Friday, February 24, 2012

Exercising after a mascectomy

A client asked about exercising after a mascectomy. I researched it and found the best explanation for recovery and rehabilitation:

 

 
Implant Reconstruction: After implant reconstruction, avoid overhead arm motions until well after the implant has settled into a satisfactory shape and placement. Refrain from performing exercises that involve pushing motions (e.g. Chest Presses) or excessive pulling motions. Be certain to receive full clearance from your surgeon.

 
Safety: When blood counts are low, exercise gently and slowly to avoid bruising, weakness, and fatigue. During this time the safest, most beneficial forms of exercise are moderate walking/stationary biking to prevent muscle atrophy and deconditioning.

 
Quality Over Quantity: The quality of an exercise is far more valuable than the quantity. Performing 5 repetitions of a specifically designed movement with perfect form will provide more benefits than performing 15 repetitions inefficiently.

 
Tram Flap Abs: Approximately 10 weeks after Tram Flap reconstruction, perform gentle, specifically designed abdominal and lower back exercises with guidance from physicians and physical therapists. To support the lower back and abdominals during floor exercises, place a thinly rolled towel horizontally under the tailbone and lower buttocks. This will help stabilize the spine and allow for a mild contraction of lower abdominals.

 
Exercise Gear: Wear activity-appropriate sneakers for exercising. Do not wear shoes with thin, smooth, or unevenly worn soles. Athletic sneakers with good arch support and an even tread on the sole provide stability and safety for all types of exercise.
(http://www.stayingabreast.com/site/browse/tips.htm)

 
  • Periodization is the long-term chronological planning of a conditioning program. It is based on the physiological principles of exercise program design and the incremental segments of time.

Phases 1 - 4 are formatted chronologically. The NON-CHRONOLOGICAL sections, which may be performed at appropriate stages of healing, are: Upper Body and Lower Body Stretches; Beyond Phase 4 (Abdominals, Spinal Stabilization, Lower Extremities, Adjuvant Treatments); and lastly, Above and Beyond, an interval training workout that combines aerobic/strength training to increase endurance, elevate the metabolism, and improve body composition, bone density, and muscle tone.

 
Timing of the various phases is dependent upon: the physical condition of the individual; duration of the healing process; type of surgery; courses of adjuvant treatments; and recommendations from physicians, nurses and physical therapists. Variables (e.g., low blood counts due to radiation or chemotherapy) may exist that will effect particular exercise choices at a given time. Physician approval is imperative.

 
Phase 1: Immediately post-surgery: Basic exercises to be performed soon after surgery to prevent swelling and tightness, to relieve pain and tension, and to promote physical and emotional healing. Towel or dowel-stick may be used for stretching and basic strengthening exercises upon recommendation of physician. Perform a few repetitions of selected exercises slowly and gently 2 - 3 times per day. Deep-breathing exercises are beneficial for relieving pain and tension.


Phase 2: Up to 6 weeks post-surgery: low, controlled movements focusing on the upper body to help prevent weakness and inflexibility. Deep-breathing exercises are important for pain-control, relaxation, and to relieve tightness in the chest and back. Frequent, slow walks will help increase endurance and prevent muscle atrophy. (Exercise on right is from Phase 3.)

Phase 3: 6 - 10 weeks post-surgery: More advanced upper body exercises. Rehabilitative lower body exercises when healing well. More active walking (without swinging or pumping arms). After 6 weeks, include other moderate activities (e.g., stationary biking). Swimming (breast-stroke and side-stroke) is suggested for rehabilitating the arms and shoulders. Free-style (crawl) and back-stroke should be avoided for 2 months after surgery; butterfly stroke should be avoided indefinitely with lymph node dissection or implant reconstruction.
  
Phase 4: 10 weeks post-surgery: Include more active aerobic (endurance) activities (e.g., walking at moderate intensities, stationary biking, slow stairclimbing). Continue to focus on inceasing strength and flexibility. Add gentle lower body exercises if healing well from TRAM flap.

 
Beyond Phase 4 and Above and Beyond: Continue cross-training with aerobic, strength, and flexibility exercises. Before progressing to advanced exercises, patients must consult with physicians.

 
Resume usual lifestyle activities upon recommendation of physicians and therapists.


HOPE THIS IS HELPFUL- this website is very helpful with more information

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