Breast Cancer, Exercise and Rehabilitation from 3 9 weeks Post op

Size: px

Start display at page:

Download "Breast Cancer, Exercise and Rehabilitation from 3 9 weeks Post op"

Cecily Powell
5 years ago
Views:

1 Breast Cancer, Exercise and Rehabilitation from 3 9 weeks Post op Annually, more than 10 million people are diagnosed with cancer worldwide. This indicates the prevalence of cancer as a universal and relevant disease in society. The most common form of cancer in women, second to lung cancer, is breast cancer. Every three minutes another woman is diagnosed with breast cancer. The woman s quality of life and self worth are affected with this life threatening disease. Exercise has been recommended for helping cancer patients recover from treatment and surgery. It has been shown that exercise levels after treatment has decreased considerably among patients with breast cancer compared to prediagnosis levels. These activity levels were not regained for 1 4 years after the treatment was completed. Exercise is not generally integrated into cancer care or even discussed with cancer patients. The importance of exercise in breast cancer patients Factors such as bone strength, mobility and cardiopulmonary function are affected due to cancer treatment and surgery and have shown to be preserved or restored through exercise benefits. Exercise patterns among cancer patients have indicated to benefit the patients both during and after treatment. Some of these benefits include improving their quality of life, reducing fatigue and improving their energy and assisting with psychosocial issues. Physical activity also has other positive effects such as improving lymphatic drainage and functional capacity, inhibiting the development of tumors by lowering certain hormone levels, improving the individual s overall strength and immune response as well as maintaining the individual s weight at the ideal level. Exercise principles to minimise the risk of breast cancer Most studies indicate that physically active women both premenopausal and postmenopausal have a lower risk of developing breast cancer than sedentary women. High levels of moderate and vigorous physical activity during adolescence have also shown to protect individuals more and a lifetime of regular, vigorous activity is thought to be the most beneficial. The exercise should include cardiovascular training, strength training, range of motion and healthy nutrition. Cardiovascular training should be of moderate intensity (50 70% of heart rate reserve), three to five times a week for the duration of minutes between RPE of

Walking and cycling are both beneficial but other exercise modes that involve large muscle groups such as swimming or hydrotherapy is also recommended but the mode all depends on the treatment side

2 Walking and cycling are both beneficial but other exercise modes that involve large muscle groups such as swimming or hydrotherapy is also recommended but the mode all depends on the treatment side effects. The strength training can begin once the ideal range of motion in the affected shoulder is achieved. The weight and repetitions can be gradually increased depending on the individual. Two sets of ten repetitions, two to three times a week is recommended. Exercises such as triceps extensions, bicep curls, frontal raises, rotator cuff exercises, and seated rows are all safe to execute. Pilates is also another form of resistive training that is beneficial. Exercise programs for breast cancer individuals should aim to achieve the optimal range of motion of the chest and shoulder, maintain optimal weight and psychological functioning, decrease lymphedema and osteoporosis risk. Please refer to the 0 3 week s program post surgery and treatment ( Progressive resistive exercise program 3 6 weeks post surgery and treatment We advise that you consult your healthcare practitioner before beginning this exercise program. If you experience any pain or difficulty with any exercises, stop and consult your healthcare practitioner. Breathing Lateral breathing can assist in stress management and reduce oedema. Place your hands on the rib cage (see below) or wrap a Theraband around the rib cage. Inhale through the nose filling up the lungs and expanding the Theraband sideways or allow the fingers to move away from each other. Exhale through the mouth like you misting up a window and the Theraband will return to normal or the fingertips will move inwards again. 2

Inhale as you hold and then exhale and slowly return your arm back to the side. Repeat this 5 to 7 times on both sides.

3 Mermaid This exercise aids the increase in movement of your trunk and body. Sitting cross legged on the floor or on a chair. Inhale and lift your one arm up over your head and exhale as you slowly laterally flex to the opposite side. Inhale as you hold and then exhale and slowly return your arm back to the side. Repeat this 5 to 7 times on both sides. Arm Scissors Lie supine with knees bent and arms. Arms are both placed at your side and the palms facing inwards, inhale and then exhale as one arm moves into flexion above the head. Inhale; hold this position and then exhale as you switch arms. Repeat 5 to 7 times on each side. 3

Side lying shoulder flexion/extension Lying on your side

Your bottom arm is bent under your ear and the top arm is

Inhale and move the top arm as tolerated into flexion.

4 Side lying shoulder flexion/extension Lying on your side with both knees bent in towards your chest. Your bottom arm is bent under your ear and the top arm is at your side. Inhale and move the top arm as tolerated into flexion. Inhale and hold at that point and then exhale and return to starting position. Repeat 5 to 7 times on both sides. 4

Side lying chest opener Lying on your side, hips stacked and with both shoulders flexed at 90. Place palm on top of palm. Inhale to begin and stabilize.

Repeat 5 to 7 times on both sides. Side lying rotator cuff Lying on your side with both knees bent in towards your chest.

5 Side lying chest opener Lying on your side, hips stacked and with both shoulders flexed at 90. Place palm on top of palm. Inhale to begin and stabilize. Exhale as you float your palm up towards the ceiling, taking your eye line with you. Inhale hold at desired point and then exhale to return to the starting point. Repeat 5 to 7 times on both sides. Side lying rotator cuff Lying on your side with both knees bent in towards your chest. Hips are stacked and your bottom arm is bent under your ear and the top arm is at your side bent at 90. Inhale and move the top arm as tolerated into external rotation. Inhale and hold and then exhale and return to neutral. Repeat 5 to 7 times on both sides 5

Wax on Wax off Standing in front of a wall

Find your scapulae neutral and then lean into

Repeat 5 7 times in both directions and on

Wall push up with a plus Standing in front of

6 Wax on Wax off Standing in front of a wall holding a towel. Find your scapulae neutral and then lean into the wall holding the towel and move the towel in both a clockwise and anticlockwise direction. Keeping your elbow straight. Repeat 5 7 times in both directions and on both sides maintaining neutral. Wall push up with a plus Standing in front of a wall with both hands placed on the wall directly in front of the shoulders. Find your scapulae neutral and then do a push up with a plus. Hold for 10 seconds and repeat 5 7 times maintaining neutral. 6

Protraction and Retraction on elbows Lying prone but the chest lifted off the floor and

Elbows are placed directly under the shoulder girdle and the palms of the hands are

Then Inhale and as you exhale press through the elbows away from the floor and feel both

7 Protraction and Retraction on elbows Lying prone but the chest lifted off the floor and your elbows are bent at 90. Elbows are placed directly under the shoulder girdle and the palms of the hands are facing inwards. Allow the upper back to completely relax. Then Inhale and as you exhale press through the elbows away from the floor and feel both scapulae move away from each other and around the ribcage. Imagine that you are widening the space between the lower scapulae angles. Hold for 5 seconds and then relax. Repeat 5 7 times. 7

8 Firing squad Standing with your scapulae in neutral and pinkie fingers against the wall. Begin to slide your pinkie up the wall and the remove and lift your pinkie off the wall. Repeat 5 7 times. 8

4 point kneeling Start in the 4 point kneeling

Ensure that you find your neutral scapulae and

Then rock forward ensuring that the elbows do not

Shell Stretch Start on your knees with buttocks to

9 4 point kneeling Start in the 4 point kneeling position. Ensure that you find your neutral scapulae and pelvis. Then rock forward ensuring that the elbows do not wing by tightening the scapular stabilizers. Shell Stretch Start on your knees with buttocks to heels. Arms are touching the ground near your knees. Move arms as far as possible to the front. Then move arms to the side and then swop to the other side. 9

Progressive resistive exercise program 6 12 weeks post surgery and treatment Frequency: Two to three times per week Resistance: Light weight or Theraband Scissors with weights Lie supine with knees

Inhale hold this position and then exhale as you switch arms. Repeat 5 to 7 times on each side. Side lying rotator cuff Lying on your side with both knees bent in towards your chest.

10 Progressive resistive exercise program 6 12 weeks post surgery and treatment Frequency: Two to three times per week Resistance: Light weight or Theraband Scissors with weights Lie supine with knees bent. Holding a light weight in both arms (500g 1kg) at 90 above your shoulders with the palms facing inwards. Inhale and then exhale as one arm moves into flexion above the head. Inhale hold this position and then exhale as you switch arms. Repeat 5 to 7 times on each side. Side lying rotator cuff Lying on your side with both knees bent in towards your chest. Place a ball between the knees and a towel rolled up between the active elbow and side. Hips are stacked and your bottom arm is bent under your ear and the top arm is at your side bent at 90 holding a light weight (500g). Inhale and move the top arm as tolerated into external rotation. Inhale and hold and then exhale and return to neutral. Repeat 5 to 7 times on both sides. 10

Side lying chest opener with weights Lying on your side, hips stacked and with both shoulders flexed at 90. Place palm on top of palm with a light weight. Inhale to begin and stabilize.

Repeat 5 to 7 times on both sides. Overhead Triceps Extensions Lie supine with knees bent.

11 Side lying chest opener with weights Lying on your side, hips stacked and with both shoulders flexed at 90. Place palm on top of palm with a light weight. Inhale to begin and stabilize. Exhale as you float your palm up towards the ceiling, taking your eye line with you. Inhale hold at point of tolerance and then exhale to return to the starting point. Repeat 5 to 7 times on both sides. Overhead Triceps Extensions Lie supine with knees bent. Holding a light weight in one hand (500g 1kg) and place your arm with the weight bent at 90 at the shoulder and elbow. Then place the other palm at the elbow of the active side to provide support. Then extend the elbow holding the weight as you exhale and then return back to starting position. Repeat 10 times on each side. This can then also progress to standing. 11

Inhale and then exhale as both arms move into flexion keeping them in line with and just above

12 Frontal Raises Lie supine with knees bent. Holding a light weight in both arms (500g 1kg) at your sides or waist. Inhale and then exhale as both arms move into flexion keeping them in line with and just above the shoulders. Inhale hold this position and then exhale as you lower back down. Repeat 5 to 7 times. This can the progress to standing and can then also be done with a Theraband. 12

Hug a fat aunt Begin with the band wrapped around your upper back.

Push band forward, extending your elbows to shoulder level.

Seated row Extend your legs and wrap middle of band around feet.

13 Hug a fat aunt Begin with the band wrapped around your upper back. Grasp both ends of band with elbows bent and palms facing inward. Push band forward, extending your elbows to shoulder level. Slowly return to starting position. Repeat 5 7 times. Seated row Extend your legs and wrap middle of band around feet. Be sure band is secure by wrapping the middle around your feet so it won't slip. Grasp both ends of band with elbows straight. Pull band upward and back, bending elbows. Slowly return to starting position. 13

Hold this position for 5 seconds and repeat 5 times.

14 Basic back extensions Lying prone with your hands placed at your side. Pull the scapulae down and out. Hold this position for 5 seconds and repeat 5 times. Then continue to stabilize, inhale and extend the chest away from the floor and exhale lower the chest back down to the floor. Repeat 10 times. 14

15 References Breast Cancer and exercise, viewed 11th September, 2013, Aaronson, N, Breast Cancer Recovery. ptonthenet. Culos Reed, SN, Shields, C & Brawley, LR Breast cancer survivors involved in vigorous team physical activity: Psychosocial correlates of maintenance participation. Psycho oncology, vol. 14, pp, Jones, LW & Demark Wahnefried, W Diet, exercise, and complementary therapies after primary treatment for cancer. The Lancet Oncology, pp Knols, R, Aaronson, NK, Uebelhart, D, Fransen, J &Aufdemkampe, G Physical Exercise in Cancer Patients During and After Medical Treatment: A Systematic Review of Randomized and Controlled Clinical Trials. Journal of Clinical Oncology, vol. 23, no. 16, pp Lippman, M, Breast Cancer Research and Treatment. Rhodes, R, Courneya, K &Bobick, T Personality and Exercise Participation across the Breast Cancer Experience. Psycho Oncology, vol. 10, pp Stevinson, C, Lawlor, DA & Fox, KR Exercise interventions for cancer patients: Systematic review of controlled trials. Cancer causes & control, vol. 15, no. 10, pp

Low Back Program Exercises

Low Back Program Exercises Exercise 1: Knee to Chest Starting Position: Lie on your back on a table or firm surface. Action: Clasp your hands behind the thigh and pull it towards your chest. Keep the opposite