Programming for Breast Cancer Group Exercise

Question:

We are in the process of developing a group exercise class for individuals recovering from a mastectomy and/or lymphectomy associated with Breast Cancer. We do have a general format for the class and have begun to compile a list of exercises to help aid in the recovery of participants. Not to mention the mental and social benefits from being in this type of supportive atmosphere with other survivors and just getting out of the house. We were hoping that you all might be able to add some additional exercises/information to the creation of this type of class format. Any information would be extremely beneficial.

Answer:

Developing ROM in a group setting after mastectomy or lymphectomy surgery.

Clients should use a gentle movement program supported by breathing to develop ROM after which resistance work with very light weights and stretches may be added. Some clients will need individual treatment to release the scar tissue and help the collagen fibers realign themselves in the direction of movement. If clients have lymphedema, they should be treated by a specialist in Lymph Drainage Therapy and progress to a gentle movement program.

Figure-8s

A dynamic, gentle three-dimensional exercise for the shoulder joint. Visualize a Figure-8 on its side in front of your body at waist level. Extend your hand as if you were about to shake hands. Leading with the thumb, trace the outline of the Figure-8 across your midline and back out to the side as you form the loops. Keep your elbow soft and your whole arm relaxed; breathe fully and easily.

By leading with the hand, the shoulder will follow a pathway of three-dimensional movement. Figure-8s can be started very small and develop in size according to the ability of the client. When an additional challenge is needed, do the exercise while holding a ½- or 1-lb. dumbbell. Count the number of repetitions until you feel fatigue. This is your starting number. Change arms and count for the other side. You may add one repetition for each set. Try two alternating sets each day for the first week and build from that base. Figure-8s will warm the tissue and encourage a greater range of motion.

Stretches may be added for work on individual muscles. Unlike a dynamic movement exercise such as Figure-8s, stretches are static. The body is placed in a specific position to target a specific muscle. The position is held for up to 30 seconds while the client “breathes into the tissue.” The following stretch targets the main chest muscle that is often restricted following mastectomy surgery, whether from fear of moving or from the procedure itself.

Supine Open-Ups Stretch

For pectoralis major: a massive muscle that originates on the chest and inserts on the arm bone. Lie on your back with your knees over a pillow but no pillow under your head, if possible. Bring your forearms and palms together in front of your face. Open your right forearm/hand to the side in one piece; keep your eye on your hand. You are aiming to rest the back of your whole arm on the surface of the bed or floor. Rest and breathe at whatever level you can achieve. Return your arm to the start position. Alternate sides; repeat at least once on each side.

Side-lying Open-Ups Stretch

This is a more advanced version of the above stretch. Lie on your left side with your head on a pillow. Your forearms and hands are in the same position as above and your hips and knees are flexed. Watch your right forearm/hand as it passes your face and opens to the side. You are aiming to rest your whole arm on the surface of the bed or floor. Allow your spine and hips to gently rotate toward your right. Rest and breathe at whatever level you can achieve. Return your arm to the start position. Alternate sides; repeat at least once on each side.

Figure 8s and many other useful exercises will be found on the videotape, 3-D WORKOUT, vol. 1: the Basics. Go to www.body-in-motion.com for further information.

Treatment for release of scar tissue may be sought from a CranioSacral Therapist. The International Association of Healthcare Practitioners has a web site where you can search for a practitioner in your location. Go to www.iahp.com and click on Search Practitioners in the menu to the left of your screen. The same site may be used to locate a Certified Lymph Drainage Therapist. This person will have three levels of LDT and have passed examinations.