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Topic: Is weight training after reconstruction possible w implants?

Forum: Working on Your Fitness —

Conversations about exercise, diet, and getting back in shape after breast cancer diagnosis and treatment.

Posted on: Jul 2, 2008 05:11PM

ailenroc wrote:

My surgeons have told me that after breast reconstruction (BR) with silicone implants, I won't be able to do upper body weights anymore because any upper body weight training -even if I only do arms- would use the pectoralis which would distort and reposition the implant making it look ugly and increasing the risk of longterm problems. Is that true? Has anyone been successfully weight training with implants after BR? Does anyone know of any good guidelines (book, video, online ... ) for safely training upper body after BR?

Oncotype score: 1; BRCA neg; bilat bc & bilat mx w recon; Dx 5/30/2008, IDC, <1cm, Stage IB, Grade 1, 0/5 nodes, ER+/PR+, HER2-
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Jul 2, 2008 06:36PM Gitane wrote:

My question exactly.  I asked it a few posts down if you want to read the responses.  I've been doing some very mild lifting, as I'm new to this.  I really think it's good for me, but I take it easy on the pecs.  I'll be watching your thread to see if we can get more info on this.

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Jul 2, 2008 10:02PM Felicia wrote:

Hmmm...The main reason I went with implants at first was so I could CONTINUE to be as active as I was before the bilateral...

I'm no expert - and  did have saline implants, not silicone - but I didn't really ever have any restrictions on upper body lifting or activity except immediately after surgery. And I lifted like a daggone maniac - three days a week, arm intensive - along with karate and all the punching and pushups that came with it. Everything stayed in place just fine!

Most docs will tend to err on the side of caution and advise against lifting stuff so as not to upset the apple cart, so to speak. But I'm curious to know what kind of long-term problems your surgeons are talking about...

I'd seek a second opinion for sure. All the best...

Cure this b*tch already!
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Jul 3, 2008 11:50PM RockHound wrote:

My PS told me that I would not have any weight limitations once I'm done with recovery after reconstruction.  Felicia, it is good to hear you are able to lift again.  I too, used to lift heavier weights before my bilateral mast. and hope to get back to it with the same intensity once I have my swap-out surgery (I am getting silicone).

bi-lat mastectomy w/ expanders 5/29/08, exchange 8/13/08 Dx 5/13/2008, DCIS, 6cm+, Stage 0, Grade 3, 0/3 nodes, ER+/PR+
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Jul 4, 2008 05:33AM roseg wrote:

My PS said to me - "don't change your lifestyle."

If you wear your implants out by lifting weights you can just get them replaced!

Of course you wouldn't run out from the hospital and lift, even my PS said no push-ups for 6 weeks. But once you're healed up you should do what ever you want to! The pectoral muscle is not real thick. Lifting isn't going to make it suddenly turn into something that looks like your rear end.

I find that some things are uncomfortable. I had an aerobics instructor who had us playing catch with weight (6 lb) balls and that was hard. However, I wasn't the only person who wasn't comfortable catching a heavy thing flying through the air at me! 

 A more important concern is to lift in such a way that you don't bring on lymphedema. That means good warm-up, cool-down, and work up to the weight. Don't go from nothing to a lot all at once. 

Rose
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Jul 5, 2008 04:33PM RockHound wrote:

Does anyone really KNOW what brings on lymphedema?  Or who will get it?  I am under the impression not, based on what I've read.  I only had SNB on both sides, but lymphedema's the only other thing I'm afraid of when I do finally get back into my weightlifting.

Interestingly, I also get conflicting advice from the various doctors.  My onc said I should avoid lifting for a few YEARS (at which point I started crying)!  My ps said go back to my workout gradually once I'm healed.

bi-lat mastectomy w/ expanders 5/29/08, exchange 8/13/08 Dx 5/13/2008, DCIS, 6cm+, Stage 0, Grade 3, 0/3 nodes, ER+/PR+
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Jul 5, 2008 07:46PM Binney4 wrote:

Hi, RockHound,

On the lymphedema front, you're right that it's presently impossible to predict who will or won't get lymphedema (LE). There are known risk factors: any breast or chest surgery (even without cancer present), damaged or removed nodes, radiation, previous trauma (or surgery) to the chest, diabetes, other vascular problems, surgery on the dominant side, obesity (especially weight gained after surgery). Other possible culprits: seromas, an inflammatory response, a genetic predisposition, certain chemo drugs. There are also triggering factors that can be identified: infection (arm, breast or chest); insect bites, burns, scratches, cuts, injections or other skin breaks; cutting off lymph flow in the arm or chest/shoulder (like a tight cuff, bp cuff, heavy shoulder bag, heavy narrow bra strap, etc.); straining the arm (unaccustomed weight or sudden or jerking motions, overworking to the point of tiredness or aching); change of altitude.

Good news is, there are at least as many things you can do to prevent LE. The National Lymphedema Network has Position Papers on Exercise, Risk Reduction and Air Travel on their website, and I think you'll find them encouraging: www.lymphnet.org.

Exercise is actually helpful for both the prevention and treatment of LE, but we need to be watchful and to make only gradual increases. LE risk remains with us for life, BTW. Some women develop it 10, 15 or more years out, so learning how to avoid it now will stand you in good stead for the rest of your long and very active life! Smile

Be well!

Binney 

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Jul 8, 2008 05:41PM ailenroc wrote:

Hi Binney,

Thank you for the good input. Is LE a risk even if no lymphnodes were removed or just one - three? I am about to have a bilateral mastectomy and was under the impression that LE is only an issue if numerous nodes have been removed. Not true?

 Cornelia

Oncotype score: 1; BRCA neg; bilat bc & bilat mx w recon; Dx 5/30/2008, IDC, <1cm, Stage IB, Grade 1, 0/5 nodes, ER+/PR+, HER2-
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Jul 8, 2008 08:48PM Binney4 wrote:

Hi, Cornelia,

Not true, unfortunately. (I have LE on both sides, one with a single node removed, the other prophylactic with no nodes purposely removed, and there are many others here on the boards with LE following SNB or prophylactic mastectomy.) Our doctors are often not aware of the actual risk, mostly because the lymph system is not well taught in our med schools or nursing programs, so it can be hard to get accurate information.

On the other hand, more nodes removed does increase the risk, so a SNB can help. And, bottom line, it's important to remember that MOST bc veterans DON'T ever develop LE. Smile So do proceed with confidence that you're doing everything you can to defeat the REAL enemy: bc. And then look over the information on LE risk reduction and take the precautions you need to to make sure there's no "swell" in your future!

Wishing you a swift and uneventful recovery!

Binney 

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Jul 8, 2008 09:42PM Felicia wrote:

Binney, you are so awesomely knowledgeable! Thank you so much for sharing it with us! We love ya Laughing!
Cure this b*tch already!
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Jul 21, 2008 03:16PM darkfairy wrote:

Ok, first up - I had no lymph node involvement so I don't know whether this will be different advice from those who had... Secondly, my implants are cohesive gel so they're pretty much unbreakable - I've seen them cut open at the onc's office and nothing leaks out.

 I had a bilat mast with implant only recon and, after the initial 8 weeks no lifting period was up, my surgeon said I could go back to doing whatever I liked. Prior to the op, I was weight-lifting and my surgeon commented that I had very strong chest wall muscles once he got in there to do the recon.

Part of my job involves lifting heavy stuff and I found that initially I had some weakness, especially in lifting down. This has improved but it's still not what it used to be. I haven't gone back onto heavy weights but am using light hand weights at the moment and doing push-ups - I have noticed that I have some distortion in my implants when I flex those pectoral muscles. This goes away once I relax the muscle but it does look odd - sort of like those super buff female body builders!

I have given the problem some thought and even consulted a physio at my local cancer centre. The only solution I can see is pilates - this works on lengthening the muscle, which would seem to be the logical step. In my mind, once the muscle is *lengthened* it can then be strengthened without causing too much disortion to the implant behind it. The physio agreed that this sounded like a sensible solution that might actually work.

At least that's my theory anyway! I'm in the process of seeing whether it works out in reality too :)

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Jul 22, 2008 09:24PM ailenroc wrote:

Thanks for sharing. Your experience  with the distorting implant is why my surgeons advised me against lifting. I am interested in finding a way to keep a fit and toned upper body without causing implant problems ... perhaps a combination of pilates, light weights with more reps, yoga ... let me know what you find out.

Cornelia

Oncotype score: 1; BRCA neg; bilat bc & bilat mx w recon; Dx 5/30/2008, IDC, <1cm, Stage IB, Grade 1, 0/5 nodes, ER+/PR+, HER2-
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Sep 25, 2008 09:51PM - edited Sep 25, 2008 09:53PM by OnEaglesWings

When you speak of being able to resume weight training after 8 weeks, does that mean 8 weeks out from having the tissue expanders placed, or 8 weeks out from the final swap-out (when the permanent implants are placed?)

I just had tissue expanders placed two weeks ago.  I am still having quite a bit of tightness and pain in my chest.  I used to lift heavy weights, and was into running and lots of cardio fitness as well.  I really am hoping I can resume all the previously enjoyed activities.

thanks for any wisdom/input!

May God bless you "immeasurably more than you can ask or imagine, according to His power that is at work within you." Ephesians 3:20 Dx 7/25/2008, DCIS, 1cm, Stage 0, Grade 3, 0/3 nodes, ER+/PR+
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Sep 25, 2008 10:41PM - edited Oct 10, 2008 02:19AM by Daffodil

This Post was deleted by Daffodil.
Life is short...Surround yourself with beautiful things and beautiful people. Dx 2/15/2008, IDC, Stage I, Grade 3, ER+/PR+, HER2-
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Sep 26, 2008 02:58AM - edited Oct 10, 2008 02:19AM by Daffodil

This Post was deleted by Daffodil.
Life is short...Surround yourself with beautiful things and beautiful people. Dx 2/15/2008, IDC, Stage I, Grade 3, ER+/PR+, HER2-
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Sep 26, 2008 05:53AM Farrah wrote:

Okay girls, I'm willing to be the guinea pig here. I'm back with my body builder trainer. I'm 9 weeks post exchange and gradually started lifting weights again. I'm now doing quite heavy weights (for me) like about 50# bench press. I'm just doing what feels reasonable and the trainer has supported the negative load. I also keep my arms quite close to my body so as not to over stretch the pecs while working them. I don't have any problems doing maximal biceps and triceps curls. Today I did triceps dips for the first time without feeling too much stress in the pecs

I do still feel a little uneasy about it and check my chest for symmetry the minute I get home! But I'm feeling more confident about it as I go on.

I will let you know if I have problems, but so far I'm feeling good. 

bilateral mastectomy May 08. Silicon implants July 08 Dx 5/8/2008, DCIS, 6cm+, Stage 0, Grade 3, 0/1 nodes, ER-/PR-
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Sep 26, 2008 10:49AM OnEaglesWings wrote:

Pansy and Farrah - so am I hearing you say that I should not do upper body until 8 weeks after I get the permanent implants?

 I will be seeing my PS on October 6th for my first fill, I will ask him to clarify as well (I assumed I could start lifting 8 weeks after my expanders were placed, even before I got my permanent.)

... it's nice to hear what other people's docs are telling them when it's safe to begin lifting.

I did my first workout post surgery - on the elliptical (I didn't use the upper body arms, just held to stationery arm handles) - and it felt so wonderful to be active again.  I did some gentle ab crunches on the stability ball and held my upper body like a plank, so I would be sure to not crunch my chest.  Did some lower leg squats.  I guess I realize just how important exercise is to my sense of well being.  I'm looking forward to when all of the reconstruction is behind me, and I can get back to a fully active lifestyle.

 Thanks ladies for all of your input and experiences.  It helps a newbie like me.

 love,

sue

May God bless you "immeasurably more than you can ask or imagine, according to His power that is at work within you." Ephesians 3:20 Dx 7/25/2008, DCIS, 1cm, Stage 0, Grade 3, 0/3 nodes, ER+/PR+
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Sep 26, 2008 10:52AM OnEaglesWings wrote:

Farrah, will you keep us posted how everything goes with your upper body weight workouts?

I will be very interested in hearing your feedback.  I am so looking forward to lifting again......

Do you have saline or silicone implants?  Just curious.  I haven't fully decided which I am going to choose when I switch out for the permanents down the road.....

 blessings,

Sue

May God bless you "immeasurably more than you can ask or imagine, according to His power that is at work within you." Ephesians 3:20 Dx 7/25/2008, DCIS, 1cm, Stage 0, Grade 3, 0/3 nodes, ER+/PR+
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Sep 26, 2008 11:04AM Farrah wrote:

Sue,

I was told to take it easy for 6 weeks after exchange. That also makes sense for the 'general rule' of 6 weeks for any soft tissue injury.

I think it would have been the same for the expanders but I found them too uncomfortable to really workout properly, even after 6 weeks. Any twisting movement of the trunk or 'crunching' movement caused a 'digging in' feeling. I didn't get that feeling at all after the exchange.

While I had the expanders in I just did lower body exercises and some gentle abs as best that I could. 

I went on a cosmetic surgery forum to ask the question from girls who had under the pec augmentations (because I thought maybe some of them might have been bodybuilders) and one said that her ps said 6 months before doing weight training (so the pocket would be fully healed) but that doesn't make sense to me. I don't see how it would be more healed after 6 months than after 6 weeks. It's kind of like saying wait 3 months for a cut on your finger to be fully healed before you use it. IOW I'm thinking that when it's healed it's healed and waiting longer won't make it stronger IMHO 

bilateral mastectomy May 08. Silicon implants July 08 Dx 5/8/2008, DCIS, 6cm+, Stage 0, Grade 3, 0/1 nodes, ER-/PR-
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Sep 26, 2008 11:17AM Farrah wrote:

Sue,

I have the mentor gummie bear silicon implants. I'm kind of pleased that I do now because I think they tend to hold their shape no matter what. My pecs can squash them, they can get all weird looking and ripply when I contract the pecs but when I relax they bounce right back to exactly the same shape.

I told my ps before the surgery that I wanted to be able to do bench presses and chin ups after the surgery and he said that there wouldn't be a problem. I don't know if he chose the gummy bear ones for me because of the exercise I wanted to do or if he like to use them for everyone. I didn't ask him.

Mine are quite firm though and there is zero bounce when I run. Personally I don't mind the no bounce, but it sure feels different and I'm not sure if it would be noticeable to others.

I'll keep you posted

Farrah 

bilateral mastectomy May 08. Silicon implants July 08 Dx 5/8/2008, DCIS, 6cm+, Stage 0, Grade 3, 0/1 nodes, ER-/PR-
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Sep 26, 2008 12:41PM ailenroc wrote:

Thank you all for your great responses.

It is quite confusing to see the differences in guidance we get from our surgeons. By now, I have my expanders in for nearly two months; am past the 1st fill and try to exercise daily (treadmill, physical therapy)  but I am careful not to use my pecs ... although that is tough to do. I never realized before how one uses the pecs for most movements, picking up somthing from the floor or counter, washing and drying hands, opening a window, etc.  Problem is, that it makes my 'breasts' look rippled. My tissue seems to have formed adhesions to the expander, so every upper body movement makes my chest look weird. Does anyone else have that? Will that go away after placing the implants?

Can one do anything, like massaging, stretching, or other ?? ... to prevent this rippled, dimpled look? My PS told me not to massage because it may cause damage ... but didn't explain why it would cause damage or what kind of damage.

Also, my expanders keep dropping slowly but surely, creating a bit of a sag, and I am wondering if any movement just pulls them down. What is your experience?

Thanks for your input.

Cornelia

Oncotype score: 1; BRCA neg; bilat bc & bilat mx w recon; Dx 5/30/2008, IDC, <1cm, Stage IB, Grade 1, 0/5 nodes, ER+/PR+, HER2-
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Oct 2, 2008 11:29AM debiker wrote:

I agree I think these silicone implants are more forgiving. I asked before i made my decision and both my BS and PS agreed I could do everything. I haven't started doing everything yet but I told them I am a triathlete and I work out 7 days a week. I am swimming and doing Yoga right now with slow walks. Surgery was August 25th.

Dx 6/6/2008, DCIS, Stage 0, Grade 3, 0/3 nodes, ER+/PR-
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Oct 2, 2008 04:10PM ailenroc wrote:

Debiker,

thanks for your reply. Do you have expanders in right now? Do they ripple? Did your surgeons say anything about massage? How to prevent adhesions?

Cornelia

Oncotype score: 1; BRCA neg; bilat bc & bilat mx w recon; Dx 5/30/2008, IDC, <1cm, Stage IB, Grade 1, 0/5 nodes, ER+/PR+, HER2-
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Nov 1, 2008 05:24PM MGrunsell wrote:

I too am looking for some guidance on the safety or otherwise of upperbody training after unilateral mastectomy, node removal (albeit only a couple) and BR with implant. I am now 51, 2 years post the final implant being inserted, & 5 months post full hysterectomy and have started weigh training in the last 4 weeks. My trainer is fully aware of my situation and is taking it slow, but my mastectomy side is so much weaker than the other side. I am now starting to feel a tightness across my pectoral muscle that I have not felt before and still have concerns re lymphodema risk & distortion of the implant. Has anyone been training for sometime post mastectomy and BR? How is it going? Are there any general guides or booklets available re the best path to take?
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Nov 1, 2008 06:56PM hollyann wrote:

Hi ladies,  I'm not sure but I do know that lady bodybuilders have implants otherwise their chests would be absolutely flat because breast tissue is mostly fat.......Goos luck...Hugs...Lucy

Hugs and Love....Lucy Dx 1-15-07 IDC stage 1b grade 1, 1.6 cm.....Also DCIS grade 3, both in left breast Dx 1/15/2007, IDC, 1cm, Stage IB, Grade 1, 0/6 nodes, ER+/PR+, HER2-
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Nov 2, 2008 10:47PM Jorf wrote:

Absolutely. You may be a little self conscious about the hysterically funny shapes your chest will make as you do the exercises but Oh well. I'm close to 2 years out on my unilateral saline implant. I don't do heavy duty weight training but I've been doing at the very least resistance stuff since right after the mastectomy/expander. I was back up to my usual 50 or so pushups before the exchange.

Without having been to the physical therapist I would never have made it through this. I am generally stronger than I was before but there's a definite discrepancy between the two sides. 

Really, you need to do the weight work so that the pec minor learns its new job. If you don't stretch and strengthen that baby it will pull your shoulder forward and down and none of us need that!

As always, I reccommend a good physical therapist or trainer.

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Nov 4, 2008 07:12PM OnEaglesWings wrote:

Here is a book that was helpful and recommended from another thread --  it goes into resuming physical activity after mastectomy with recommendations primarily for the immediate post op period through 12 weeks.  http://www.amazon.com/Living-Through-Breast-Cancer-Carolyn/dp/0071444637

May God bless you "immeasurably more than you can ask or imagine, according to His power that is at work within you." Ephesians 3:20 Dx 7/25/2008, DCIS, 1cm, Stage 0, Grade 3, 0/3 nodes, ER+/PR+
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Nov 9, 2008 04:57PM - edited Nov 9, 2008 05:04PM by donnar

hi,

It is my first time on this site,  I am so glad i found you.  I had a double mastertomy w/ tissue expanders, then saline implants, return to gym after 6 motnhs with no problems.  Two years into it i found left breast hurting a lot.  p/s said he thought it may be capsular contration, he suggested we change them out to silicone.  All seemed fine. I followed his orders no activities for 6 weeks.  I slowing returned to gym.  After 6 months i developed a seroma, i needed to have it drained (350cc) of fluid was removed and i was sent home with a drain for a week.  Everything seemed to return to normal, until again 6 month later same thing.  My p/s surgeon was besides himself unsure of what to do.  In the mean time i have been in search for someone to help with on going pain both in breasts and under arms, down arms, tighting in chest, etc.  I have been to pain management, orth, arthris, meds, etc.  NO MORE GYM  i am afraid, but i miss it so much. 

I am thinking of having these implants removed and not replaced for a while to see if pain will go away.  My plastic surgeon had me scheduled for surgery in march, but cancelled becuase he wasnt sure if that was the anwser.  I have been searching for a plastic surgeon that deals with complications ever since.  What a mess!!!

donnar
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Nov 13, 2008 08:51AM Boscoe wrote:

Hi ladies, I can't believe I just found this forum.  I'm not the most knowledgeable person in the world, but I'll throw my 2 cents in.  I was beginning to study for my certification test in personal training when I was diagnosed in September.

My PS said I will be able to go back to lifting-probably around the 8 week mark after surgery (haven't had any surgery-will have bi-lateral mx with expanders on Monday)  I have implants right now, it does sort of "distort" them to a certain degree when I work my upper body, but I"ve never heard anything about them coming dislodged and staying distorted.  Look at your doctor-is he fit?  Alot of times doctors will give advice/opinions on exercise and they are so out of shape and I know they don't have the slighest idea what they are talking about.

It's all about moving your muscles "mindfully" and with purpose..don't jerk or flail..slow down-take your time and THINK about what body part it is that you are working.  Exercise is wonderful for your body and should be enjoyed and used to rebuild who it is that we are.

I would also like to suggest yoga, it does wonders for body and mind..The deep breathing alone is worth the time. If you don't have a place around you, there are wonderful dvd's you can buy.

I bought "The Breast Cancer Survivor's Fitness Plan" by Carolyn Kaelin,,.has been a wonderful resource and will use it to help speed my recovery after surgery.  Fitness is just a part of who I am and I refuse to let cancer have that.  I gave it my damn breasts, isn't that enough?:)

"If you think breast cancer is a gift then you can't come to my birthday party" Dx 9/27/2008, DCIS, Stage 0, Grade 2, 0/4 nodes, ER-/PR-, HER2+
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Nov 14, 2008 06:43PM ailenroc wrote:

Hi All: Here a quick update: Since my initial question 4.5 months ago, I have been working out. I am still with expanders. I don't use as much weight as before but use light weights, no more than 5 pounds, and lots of reps 50-100. That creates less of a tug on the chest but effectively tones my upper body. Lots of stretching exercise for the upper body, chest, thoracic spine (very tight there) which help. If I skip a day stretching, I really feel the difference: everything tightens up. I second the recommendation for

"The Breast Cancer Survivor's Fitness Plan" by Carolyn Kaelin,,.

 It gives lots of valuable info and specific exercises for each kind of reconstruction. I have expanded on those exercises but it was helpful to know what to pay attention to.

Boscoe: I am also with you in regard to looking at your ps. Most of them don't seem to get much exercise themselves and yeah ... don't know what they are talking about. Perhaps all exercise is painful and distorting to them. I, on the other hand, feel lightyears better after exercise. I do lots of cardio, uphill on the treadmill, (to get the oxygen flowing), elliptical trainer: feels good to get the arms involved without too much resistance, and additional functional whole body exercises mixed with lifting light weights with lots of reps. I stumbled upon the "Tracy Anderson Method" - Madonna's trainer. While the "method" seems to be a bit home cooked without much specific knowledge, I have gotten some good ideas about stretching, making endless reps more interesting, and whole body toning. Her mat work out dvd does give a good workout: although the exercises are fairly easy, I was badly sore for a whole weekend because of the many reps and rotations.

Cornelia

Oncotype score: 1; BRCA neg; bilat bc & bilat mx w recon; Dx 5/30/2008, IDC, <1cm, Stage IB, Grade 1, 0/5 nodes, ER+/PR+, HER2-
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Nov 14, 2008 06:43PM ailenroc wrote:

Jorf: what exercises do you do for your pec minor? I definitely notice an urge to slump forward and constantly need to pull myself back since the expanders.

Cornelia 

Oncotype score: 1; BRCA neg; bilat bc & bilat mx w recon; Dx 5/30/2008, IDC, <1cm, Stage IB, Grade 1, 0/5 nodes, ER+/PR+, HER2-

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