch for a count of Return to the starting position. 10. Relax. 11. Repeat 3 times. Target Areas: Sternocleidomastoid, Trapezius 15

23 YES 1. Stand with the OsteoBall at waist level with your hands on either side of the OsteoBall. 2. Assume the chin-in, pelvic pinch position. 3. Keeping your shoulders down, look straight ahead. 4. Bring your chin to your chest until you feel a stretch. 5. Breathe comfortably and hold stretch for a count of Return to starting position. 7. Relax. 8. Repeat 3 times. Target Areas: Trapezius, Scalenes 16

24 NO 1. Stand with the OsteoBall at waist level with your hands on either side of the OsteoBall. 2. Assume the chin-in, pelvic pinch position. 3. Keeping your shoulders down, move your neck slowly to each side as if to say, No. 4. Breathe comfortably and hold stretch for a count of Return to the starting position. 6. Relax. 7. Repeat 3 times. Target Areas: Sternocleidomastoid, Levators 17

25 LYING DOWN LOWER EXTREMITIES STRETCH 1. HAMSTRING STRETCH (KNEE BENT) 2. HAMSTRING STRETCH (KNEE STRAIGHT) 3. CALF STRETCH 4. FIGURE 4 18

26 HAMSTRING STRETCH (KNEE BENT) 1. Lie Down with knees bent, chin-in and do a pelvic pinch with the OsteoBall next to you. 2. Place one handle of the OsteoBall around the ball of the foot of your left leg and grasp the other handle with both hands. 3. Keep your chin-in and pelvic pinch as you straighten your left leg. 4. Gently pull the handle of the OsteoBall with both hands, bringing your left leg up towards you, until you feel a stretch in the back of your left thigh and knee. 5. Hold this stretch for 5 seconds. 6. Relax. 7. Repeat 3 times. 8. Repeat this stretch with the OsteoBall placed around the ball of your right foot. 9. Relax. Target Areas: Hamstrings 19

27 HAMSTRING STRETCH (KNEE STRAIGHT) 1. Lie down with knees bent, chin-in and do a pelvic pinch with the OsteoBall next to you. 2. Place one handle of the OsteoBall around the ball of the foot of your left leg and grasp the other handle with both hands. 3. Gently pull the handle of the OsteoBall with both hands*, bringing your left leg up towards you with your knee straight. Keep your right leg straight on the floor. Pull until you feel a stretch in the back of your left thigh and knee. 4. Hold this stretch for 5 seconds. 5. Relax. 6. Repeat 3 times. 7. Repeat this stretch with the handle of the OsteoBall placed around the ball of your right foot with your left leg straightened on the floor. 8. Relax. 9. Repeat 3 times. *Note: Keep wrist(s) as straight as possible. Target Areas: Hamstrings 20

28 CALF STRETCH 1. Lie down with knees bent, chin-in and do a pelvic pinch with the OsteoBall next to you. 2. Place one handle of the OsteoBall around the foot of your right leg and hold the other handle with both hands. Note: Keep wrist(s) as straight as possible. 3. Maintain chin-in, pelvic pinch as you extend your right leg. 4. Bend your right ankle towards you as you gently pull on the handle of the OsteoBall. 5. Feel a stretch in the back of your right calf. 6. Breathe as you hold the stretch for 5 seconds. 7. Relax. 8. Repeat 3 times. 9. Repeat this exercise extending your left leg and bending your left ankle toward you. 10. Relax. 11. Repeat 3 times. Target Areas: Gastroc-Soleus 21

29 FIGURE 4 1. Lie on your back with your knees bent and feet flat on the mat with the OsteoBall next to you. 2. Do a mild pelvic pinch. 3. Cross your right leg over your bent left leg resting your right ankle on your left knee. 4. Place the OsteoBall on your lap. 5. Push the OsteoBall against your right leg. 6. Feel the stretch in your buttock or outer thigh. 7. Hold for 5 seconds. 8. Relax. 9. Repeat exercise 3 times. 10. Repeat exercise on your left side. Target Areas: Gluteus Maximus, Plantaris 22

30 UPPER EXTREMITIES STRENGTHENING 1. POSTURE TONER 2. UPPER BACK STRENGTHENER 3. ARM PULLER 4. PECT SQUEEZE 5. INTERNAL ROTATION 6. EXTERNAL ROTATION 7. LATERAL SHOULDER PRESS 8. SHOULDER PUNCH 9. SHOULDER PUSH BACK 10. WALL PUSH UP 11. SHOULDER ROLL 12. SIDE SHOULDER ROLL 23

31 POSTURE TONER 1. Stand with feet hip width apart, knees soft and the OsteoBall in your hand. 2. Hold onto the handles with each hand and place the OsteoBall behind your neck and upper back with your elbows facing forward. 3. Assume the chin-in, pelvic pinch position. 4. Take a deep breath. 5. Without moving your head, pull the handles of the Osteoball forward. 6. As you exhale, feel your neck lengthen and slowly count out loud, Push 1 to Push Relax and lower the OsteoBall in front of you and count, 1001 to Repeat 3-5 times. Target Areas: Trapezius, Semispinalis 24

32 UPPER BACK STRENGTHENER 1. Stand with your back to the wall, with your feet hip width apart, knees soft and the OsteoBall in your hand. 2. Place the OsteoBall behind you against the wall at a level between your waist and buttocks. 3. Place the palms of your hands flat on the OsteoBall. 4. While keeping the pressure on the OsteoBall with your hands, step one to two inches forward. 5. Assume the chin-in, pelvic pinch position. 6. Take a deep breath. 7. PUSH the OsteoBall with your hands with increasing force. (Do not lean your body into the OsteoBall.) Your back should not touch the OsteoBall. 8. As you push the OsteoBall with increasing force, exhale and slowly count out loud, Push 1 to Push While keeping your hands in place, lean against the OsteoBall to relax and count, 1001 to Repeat 3-5 times. Target Areas: Rhomboids, Traps 25

33 ARM PULLER 1. Stand with your feet hip width apart, knees soft and the OsteoBall in your hands. 2. Hold the Osteoball at waist level. 3. Grasp each handle of the OsteoBall. 4. Assume the chin-in, pelvic pinch position. 5. Take a deep breath. 6. Pull the handles away from the OsteoBall steadily and with increasing effort. 7. Exhale as you slowly count out loud, Push 1 to Push Relax your arms and count out loud, 1001 to 1005, to rest. 9. Repeat 3-5 times. Target Areas: Deltoids 26

34 PECT SQUEEZE 1. Stand with your feet hip width apart, knees soft and the OsteoBall in your hands. 2. Assume the chin-in, pelvic pinch position. 3. Place the OsteoBall between your forearms with your palms flat and raise the Osteoball to chest level. 4. Take a deep breath. 5. Squeeze your forearms together with increasing force. 6. Count exhaling, Push 1 to Push Take an additional breath as needed. 8. Relax, lower the OsteoBall. 9. Count, 1001 to Repeat exercise 3-5 times. Target Areas: Pectoralis Major 27

35 INTERNAL ROTATION 1. Stand with your feet hip width apart, knees soft and the OsteoBall in your hands. 2. Hold the OsteoBall at waist level. 3. Bend your elbows and place your palms flat against the OsteoBall. 4. Keep your elbows tight at your sides. 5. Assume the chin-in, pelvic pinch position. 6. Take a deep breath. 7. Push your forearms together with increasing force, count, Push 1 to Push Relax, lower the OsteoBall. 9. Count, 1001 to Repeat exercise 3-5 times. Target Areas: Subscapularis 28

36 EXTERNAL ROTATION 1. Stand with your feet hip width apart, knees soft and the OsteoBall in your hands. 2. Hold the OsteoBall at waist level. 3. Grasp each handle of the OsteoBall. 4. Bend your elbows at right angles. 5. Assume the chin-in, pelvic pinch position. 6. Keep your head erect with your elbows tight at your side. 7. Take a deep breath. 8. Steadily and with increasing effort, pull the handles away from the OsteoBall. 9. Exhale as you slowly count out loud, Push 1 to push Relax your arms and count out loud, 1001 to Repeat 3-5 times. Target Areas: Infraspinatus 29

37 LATERAL SHOULDER PRESS 1. Stand holding the OsteoBall with your side one foot away from the wall. 2. Place the OsteoBall between your right forearm and the wall. 3. Bend your right elbow and keeping your shoulder down, push the OsteoBall into the wall with your right forearm. 4. Continue to Push as you count, Push 1 to Push Relax. 6. Repeat 3-5 times. 7. Turn around and repeat the Shoulder Press with your left forearm. 8. Repeat 3-5 times. Target Areas: Deltoid, Supraspinatis 30

38 SHOULDER PUNCH 1. Stand facing the wall with the OsteoBall in your hands. 2. Place the OsteoBall against the wall at your waist height and keep the OsteoBall in place. 3. Bend your right elbow. 4. Make a fist with your thumb up. 5. Push your fist straight into the Osteoball and hold for 5 seconds. 6. Relax. 7. Repeat 3-5 times. 8. Repeat exercise on your left side. Target Areas: Anterior Deltoid 31

39 SHOULDER PUSH BACK 1. Stand in good posture with your back to the wall. 2. Place the OsteoBall between your right elbow and the wall. 3. Assume the chin-in, pelvic pinch position. 4. Take a deep breath. 5. Hold the OsteoBall handle with your left hand. 6. Push your right elbow into the OsteoBall with your palm up. 7. Count out loud, Push 1 to Push Relax and count, 1001 to Repeat 3-5 times. 10. Repeat 3-5 times on your left side. Target Areas: Latissimus Dorsi, Deltoids 32

40 WALL PUSH UP 1. Stand facing the wall with the OsteoBall in your hands. 2. Position yourself 2 to 3 feet from the wall with your feet hip width apart and knees soft. 3. Place the OsteoBall against the wall at shoulder height. 4. Assume the chin-in, pelvic pinch position. 5. With your arms straight, place the palms of your hands flat on the OsteoBall. 6. Tighten your abdominals, do a pelvic pinch and lower your chest toward the OsteoBall. 7. Breathe comfortably. 8. Push back from the wall with your arms and return to the starting position. 9. Relax. 10. Repeat 3-5 times. Target Areas: Serratus Anterior 33

41 SHOULDER ROLL * 1. Stand facing the wall. 2. Assume the chin-in, pelvic pinch position. 3. Place the OsteoBall against the wall at shoulder height. 4. Hold it in place with the palm of your right hand. 5. Keep your shoulder blades down and in and keep your elbow straight. Roll 10 small circles with the OsteoBall against the wall. 6. Relax. 7. Repeat the exercise, rolling the OsteoBall in the opposite direction. 8. Relax. 9. Repeat exercises with your left hand against the OsteoBall. *STABILIZATION Target Areas: Trapezius, Scapular Stabilizers 34

42 SIDE SHOULDER ROLL 1. Stand with your right side to the wall. 2. Assume the chin-in, pelvic pinch position. 3. With your right hand, keeping your elbow straight, place the OsteoBall against the wall at shoulder height. 4. Keep your shoulder blades down and back. 5. Roll 10 small circles. 6. Relax. 7. Repeat 10 circles in the opposite direction. 8. Relax. 9. Turn and place the OsteoBall against the wall with your left hand and repeat the exercise. Target Areas: Trapezius, Scapular Stabilizers 35

43 LOWER EXTREMITIES STRENGTHENING 1. HEEL RAISES 2. OUTER THIGH TONER 3. INNER THIGH TONER 4. INNER THIGH TONER WALL SLIDE 5. WALL SLIDE WITH OSTEOBALL 36

44 HEEL RAISES 1. Stand with your feet hip width apart. 2. Hold the OsteoBall with the palms of your hands on either side of the Osteoball. 3. Lift both heels off the ground as high as you can. 4. Hold this position for 5 seconds. 5. Slowly, lower your heels down to the ground. 6. Relax. 7. Repeat 3-5 times. Target Areas: Gastrocnemius, Soleus 37

45 OUTER THIGH TONER 1. Stand with your right side against a wall, knees soft and the OsteoBall in your hand. 2. Assume the chin-in, pelvic pinch position. 3. Place the OsteoBall between your right upper thigh and the wall. 4. Keep your right hand on the wall for support. 5. Raise your right foot 1 inch off the ground. 6. Maintain posture. Push your right outer thigh into the OsteoBall. (Do not lean to either side.) 7. Hold for 5 to 10 seconds. 8. Return your foot to the floor. 9. Repeat 3-5 times. 10. Relax. 11. Repeat 3-5 times on your left side. Target Areas: Gluteus Medius 38

46 INNER THIGH TONER 1. Stand with your back against the wall, feet facing forward hip width apart and your knees soft. 2. Place the OsteoBall between your inner thighs. 3. Assume the chin-in, pelvic pinch position. 4. Squeeze the OsteoBall between your inner thighs. 5. Hold for 5 seconds. 6. Relax. 7. Repeat 3-5 times. Target Areas: Hip Adductors, Adductor Magnus 39

47 INNER THIGH TONER WALL SLIDE 1. Stand with your back against the wall, feet facing forward hip width apart and your knees soft. 2. Place the OsteoBall between your inner thighs. 3. Assume the chin-in, pelvic pinch position. 4. Squeeze the OsteoBall between your inner thighs. 5. Bend your knees as you slowly slide down the wall to a comfortable position. (Avoid leaning forward.) 6. Hold for 5 seconds. 7. Slide back up the wall. 8. Relax. 9. Repeat 3-5 times. Target Areas: Hip Adductors, Adductor Magnus, Gracilis, Quadriceps, Gluteus Maximus 40

48 WALL SLIDE WITH OSTEOBALL 1. Stand with your back a foot away from the wall with your feet hip width apart and your knees soft. 2. Assume the chin-in, pelvic pinch position. 3. Place the OsteoBall between your lower back and the wall. 4. Maintain posture as you hold the OsteoBall against the wall. 5. Bend your knees as you slowly slide the OsteoBall down the wall. To a comfortable level. (Avoid leaning forward.) 6. Hold the slide for 5 seconds. 7. Slowly slide back up the wall. 8. Repeat 3-5 times. 9. Relax. Target Areas: Quadriceps, Gluteus Maximus 41

49 A portion of this Workout for Breast Cancer Survivors will be donated to Breast Cancer Research Sixteenth Street, Santa Monica, California MMXI, Dr. Robert L. Swezey, MD, Annette M. Swezey, MSPH

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