There’s a Hurdle for some Breast Cancer Patients with Exercise

Marian Barnick

Marian Barnick

Marian Barnick is a Registered Kinesiologist and Movement Coach helping you decrease pain and improve performance by correcting biomechanics and body alignment.

breast cancer

There’s a Hurdle for some Breast Cancer Patients on the Road to Exercise

I think everyone should exercise – I really do!  Not only because of the health benefits but because I know how great it can make you feel.  To me, one of the best feelings is that feeling after you’ve finished a great workout.

Over the years I’ve had some gaps in being able to exercise – diagnoses, injuries, surgeries…  And it’s hard – REALLY HARD – to try and get back to an active lifestyle after being away.

So when I say that ‘everyone should exercise’ it comes with the knowledge and experience that it’s easy to say but not so easy to do.

So how do you fight your way back to an active lifestyle?

There’s the question.

I think my experience – along with my professional skills – has given me some really good insight in helping my patients make the move from ‘patient’ back to being an active participant in their life.

There’s no question about it – exercise is awesome for cancer patients.  Research continues to support the benefits including increased energy, decreased fatigue, less symptoms during treatment, decreased risk of recurrence.  These are amazing benefits.

But how do you get there?  It doesn’t just happen.  After chemo, radiation, surgery – cancer patients hear the message to get exercising but not on how to get there.

The Research

I wanted to see how the research on exercise is ‘handling’ the road to recovery.  Two of the studies I looked at followed breast cancer patients for a year after surgery.  Patients were provided with education and an exercise program.  The studies looked at how well patients progressed after surgery in a number of areas including function, movement, pain, and lymphedema.

What both studies found was that some patients needed extra help – something more than a regular exercise program.  Although the number of patients within the studies wasn’t large – one study found that one third of the patients required rehab and the other study found that almost half the patients required rehab.  When I say ‘rehab’ I mean treatment that’s geared specifically to the difficulties that the patients are having.

Now this is where words can get in the way.

Exercise vs. Rehab

In the gym or at the clinic, words can get tossed around like therapy, treatment, exercise, rehab….and these can all mean the same thing…well sort of.

After surgery, you can have ‘exercises’ as part of a rehab program.  But your surgeon will also tell you that you’re NOT allowed to exercise for a period of time, for example 6 weeks, after surgery.

It can be confusing when the words are interchangeable or when they mean different things to different people.

There are times when ‘rehab’ can include exercise.  For example, if we think about a patient who’s had a total hip replacement.  She’ll have ‘exercises’ to do.  But what kind of exercises?  She’s not going to go bike riding a day after surgery.

If you can grab your keys, head to the gym, and do a Cardio-Pump fitness class, I’d call that exercise.  But if you’re not there yet, you may need really specific exercises.  I call those “really specific exercises” rehab.

So what’s important here is the type of exercise.  But how, as a ‘recovering’ patient do you know what to do and what you need?

The Hurdle

And this, unfortunately, is where the hurdle lies for some patients on their road back to health and activities.  Trying to navigate the road back isn’t easy and patients can get lost along the way when they’re not sure what to do, what’s safe, and where to find the support they need.

In the case of breast cancer patients, often times rehab is limited or even non existent after surgery.  And this is a CRITICAL TIME for movement therapy.  Rehab as soon as you’re able after surgery provides much better outcomes AND in a shorter period of time.  If you postpone rehab you not only increase the time it will take to get back your range of motion but you increase your risk factors for a number of issues including frozen shoulder and lymphedema.

YES – movement helps with all sorts of things.

But because of being unsure of what to do and fearful of causing injury and increasing pain levels, patients are limiting their movement and never reaching their maximal potential.

What Can You Do As a Patient?

The research studies looked at two separate things – the evaluation by the patients themselves (how they felt, pain levels, function at home etc.) and the evaluation by the therapists (range of motion, arm measurements, strength etc.).  The information from both of these areas determined the need for more focused treatment.

So take an inventory of your daily routine.  Are you having difficulty with tasks around the house?  Is pain limiting your activities?  Are you not where you WANT to be after surgery?

When you take stock of these areas it will help you focus in and become aware of areas that may need some extra TLC.  Look at your abilities over a number of days because you’re going to have ‘good’ and ‘bad’ days.  So get an overall picture of where you’re at with your pain levels and your functional levels.

And be honest with yourself.

Did you receive clearance from your Surgeon to move forward with a rehab program?  Did you see a therapist or get a printout of exercises you should do?  Did you do them?  Religiously?  If not, then pull out that program, call your therapist, and give it another try.

Movement Action Tip

The research studies found that patients in need of rehab had limitations with shoulder movement.  Shoulder range of motion is one of the first things I check with my breast cancer patients and usually one of the first things we work on during treatment.

So when you’re at home and on your own, how you are going to know if your shoulder movement is ok or something you need to work on?

WELL – I’m going to give you a hand with that.

In fact, I’m going to give you your own assessment that you can do at home.

My Shoulder Mobility Self Assessment 

I’ve given you step by step instructions so you can check how your shoulders are moving – right from home.  This Level One Mobility Self Assessment takes you through all of the shoulder ranges.  Answering ‘Yes’ or ‘No’ to each movement let’s you know what you can do, what you can’t do (YET!), what may be painful, and where you may have limitations.

And this is really important.


Because movement is the first step in any rehab program.  If you’re not moving well, you’re not moving forward in getting back to your active lifestyle and the things you really want to do.

And…you can use the Mobility Self Assessment to check your progress.  Set your start date, do your Self Assessment, and then check back in one, two, three weeks later and see how you’re improving.  Seeing that progress is empowering.  And it keeps you motivated and moving forward.

Remember, with any activity, make sure you have the consent of your Surgeon/Oncologist to participate.

So give it a try and let me know how you’re doing!  Send me a picture, a comment, and your updates.  I love to hear from my Motivated Movers.

To get your Shoulder Mobility Self Assessment, just click the button below.

Lai, L. et al. Implementing the Prospective Surveillance Model (PSM) of Rehabilitation for Breast Cancer Patients with
1-Year Post-Operative Follow Up, A Prospective Observational Study, Ann Surg Oncol, October, 2016. 

Rafn, B. et al. Prospective surveillance and targeted physiotherapy for arm morbidity after breast cancer surgery: a pilot randomized controlled trial, Clinical Rehabilitation, February, 2018.


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