Use this link for for specific information about Pilates and Breast Cancer

• Is exercise beneficial after breast cancer treatment?
  • Yes, appropriate exercise has been shown to be beneficial in all periods following breast cancer treatment. Studies show that exercise has a vital role to play in the recovery from breast cancer treatment and also suggest that exercise is somewhat protective of cancer. Exercise can help with symptoms following breast cancer treatment, such as fatigue, mood and self esteem, help to stretch scar tissue and restore the range of movement, relieve frozen shoulder, possibly prevent and manage lymphoedema and help with menopausal symptoms, whether occurring naturally or brought on by the treatment. Exercise might also help immune function and is even thought to increase chemotherapy completion rates. Controlled breathing, as in Yoga and Pilates, can help with lymphoedema and anxiety. Exercising with other breast cancer survivors can also help emotional recovery and improve mood.
• Is there any exercise that is specifically designed for those with breast cancer?
  • Yes, Lebed is specifically designed for those recovering from breast cancer treatment and can be done once the drains have been removed, even during chemo- and radiotherapy. Always check with your consultant or breast-care nurse before exercising, however! Lebed is a medical dance programme, where physiotherapy exercises are combined as short dances or routines. Lebed also provides a whole body workout but includes regular short breaks and can be done either sitting or standing. There is no floor work involved in Lebed, so you do not have to worry about applying weight to your affected arm. It has also been found useful for those with lymphoedema.
• I used to love Pilates and would prefer to do this now, too. Is this possible?
  • Yes, but work carefully. Pilates can help in the rehabilitation of those treated for breast cancer too but don’t overexert yourself, especially in the early stages of recovery. Please note that most Pilates classes involve a lot of floor work. If you feel that getting down and up from a floor might be a problem, you may want to try Lebed instead.
• What are the benefits of Pilates?
  • Remedial exercise after breast cancer treatment often concentrates on the upper body area. Whilst it is important to stretch scar tissue and recover range of movement, it is also important to exercise the whole body.
  • Pilates is a whole-body workout that focuses on moving from the centre, building core stability and abdominal muscles, and improving overall muscle tone and flexibility.
  • Pilates can also help by gently stretching the upper back, shoulders and chest. It will also help to stabilise and strengthen the muscles around the shoulder blades to help release muscle tension in the neck and shoulders.
  • Breathing exercises can help with anxiety and lymphoedema, whilst mobilisation and re-alignment of the spine and hips will help balance and prevent back problems. Strengthening the deep abdominal and deep back muscles will also prevent back problems and also help with balance, whilst working the pelvic floor is important as the pelvic floor often weakens after menopause and with low levels of oestrogen. Increase in muscle strength and balance training can also help with osteoporosis, another potential problem of low oestrogen levels and the menopause.
• Is there anything I should be aware of when exercising after treatment for breast cancer?
  • Always ask your consultant, breast-care nurse or GP whether it is safe to exercise.
  • Lebed is a great way to get fit as it was specifically designed for those who have been treated for breast cancer but if you would rather take another form of exercise remember the following guidelines:
  • It is important to exercise responsibly. Only do what you can do and what you feel happy to do! Enjoy it! Anyone recovering from surgery and who is in or has recently had chemo or radiotherapy should avoid overexertion. Some forms of exercise might not be suitable immediately after surgery or during recovery. For example:
  • Walking, cycling and swimming are generally thought to be safe forms of exercise for anyone recovering from breast cancer treatment. However, avoid cycling if you are suffering from spells of dizziness and avoid swimming or public gyms if you are at risk from infection.
  • Anyone with bone pain and primary or metastatic bone cancer should avoid high-impact exercise or contact sports.
  • Always wear your fitted sleeve if you have lymphoedema.
  • Guidelines suggest that lifting and weight-bearing exercise should be avoided in lymphoedema. A recent study, however, suggests that controlled progressive strength training might be safe. As it is early days, however, it’s probably advisable to be careful. If you do wish to try progressive strength training then work with a trainer who knows about lymphoedema and stop immediately if your lymphoedema is getting worse. Maybe it’s best to leave the heavy weights to Arnold Schwarzenegger for now!
  • The Lebed warm-up is a great way to prepare for exercise if you have had breast cancer treatment and especially if you have lymphoedema as it gently stretches the scar tissue and prepares the lymph nodes to receive increased amounts of lymph when exercising.
  • Avoid de-hydration by sipping water regularly.
  • Forget “no pain, no gain”. Exercise should be enjoyable. If you only want to do half the exercises or leave out an exercise, do. Your instructor might offer you an adaptation or you can just rest and concentrate on breathing. That’s completely fine – breathing is probably the best exercise anyhow! And make yourself comfortable: Depending on the type of reconstruction, some areas of your affected shoulder or arm might be tight or even numb. Avoid pain and use props, such as towels or blocks to support painful areas.
• Medical papers that might be of interest:
  • Bicego, D., Brown, K, Ruddick, M., Storey, D., Corinne, W., Harris, S.R., (2006). Exercise for Women with or at risk for breast-cancer related lymphedema. Physical Therapy. 86, 10. 1398-1405.
  • Demark-Wahnefried, W., (2009). A Weighty Matter – Lifting after Breast Cancer. NEJM. 361,7. 710-11.
    
  • Hayes, S.C, Spence, R.R., Galvao, D.A., Newton, R.U., (2009). Australian Association for Exercise and Sport Science position stand: Optimising cancer outcomes through exercise. Journal of Science and Medicine in Sport. 12. 428-434.
    
  • Oliverira M.M.F., Gurgel M.S.C., Miranda M.S., Okubo M.A., Feijo L.F.A., Souza, G.A., (2008). Efficacy of shoulder exercises on locoregional complications in women undergoing radiotherapy for breast cancer: clinical trial. Revista Brasileira de Fisioterapia.
    
  • Schmitz, K.H., Ahmed, R.L, Troxel, A., Cheville, A., Smith, R., Lewis-Grant, L. et al, (2009). Weight Lifting in Women with Breast-Cancer-Related Lymphoedema. NEJM. 361,7. 664-73.
    
  • Schmitz, K.H., Ahmed, R.L, Troxel, A., Cheville, A. et al., (2009). Physical Activity and Lymphedema (the PAL trial) Assessing the safety of progressive strength training in breast cancer survivors. Contemporary Clinical Trials. 30. 233-245.
    
  • Twiss, J.J., Waltmann, N.L., Berg, K., Ott, C.D., Gross, G.J., Lindsey, A.M., (2009). An Exercise Intervention for Breast Cancer Survivors With Bone Loss. Nursing Scholarship. 41,1. 20-27.
• The above information does not replace medical advice. If you suffer from any of the above medical conditions you should always seek the advice of a suitably qualified practitioner.