San Antonio 2010 Take Aways: Strength Training and Lymphedema
Did you stop arm exercises after your breast cancer surgery or radiation? Did you get lymphedema despite babying your affected arm? A new study may have the answer to why that might have happened.
Kathryn H. Schmitz, PhD, MPH, of the University of Pennsylvania in Philadelphia, and her colleagues studied progressive strength training with weights in breast cancer survivors and found similar rates of lymphedema in the group that exercised versus the group that did not exercise. These findings presented at the San Antonio Breast Cancer Symposium in December 2010 and published by the Journal of the American Medical Association support other research that says arm exercise is not the "no-no" that many breast cancer survivors have been led to believe.
Weight lifting helped the women build strength and drop body fat. Schmitz points out that the usual advice to breast cancer survivors to avoid lifting more than five pounds with the affected arm leads to deconditioning that arm and loss of muscle tone. Therefore, later stress on that weak arm may actually make a women more prone to lymphedema.
Before you run off to the gym, it is important to note that the women in this study wore a compression sleeve while exercising and were carefully monitored by trainers taught about lymphedema in a three-day training course.
The trainers monitored arm volume on a monthly basis and had instructions to call for medical evaluation if there was a problem. Training began at one or two pounds and progressed very gradually over 13 weeks. The trainers in the Schmitz study had patients start over if they missed a week or more of exercise.
If you are interested in trying strength training, ask your oncologist about exercise programs available in your community for cancer survivors. Increasing evidence shows that exercise helps reduce the chance of cancer recurrence. It also helps survivors rebuild muscle after chemo and increases their sense of well being, so some cancer centers offer exercise programs.
What can you do if you want to try strength training, but don't have access to a gym with trainers who know about lymphedema? I'd suggest asking your doctor for a referral to a lymphedema therapist or a physical therapist who has experience with breast cancer patients. Ask for an exercise plan that will be safe for you. Get a compression sleeve and check with the therapist to make sure it fits you properly. Too tight or too loose can both cause problems.
Begin very gradually and monitor both arms by measuring at several points: wrist, forearm, elbow, upper arm, and top of the arm. My therapist measures about every two inches, but that would be too hard for most people to manage on their own. Monitor your arms frequently and if you notice changes as you increase the number of repetitions and the amount of weight, check back with the therapist.
Use this news from San Antonio to get back in shape, but do it safely.