Pilates Exercises for Breast Cancer : Part 2

Part 2 of a three-part series of Pilates exercises for recovering from Breast Cancer.  Please see last weeks post for Part One as these are meant to be done in order.  As a reminder, these articles were written for teachers so if practicing them at home, please be extremely mindful of your body.

To get started, you’ll need a cushioned Pilates Mat and a pair of soft-weighted Toning Balls.

Pilates Exercises for Breast Cancer: Rebuilding the Foundation, Part Two

In the second part of phase one programming for breast cancer survivors, the goal is to continue to introduce some very basic biomechanical principles commonly used in Pilates. These basic principles focus on restoring joint mobility with gentle range of motion exercises designed to break down residual scar tissue both from surgery and various treatments. We continue our work to increase overall body awareness with slow, controlled and concentrated movements. These simple exercises in the phase one work are designed to prepare the client for the exercises that will be added for strength and endurance in phase two.

While Pilates is a wonderful format for joint mobility and overall strength, walking is the cardiovascular exercise of choice for breast cancer survivors and should be incorporated as part of a well-balanced recovery regimen. Start slow and progress as able—a little goes a long way in rebuilding the foundation. Remember to work closely with the client’s medical team and don’t begin without clearance.

Phase Two Movements
The following exercises are not meant to replace the foundational exercises from part one of this series (see the April issue), but rather as an adjunct to progress the client in a conservative yet effective fashion. Introduce movements a few at a time to avoid overload. Only add one or two new exercises at a time; it’s easier to determine which exercises are successful and which may prove problematic. If you add too many at a time and the client doesn’t respond favorably, you may not know immediately which exercise was premature. Consistency with quality movement is the key to success with this population.

Vary the exercises from upper to lower body repertoire to avoid stressing the affected areas and allow for adequate rest in between exercises. Work with the client one to three times per week for 30 minutes. This may prove more beneficial than working with her once per week for an hour.

You will note we have added STOTT PILATES® Toning Balls to a couple of the exercises. The weight of the balls is not relevant, as you will not be using them for resistance. Rather, use them to support the limbs and assist in the movements.

  1. Scapula Elevation and Depression with Toning Balls
  2. Hip Release
  3. Butterflies with Toning Balls
  4. Spinal Rotation

1. Scapula Elevation and Depression with Toning Balls
The lymphatic system helps rid the body of toxins and is an essential part of the immune system. This is vital for cancer patients. In addition to gravity and muscular contractions, the breath serves as the primary pump for the lymphatic system. The breath also encourages engagement of the deep core musculature—transversus abdominus, internal obliques, pelvic floor and the multifidus.

Benefits: Like the scapula protraction and retraction shown in the first part of this series, this exercise creates awareness of how the scapula glides along the rib cage. This move warms up the shoulders, improves mobility and helps restore range of motion. The balls assist in the muscular action by providing proprioceptive feedback.

Start Position: Lie supine with knees bent, feet hip-distance apart, entire spine neutral, arms long by sides with palms resting on the balls (you may support the weight of the affected arm with a cushion as shown).

Exercise and Breath Pattern:

  • Inhale: slide shoulders up toward ears, elevating the scapula.
  • Exhale: slide shoulders away from ears, lightly pressing hands down on the balls, depressing the scapula.
  • Repeat 8-10 times.

Beneficial Cues:

  • Allow the balls to roll up and down, which will help keep the movement smooth and steady.
  • Watch that the arms do not round forward as they roll down away from ears.

2. Hip Release
Benefits: This exercise mobilizes the hip joint and strengthens the abdominals and spinal muscles to help hold the spine in neutral. The goal is to use the abdominals to maintain symmetry while moving the leg away from the midline of the body. While appropriate for all breast cancer clients, this is especially beneficial for those who have had TRAM flap surgery and experience core weakness as well as inflexibility in the hip joint.

Start Position: Lie supine on the mat with spine neutral, knees flexed, legs hip-distance apart, arms long by sides (place pillow under arm of affected side).

Exercise and Breath Pattern:

  • Inhale, rotate one leg laterally, allowing it to drop out away from the midline of the body. Extend the knee and slide the foot down along the mat.
  • Exhale, medially rotate the leg and slide the foot back up. Bend the knee and return to the start position.
  • Repeat 3 times on each leg.

Beneficial Cues:

  • Keep core muscles engaged when the leg drops out to the side, think small range of motion first.
  • As you exhale visualize the core musculature wrapping around you like a gentle corset.
  • Keep leg relaxed and hip socket tension free; avoid rigidity.

3. Butterflies with Toning Balls
Benefits: This exercise focuses on scapulohumeral rhythm, which is often compromised with breast cancer surgeries. You want to mobilize the shoulder, but not at the expense of dynamic stability. The balls are a perfect prop to assist in controlling range of motion and aiding dynamic stability.

Start Position: Lie supine on the mat with spine neutral, knees flexed, legs hip-distance apart. Arms are bent and hands hold toning balls on the tops of the shoulders. If the client needs arm support on the affected side, place a cushion under the elbow.

Perform this exercise in two parts. Do not add part two until client can do part one without pain. Keep the range of motion small at first.

Exercise and Breath Pattern:

  • Part one: Inhale, lift elbows off the mat straight up to the ceiling. Exhale, lower them back down to the mat.
  • Repeat 5 times.
  • Part two: Inhale, lift elbows straight up to the ceiling. Exhale, open the elbows out to the sides. Inhale, lift elbows back up straight over shoulders. Exhale, lower them back down to the start position.
  • Repeat 3-5 times

Beneficial Cues:

  • Let the arms feel as though they are floating. Avoid tensing hands or forearms and do not grip the balls.
  • Only open arms as wide as you can while maintaining pain-free control.
  • Use your exhalation to maintain core stability as you open the elbows. The breath precedes the movement.

4. Supine Spinal Rotation
Benefits: Rotation of the axial skeleton is a necessary and functional movement that may have been compromised during treatment. Abdominal tightness and spinal rigidity are common side effects of certain breast cancer surgeries. This exercise will help mobilize the spine and core musculature as well as provide a nice stretch to the upper body.

Start Position: Lie supine on the mat with spine neutral (may imprint the lumbar spine for additional support), knees flexed, legs together, arms out to sides just below shoulder level with palms facing up.

Exercise and Breath Pattern:

  • Inhale to prepare. Exhale, rotate lower torso allowing both legs to lower toward the mat, keeping legs together. Inhale to stay. Exhale, rotate back to the start position.
  • Repeat going in both directions 3-5 times.

Beneficial Cues:

  • Keep the inner thighs engaged as you lower legs to one side—this will help with abdominal connection.
  • Do not let your upper body rotate with the lower body.
  • Maintain a lifted sensation in your pelvic floor muscles as you rotate your spine.

Look for the next installment of phase one Pilates exercises for breast cancer in the June issue of Inner IDEA Body-Mind-Spirit Review.

PJ O’Clair is the owner of Northeast Pilates Certification Centers and Master Instructor Trainer, STOTT PILATES®.

Balance/Wobble Board : Plank w/ Knee Crossover

HOW TO do a Plank w/ Knee Crossover using a Balance or Wobble Board


Featured Product: Round Balance Board 
Brand: J Fit
Purpose:  Improve balance and coordination at the same time increasing strength and reaction time
Compatible Exercises: Strength Training, Balance Training, Coordination Training and overall Toning
Rolling Sands Harmony Retail Sale Price: $28.98


A quick video showing how to perform this plank variation while on a Balance Board.

Balance Boards, Wobble Boards, and Balance Discs come in a variety of sizes and materials but essentially can be used interchangeably in a variety of exercises. Balance Boards, or Wobble Boards, are wood with a round base to create your unstable surface. While the Balance Discs are made of a soft inflatable vinyl.

As your leading Fitness Equipment and Yoga Supply Store, we offer a Round Balance Board at the lowest price!

Pilates for Breast Cancer : Part 1

This is the first of three articles describing Pilates exercises that you can perform to help in your recovery of breast cancer.  Unfortunately the images in this first part were not available from the original article, but hopefully you’ll be able to follow along with the detailed descriptions.  When performing Pilates floor exercises it is helpful to have a cushioned Pilates mat.  Pilates mats are non-slip mats with a little more cushion than a standard yoga mat.  We’d recommend 1/4″ thickness or greater to help cushion your spine and joints during your practice.  Visit our Pilates Products page for our selection of Pilates mats.

These articles are written for instructors to help teach their students.  So please keep this in mind if you are trying this on your own at home.  Some knowledge of Pilates would be very helpful when starting your own home practice.

Pilates Exercises for Breast Cancer: Rebuilding the Foundation, Part One

According to the National Cancer Institute, approximately 2.4 million women living in the United States in 2004 had been treated for breast cancer (American Cancer Society 2007). Fortunately, thanks to early detection and advancements in treatment, many more women will survive breast cancer and go on to live out their natural life expectancy. Despite this good news, cancer treatments take an enormous toll: in just a year of treatment, the body can age a decade. Between the inherent weight gain, muscle atrophy and premature bone loss, women are left weak and physically challenged even by normal day-to-day activities.

Pilates is a gentle restorative exercise regimen perfectly suited for women as they recover and work to rebuild their bodies. (The benefits also extend to the very small minority of breast cancer patients who are men.) Many people considered Joseph Pilates a master of rehabilitation during his lifetime. His approach emphasized precision and control. Combine those qualities with current exercise science and you have a recipe for success.

For a cancer survivor who is re-building her foundation of physical strength—flexibility, endurance and self-esteem are priorities. Once the client’s medical team has given the okay to begin a gentle exercise program, the process begins.

Phase One
In the first session, be sure to review the client’s overall health history as well as the types of treatments and surgeries she may have undergone. This information is instrumental in developing an effective and safe Pilates program. Remember that you are not here to diagnose, but to help with her rehabilitation. Therefore, it is imperative that you prepare by gathering all of the facts before beginning.

Keep in mind that the usual stages for tissue healing and exercise progression for a client who has had cancer differs greatly from a client who has an acute or chronic injury. Symptoms like muscle tightness and joint stiffness are present in both instances. However, while the symptomology may appear similar, you cannot treat a mastectomy or a lumpectomy like you do a rotator cuff or joint injury. Treatments such as chemotherapy and radiation coupled with surgery greatly affect the time it takes to heal and fully recover. Also keep in mind there are ongoing side effects this client may experience that are unlike those an injured client might have.

The phase one exercises focus on developing the clients’ kinesthetic awareness and teach very basic biomechanical movement principles. These principles are foundational and can be part of the client’s daily exercise regimen forever.

In this first of three installments we will cover three principles:

  1. Breathing
  2. Pelvic Rocking – Imprint and Release
  3. Scapula Protraction and Retraction

1. Breathing Flexed Forward
Benefits: The lymphatic system helps rid the body of toxins and is an essential part of the immune system. This is vital for cancer patients. In addition to gravity and muscular contractions, the breath serves as the primary pump for the lymphatic system. The breath also encourages engagement of the deep core musculature—transversus abdominus, internal obliques, pelvic floor and the multifidus—all important for restoring posture and functional strength.

STOTT PILATES®  photography © Merrithew Corporation.  <image missing>

Start Position: Seated with knees bent, pelvis vertical, spine neutral, arms resting long by sides.

Exercise and Breath Pattern:
Inhale to prepare, exhale, initiate from the top of the head and articulate the spine into forward flexion (position shown in photo). Maintain a vertical upright pelvis, relax arms over shins, inhale through the nose and expand the entire rib cage. Exhale through the mouth, allowing the ribs cage to soften.

Complete three to five full breaths while flexed forward. On the last exhale, initiate from the tail and articulate the spine, rolling up to the start position.

Beneficial Cues:
• On the inhalation, allow the ribs to expand like an accordion.
• On the exhalation, feel a gentle wrapping sensation around the torso.
• Focus on full breath patterns and relax; get centered.

2. Pelvic Rocking – Imprint and Release
Benefits: This move helps mobilize the lumbar spine and strengthen the abdominals, especially the obliques, which are essential in the case of TRAM flap surgeries where the rectus abdominus is used for breast reconstruction.

STOTT PILATES®  photography © Merrithew Corporation. <image missing>

Start Position: Supine on the mat with spine neutral, knees flexed, legs hip-distance apart, arms long by sides (place pillow under arm of affected side). Note: photo shows arms in the air so that the reader can see the neutral shape of the spine, but the arms should be kept long by sides, supported with props if necessary on the affected side).

Exercise and Breath Pattern:
Inhale to prepare, exhale, contract the abdominals and imprint spine toward the mat. Inhale to release back to neutral.

Beneficial Cues:
• Gently rock the hips toward the ribs.
• Visualize a fossil imprint of your spine in sand; avoid pressing the lower back into the mat.

STOTT PILATES®  photography © Merrithew Corporation. <image missing>

3. Scapula Protraction and Retraction
Benefits: This exercise focuses on scapulohumeral rhythm, which is often compromised with breast cancer surgeries. Strengthens the middle and lower fibers of the trapezius, the serratus anterior and the rhomboids, which are all are extremely important for shoulder girdle mobilization and dynamic stability.

Start Position: Supine on the mat with spine neutral, knees flexed, legs hip-distance apart. Arms are long to ceiling (may have to do one arm at a time and use the strong arm to help hold the affected arm up). Note: photo shows exercise seated upright so reader can see the scapula movement. However, this exercise should be performed on the mat in the supine position with the arms straight over the chest reaching toward the ceiling. See photo #2 for reference.

Exercise and Breath Pattern:
Protract: Inhale to protract the scapula, reaching arms toward the ceiling, exhale to come back to neutral. Repeat 3-5 times.
Retract: Inhale to retract the scapula, bring them closer to the spine; exhale go back to neutral. Repeat 3-5 times.

Beneficial Cues:
• Feel the gliding of the shoulder blades along the ribs. They glide toward the spine and away.
• Visualize holding a roll of paper towels in your hands so that arms don’t go wider or narrower.
• Minimize the range of motion and pay attention that movement occurs just with the shoulder blades and not the spine.

Look for the next installment of phase one Pilates exercises for breast cancer in the May issue of Inner IDEA Body-Mind-Spirit Review.

PJ O’Clair is the owner of Northeast Pilates Certification Centers and Master Intructor Trainer, STOTT PILATES®.

Reference
American Cancer Society. 2007. Breast cancer facts & figures 2007-2008. www.cancer.org/downloads/STT/BCFF-Final.pdf; retrieved Feb. 14, 2008.

Yoga Straps : Relieve Back Pain

HOW TO Relieve Back Pain using Yoga Straps


Featured Product: Yoga Straps 
Brand: Varies
Purpose:  Improve Balance, Strengthen Yoga Poses, Assist with Flexibility
Compatible Exercises: Yoga, Stretching
Rolling Sands Harmony Retail Sale Price: $5.58-$15.98

 


Many people suffer from chronic back pain. This video will teach us how to do three yoga poses that will help relieve our pain. The poses are: Reclining Big Toe, Standing Twist, and Legs Up the Wall. If practiced daily, you are sure to see some results.

Before following along with this video, gather your yoga mat, two yoga blankets, a yoga strap, and finally a folding chair (or straight-back chair).


Back Pain:
Yoga – Postures To Help Relieve Back Pain

Hand Weights : Pilates Boxing

HOW TO do Pilates Boxing Exercises with Hand Weights


Featured Product: Hand Weights (1 lbs, 3 lbs, 5 lbs)
Brand: JFit
Purpose: Develop upper body strength
Compatible Exercises: Pilates, Strength training, Core Training, Walking, Jogging, Balance Training
Rolling Sands Harmony Retail Sale Price: $6.98-$11.98


A quick video showing us how to perform the Pilates Boxing exercise with small hand weights.  Can us any weight that you feel comfortable with.

Yoga Blanket : Neck Pain

HOW TO Use a Yoga Blanket for Neck Pain 


Featured Product: Hand Woven Yoga Blanket
Purpose: Use during kneeling poses to cushion bones and joints, underneath you in repose positions to insulate from cold flooring, rolled or folded to provide support and stretch in poses, or just as a cover to warm you in Savasana
Compatible Exercises/Uses: Yoga, Restorative Yoga, Iyengar, Meditation
Rolling Sands Harmony Retail Sale Price: $13.98-23.98


Here’s a quick fix to get that kink out of your neck.  All you’ll need is a yoga blanket.  We offer several for you to choose from!

Crick Fixes Asana Sequence – Yoga Journal

By Barbara Benagh

Neck Blanket Stretch

Roll a blanket into a firm, even cylinder large enough to wedge between the base of your skull and the tops of your shoulder blades. Lie back over the roll so it gently stretches your neck; the roll should wedge just under the occipital ridge at the back of your skull and support your neck and your first few upper back vertebrae. Keeping your knees bent, place both palms on your forehead, fingers pointing toward the crown of your head, and bring your elbows close to each other. Close your eyes and tune in to your breath, feeling how its rhythm creates subtle movement. Notice areas in your neck, shoulders, and upper back that seem dense, dull, and resistant to the breath’s wavelike action, and invite them to relax against the blanket roll. As your muscles begin to release, slide your shoulder blades away from your skull; you may want to repeat this movement several times as your muscles continue to relax. Remain on the roll for up to five minutes, then remove it and continue to lie on your back for a few breaths, tuning in to the sensations in your neck, shoulders, and upper back.

For nine more poses to practice to reduce neck tension, see the entire sequence from Yoga Journal’s website.

Yoga Blanket : Shoulder Stand

HOW TO Use a Yoga Blanket for Shoulder Stand 


Featured Product: Hand Woven Yoga Blanket
Purpose: Use during kneeling poses to cushion bones and joints, underneath you in repose positions to insulate from cold flooring, rolled or folded to provide support and stretch in poses, or just as a cover to warm you in Savasana
Compatible Exercises/Uses: Yoga, Restorative Yoga, Iyengar, Meditation
Rolling Sands Harmony Retail Sale Price: $13.98-23.98


In the following 5-minute long video you’ll learn how to do a supported shoulder stand using a wall and the full pose. In both poses, she’ll show us how to do the shoulder stand using a yoga blanket under the shoulders.

You may wish to practice this by also wrapping your yoga mat over the top of the blanket as well. By doing this, your elbows will be on a non-slip surface and it may make it a little easier to hold your pose without your elbows sliding away from one another.

Meditation : Guided with Anusara Yogi

HOW TO Meditate : Anusara Yogi 

Before listening and watching the following 8+ minute video, find a quiet spot to sit comfortably with an erect spine. This video is by an English Anusara yogi and would be a beautiful Savasana meditation to do as well at the end of your yoga practice.

If you will be sitting cross-legged on the floor or earth, and if your knees are higher than your hips, Bridget suggests tucking a blanket under both of your knees to allow you to fully and deeply relax your inner thighs during this meditation practice. Another option would be to sit higher. How high would depend on how high your knees are – you may just need to sit on a yoga blanket, or your may prefer to sit on a Zafu. We offer a large selection of Zafus: round or crescent-shaped; regular cotton covers or organic; and cotton, buckwheat or kapok stuffing.

Balance/Wobble Board : Plank w/ Crunch

HOW TO do a Plank w/ Crunch using a Balance or Wobble Board


Featured Product: Round Balance Board 
Brand: J Fit
Purpose:  Improve balance and coordination at the same time increasing strength and reaction time
Compatible Exercises: Strength Training, Balance Training, Coordination Training and overall Toning
Rolling Sands Harmony Retail Sale Price: $28.98


In seconds you can quickly learn how to use a balance board or a balance disc to increase the difficulty level of doing a Plank pose with a Crunch. Adding an unstable base to any exercise or pose will force you to incorporate additional muscles and will also train your proprioceptors to reduce the risk of injury.

As your leading Fitness Equipment and Yoga Supply Store, we offer a Round Balance Board at the lowest price!