When a friend took up yoga about 10 years ago, she told me it had toned and strengthened her body and helped to calm her anxiety. I decided to try it, too. I now do my yoga practice at home, and I really look forward to it as a peaceful, centering experience. It has also helped me to increase my strength, flexibility, and comfort.
Several patients have asked me if I thought yoga could help manage their complex emotional challenges as well as help them regain physical strength during and after breast cancer treatment. In this column, I’ll tell you a bit about yoga, what the science says about the health benefits, and offer some tips on how to get started.
The practice of yoga was started in India more than 5,000 years ago to help unite the energy of the body, the mind, and the spirit. In Sanskrit, yoga means “to join” or “to unite.” Doing yoga poses, breathing exercises, and meditations challenge you to create balance, harmony, strength, and flexibility in all aspects of your emotional, physical, and spiritual being. You then carry this balance and flexibility into your day-to-day life with the goal of dealing calmly and steadily with any challenges you face.
Yoga became popular in North America in the 1960s and ‘70s. In a yoga class, a teacher guides you through a series of poses to stretch and strengthen your body. The teacher might also cue you when to breathe in and out during the class. Depending on the type of yoga, you also might chant, do breathing exercises, or meditate.
Like any exercise, consider safety first
In general, yoga is safe for most people who have been diagnosed with breast cancer and can be modified to any level. It’s important to work with an experienced yoga teacher who understands any physical constraints you have and can adjust the yoga practice to fit your situation.
If you are going through or recently had breast surgery, breast reconstruction, or radiation, your body has experienced injuries. Tissues have been cut, stretched out, inflamed, or upset in one way or another. There’s a lot of healing to do. It’s important to respect these tissues and not put too much pressure, strain, or tension on incisions and other tender areas. Your yoga practice can be adjusted accordingly. For example, to avoid strain on the chest muscles and breast tissue, many women avoid the plank position and push-ups.
If you’ve been diagnosed with or are at risk for lymphedema — the swelling of the soft tissues of the arm, hand, trunk, or breast that may be accompanied by numbness, discomfort, and sometimes infection — you might need to avoid certain poses, such as downward facing dog, cobra, or inversions because they put too much weight on your arms. Always talk to your doctor before you start any new form of exercise. If you’ve been diagnosed with lymphedema or are worried about it, you can talk to a lymphedema specialist about precautions that might be right for you.
While performing yoga, if something doesn’t feel right, stop immediately and talk to your doctor and the yoga teacher.
Several studies show that yoga can improve emotional health by easing anxiety and depression. Many of my patients have told me that they started doing yoga to cope with the stress of diagnosis.
Studies comparing people diagnosed with cancer who did yoga and those who didn’t found that doing yoga for 3 months was linked to better quality of life.
People diagnosed with breast cancer who took a yoga course told researchers that they were “rediscovering and finding strength and confidence in their changed bodies.” They also said that the yoga classes made them feel “mentally tough” and created a sense of community.
Other studies suggest that yoga can reduce fatigue and help ease chemo brain — the foggy thinking and forgetfulness that many women have during and after chemotherapy. And other research hints that yoga may help ease the joint pain and hot flashes that are known side effects of hormonal therapy, especially the aromatase inhibitors.
Personally, yoga has helped me regain my strength, flexibility, tone, balance, and posture. Yoga with stretching also has helped me reduce pain and increase my physical comfort. Yoga also helped me manage the complex emotions that can erupt during treatment.
It’s useful to know that yoga can release your emotions — sometimes in the middle of class. It’s fine to shed some tears from the challenges you’ve struggled with. Yoga also can be freeing. You can let go of feelings that are harmful — and hold onto feelings that are meaningful and helpful. You also can feel things more deeply by focusing your mind and building awareness.
While doing yoga, I don’t try to be Wonder Woman. Six years after my diagnosis, I still have to limit the use of my chest muscles. My hip and thigh muscles are a little weaker from the aromatase inhibitor that I’m on. It takes me a little longer than others to shift from one position to another. But with all these adjustments, I still get many benefits from yoga. And it nicely complements the other types of exercise that I do, like Zumba and Pure Barre. Together, these activities keep me strong and sane.
As I said earlier, it’s a good idea ask your doctor if yoga is a good idea for you. It also makes sense to talk the instructor before class and explain that you’ve been treated or are in treatment for breast cancer. Tell the instructor what you can and can’t do and ask for modifications for any movements you can’t do. It also makes sense to ask the instructor if she or he has experience working with people who’ve been treated for breast cancer.
An experienced teacher can help you adjust poses to meet your needs. A local hospital or cancer center might offer special yoga classes for people who’ve been diagnosed with cancer. These classes might be called gentle yoga, restorative yoga, or integrative yoga therapy. If you can’t find classes for people diagnosed with cancer, look for ones that are marked as gentle or beginner.
The two forms that I think are best for my patients are Iyengar (pronounced “eye-YEN-gar”) and restorative. Iyengar uses props like blocks, straps, bolsters, chairs, and blankets to help you get into a pose comfortably and correctly. The teacher will help you as well. You’ll likely hold a pose for a minute or so. Restorative yoga also holds poses and uses props. The difference is that most restorative poses are done while you’re lying down or sitting.
If you’re in the middle of treatment, I’d advise against the following types of yoga:
- Both Ashtanga and Vinyasa yoga move quickly from pose to pose and are physically demanding.
- Bikram, or hot yoga, also moves quickly from pose to pose and is done in a room heated to the high 90s or hotter.
What to expect from a yoga class:
- Classes are usually 60 to 90 minutes long. You may be able to drop in and pay at the door or you may need to register and pay in advance.
- You will need a yoga mat. Most classes provide them but you may prefer to bring your own. If it’s a class that uses props such as bolsters, blocks, and straps, the props will be provided.
- Wear comfortable, stretchy clothing that allows you to move freely. Clothing that is too loose might get in your way. An extra layer can help keep you warm during poses when you’re lying down.
- You will have to remove your shoes before you go into the room where the yoga class is held. Wearing flip flops or slides allows you to take your shoes off and put them back on easily.
- Classes usually start with seated breathing or meditation exercises, then move into a series of poses, and finish with a relaxation period.
- The teacher should be available before, during, and after the class so you can ask questions.
- Class fees vary. Yoga classes are not usually covered by health insurance.
Namaste! (nah-mah-STAY) The teacher will often say that at the end of class. In a yoga class, it means, “the light within me honors the light within you.”