By: Andrea LeonardOne of the most important, if not THE most important part of recovery from the debilitating side-effects of breast cancer surgery and treatment, is correcting postural deviations that are the result of muscle imbalances. We must re-educate the body to restore normal muscle endurance and balance. Most of us think of balance as one’s ability to stand without falling, but it actually represents the ability to stabilize and maintain a specific body position. Postural control is defined as the act of maintaining, achieving, or restoring a state of balance during any posture or activity. It only makes sense that performing exercises to correct range of motion and postural deviations, while incorporating the aspect of balance, would yield the greatest results!
The following exercises and descriptions are a brief sampling of the exercise programming in the Breast Cancer Recovery BOSU® Specialist Handbook available at www.thecancerspecialist.com.
It is essential that you begin your exercise session with a gentle cardiovascular warm-up of at least five minutes. You may climb stairs, march in place, and eventually bounce on the BOSU® Balance Trainer if you 1) do not have neuropathy in your feet 2) can balance with or without holding on to something or someone.
Following a mastectomy and/or radiation, there is bound to be tightness in the chest wall from scar tissue and/or adhesions. Over time this can create the appearance of rounded shoulders and a forward head. This can be minimized, if not completely remedied, by the proper combination of stretches and strengthening exercises. We will begin with four chest stretches varying in intensity from easiest to most challenging.
This second back exercise is known as a Row. The beginner should stand on the floor with their feet shoulder width apart and no resistance to begin with. Bend forward or “hinge” at your waist and allow your arms to hang down with your palms facing each other. Make sure that your abdominal muscles are engaged and that your belly button is “drawn” in towards your spine while keeping your cervical spine (neck area) in neutral. Exhale, retract your shoulder blades, and bring both arms up at ninety degree angles so that at the end of the movement your hands are next to your hips. Inhale, and slowly return to starting position. Repeat 8-12 times, but stop shy of that if you experience any pain or discomfort. When you can perform 12 repetitions with no resistance and, experience no pain or discomfort, you may begin with 1 or 2 lb. weights in each hand and follow the same procedure.
In positions 1 and 2, you must engage your abdominal muscles by “drawing” your belly button towards your spine, while simultaneously retracting (pulling back) your shoulder blades until you feel a GENTLE stretch across your chest. Anything beyond a MILD discomfort should be a warning sign for you to back off, or stop completely. You can always try again in another week or so and see how your body responds.
In positions 3 and 4, you will position yourself at the edge of the BOSU® Balance Trainer and slowly roll back until your upper body rests over the dome and your head is supported (it should not be tilting back). If you have undergone an abdominal TRAM, you may need to roll up sideways so that you don’t strain your surgical incision and/or your back.
All four of these pictures are stretches designed to “open up” the chest, increase blood and lymphatic flow and minimize pain associated with muscle spasms. By squeezing your shoulder blades together while holding the stretch, you incorporate an isometric strength training component as well. As you contract and strengthen your back muscles, it will naturally stretch your chest through a process known as reciprocal inhibition.
When you can perform all four levels of the chest stretches with no discomfort, you can move on to the chest strengthening exercises that are addressed in the book.
As I already mentioned, through the process of reciprocal inhibition (when one muscle is stretched, the opposing muscle will automatically contract), by strengthening the back muscles, we will automatically stretch the chest muscles. The following exercises are designed to develop strength in your back muscles.
The first exercise is known as a reverse fly. The beginner should attempt this exercise sitting in a chair with no resistance to begin with. You should begin with your arms straight out in front of you, slightly lower than shoulder height, retract your shoulder blades, and simultaneously expand your chest as you open your arms out to the side (reverse barrel hug). Make sure that your abdominal muscles are engaged and that your belly button is “drawn” in towards your spine and that your head is centered over your shoulders (don’t let it migrate forward). Inhale as you slowly return back to starting position. Repeat 8-12 times, but stop shy of that if you experience any pain or discomfort. When you can perform 12 repetitions with no resistance and, experience no pain or discomfort, you may begin with a very light resistance band and follow the same procedure.
Andrea Leonard, Founder and Owner of the Cancer Exercise Training Institute