Breast cancer patients rarely receive rehabilitative services unless they seek them out, according to Doreen Puglisi, founder of the Pink Ribbon Program, a post-operative Pilates workout aimed at enhancing recovery after breast cancer surgery. As a result, survivors often lose range of motion in their affected arm after mastectomy or lumpectomy surgery. The precise alignment and body mechanics of Pilates exercise make it a good match for retraining posture and body mechanics after surgeries that cause misalignment and muscle shortening.
Pilates and Rehabilitation
Originally developed as a means of rehabilitating hospital patients during World War I, Pilates is used today by physical and occupational therapists in tandem with their medical training to create rehabilitation programs for breast cancer survivors. Pilates trainers work with post-rehab patients to continue their work on regaining functional and comfortable movement.
Background
A 2010 breast cancer rehabilitation study at Ege University in Turkey noted that there are so few studies of the effects of exercise on breast cancer patients that no recovery guidelines exist regarding exercise choices or difficulty levels. Several Pilates teaching organizations have created programs based on anecdotal evidence to assist survivors in regaining functional movement after surgery. The training programs are available as continuing education modules for physical and occupational therapists, as well as Pilates trainers, cancer advocates and other health care and movement professionals.
Mastectomy Ramifications
Although breast muscles are typically left intact during mastectomy and lumpectomy surgeries, the procedures can cause swelling and tightness, loss of strength, nerve damage and limited range of motion in the affected arm, according Puglisi. Those undergoing radical mastectomy may experience significant changes to their posture due to the shortening of muscles in the chest wall and shoulder during healing.
Reconstruction Ramifications
Some breast reconstruction surgeries, like TRAM flap, lat flap and gluteal free flap, involve moving tissue from the abdominal, underarm or buttocks areas to create a new breast. These surgeries affect additional muscles and nerves at the harvest sites, says Puglisi. Survivors who undergo any of these procedures benefit from Pilates exercises designed to help them regain full functional movement in the additional areas as well.
Considerations
Check with your health care provider before beginning any exercise plan during or after breast cancer treatment. You doctor can guide you in choosing the best time to begin exercise. When Pilates is used as part of a physical or occupational therapy program, some insurance companies cover the training costs, says Puglisi. Post-rehab patients sometimes use an exercise prescription from their health care provider to allow for pre-tax payment for their training under an FSA or HSA plan. Check with your insurance plan to confirm coverage.
References
- Doreen Puglisi, M.S.; Pink Ribbon Program; Mount Freedom, N.J.
- European Journal of Physical and Rehabilitation Medicine: Effects of pilates exercises on functional capacity, flexibility, fatigue, depression and quality of life in female breast cancer patients: a randomized controlled study.
