The benefits of healthy eating and regular exercise are well documented, however there is a growing body of evidence suggesting the benefits of regular exercise for those living with cancer and beyond and how it can play a crucial part in their recovery.
February 4th, 2023 was World Cancer Awareness Day, a designated day each year that unites people and communities across the Globe in an effort to raise awareness and take action.
Starting or maintaining a regular exercise program following a cancer diagnosis can help some cancer patients achieve dramatic improvements in their physiological and psychological function, helping to reduce cancer related fatigue, body weight composition and giving an added boost to their immune function. *Various studies note exercise also increased stamina, functional capacity and strength, improved self-esteem, self-confidence, treatment tolerance, satisfaction with life and decreased pain.
Even the smallest of steps to recover can be monumental. One client who had limited arm movement following a mastectomy, was thrilled with the fact that following a few weeks of Pilates she was able to reach for her coffee mug from the top cupboard without the assistance of her husband. This tiny step back to normal daily routine was a significant triumph for her.
Pilates can play a vital role in assisting those living with cancer as it offers the perfect environment to carefully address many of the post-surgical muscular imbalances, while gently strengthening and lengthening the body and increasing range of movement where radiation and scar tissue have robbed joint mobility.
The ‘Coffee Cup Challenge’ as my client and I jokingly referred to it, was a slow steady road of gently opening the Pectorals muscles and fascia of the Superficial and Deep Front Arm Lines, where she had become tight and constricted. Initially any abduction and external rotation of the affected arm required support and we found supine on the foam roller with the affected arm below shoulder height supported on pillows was tolerable for a few minutes.
In time we explored little additions like resting the arm on a Free Form (rotator disc on wheels) to add gentle mobilisation of the shoulder and arm without load, eventually followed by seated arm work on the Cadillac using the Push Through Bar. We were careful not to add any load to her arm movements beyond the weight of the arm itself until she had achieved 90% of regular arm movement in supine; additional load on the arm and shoulder muscles too early could potentially hinder improvements.
Special attention was given not to restrict the affected arm with any straps, ropes or bands as any tight restrictions or the introduction of too much load too quickly could lead to issues with lymphedema.
No two cancer patients are the same and each person’s cancer journey is a unique experience, therefore it is vital that the exercise approach must be appropriately tailored to safely meet the needs of the individual as required on that particular part of their road to recovery. Until you have a good understanding of your client’s post-surgical capabilities and are confident that they can follow your instructions independently and safely without your constant supervision it is always safer to work in a private Pilates environment. Many clients fighting cancer have heavily compromised immune systems, which is another good reason for private over group Pilates sessions, essentially each case must be assessed and handled on its own merits.
A comprehensively equipped Studio Pilates environment offering not just the Reformer, but the Wunda Chair, Cadillac, Barrels, Mat, Balls and Exercise Bands all at the disposal of the instructor is a huge advantage as this allows for adaptation of the repertoire and movement modifications that challenge, support and encourage steady progressions, confidence building and recovery. Of course, one tool can do many things, on a recent trip to the UK I packed a deflated Pilates ball for my own daily exercises, but also with a view to using it on my brother who had extensive throat reconstruction surgery in April. By laying my brother in supine, (knees bent) and supporting the back of his head on the semi-inflated Pilates ball he was able to circle his head and neck muscles without load of the head (Approx 10 kilos) into ranges of movement that he had not felt for months; his relief was palpable.
His surgeons, (there were a team of many), took tissue from his right quadriceps to reconstruct his throat and neck… amazingly clever. However, the legacy of this lifesaving surgery is that the fibres of his right hip flexors are short and tight, and Glute Med and Max are now a little inhibited and have somewhat switched off resulting in compromised hip extension and poor balance in single leg stance. As Pilates instructors we can make these observations and use the wonderfully simple but effective equipment that we have in our studios to help clients such as my brother to stretch the hip flexors and work the glutes or address any other musculoskeletal imbalance that the ravages of cancer have left our clients with.
Choosing the correct level of challenge for your client is paramount, too much too soon could setback their recovery and creative modifications of the regular repertoire may be called for to accommodate your client’s current capabilities. This is where the skill of a comprehensively trained Pilates instructor comes into its own and where many will agree, the job satisfaction peaks.
I have never regretted any investment in further training and upskilling. It makes me a better Pilates instructor and benefits my clients, but ultimately it prevents burnout because in my experience the more I know the more interesting my job becomes, being ever mindful to work within my scope.
Before starting any exercise programme medical clearance is an absolute must for anyone with a pathology, but particularly important for those living with cancer and beyond, as there are many implications and contraindications regarding treatment and post-surgical protocols, plus the need for eternal vigilance for the possible onset of lymphedema. That said, there is clear evidence to support that movement is medicine and as such Pilates has a lot to offer those fighting and living with Cancer.
Liane Geeves, PAA Member, Owner/Operator of Pilates Connection Lane Cove, Sydney.
Pilates: ITC (Diploma)
Cancer Exercise Specialist: CETI
Structural Integration Therapist: ATSI
Scar Tissue Therapist: STRAIT Method
Hypopressive Technique Therapist: IHC
*(P.Rajarajeswaran & R.Vishnupriya, Exercise in Cancer, India J Med Paediatr Oncol. 2009 Apr-Jun; 30(2): 61-70. doi 10.4103/0971-5851.60050)
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