Anyone with lymphedema risk get back to full yoga practice

LeesaD

Prior to dx I had a very active exercise regime. Kickboxing, personal trainer, weights, an advanced yoga and hot Pilates practice and a recreational runner of just 2 miles a day for cardio. Since my two surgeries and port placement and now just having begun my chemo, I have basically been inactive since March 27. Adjusting to my new body post BMX and now seeing my body change from the inactivity is effecting me tremendously in addition to dealing with the cancer dx. . I had 2 nodes removed left side but 18 nodes removed on my right. With the lymphedema risk I am wondering will I ever be able to get back to who I was prior especially the yoga? I feel like I've lost my identity. Is there anyone here with many nodes removed who is back to a full yoga practice that includes planks, push ups, side planks, chadurungas, down dogs, arm balances etc...? I've read the various materials on this site re the risks and it seems like a contradiction of the benefits of strength training and muscle building vs. the lymphedema risk. Just looking to see if it's possible to get back to doing what I loved and how others have faired. Thank You.

livebig

Hi LeesaD - I'm sorry I don't have any answers, but I am also following and hoping some will chime in. I have not had my BMX yet, but will have lots of nodes removed. Currently I practice Yoga and am an avid runner, so I am obviously concerned with how my active life can continue post surgery.

muska

Leesa, I had not been very athletic before my surgery and other treatments all of which had some risk of lymphedema. Fortunately, I haven't had any lymphedema in my upper body so far. Soon after completing rads I started regular exercise at a local gym that included once a week half hour session with a personal trainer and two classes lead by instructors one of which was yoga. Speaking of yoga I now do everything you mentioned except for arm balances. Not good at side planks but I have to say I had always had weak arms, so it's not surprising. I am sure someone like you will get back to pre-cancer shape fairly quickly once you get back to the gym. Just be careful, take it slow and listen to your body.

I do not do any exercises for pectoral muscles because of the implants that are under the pectoral. Other than that, all exercises are fine just don't push it, especially at the beginning.

MinusTwo

I also have implants under the pecs. I have truncal & breast LE that I'm hoping never progresses to my arms. I have a good LE/PT and learned how to do MLD. I wear a compression bra 24/7 and add sleeves & gauntlets for flying. I only do modified Yoga now - so I don't do planks or downward dog or chest presses from the floor. Others will chime in and will have different thoughts. When you do start back up, go very slowly. For example start back with only 2 lb weights and hopefully you can move up very gradually to your previous level.

LeesaD

muska- Thank You so so much for your response! That is so encouraging to hear!!! Awesome!

livebig- all the best to you!

LeesaD

MinusTwo- Thank You for your input! Very helpful!

LisaAlissa

I can't offer any help on Yoga, but for Pilates, you might want to check into someone certified by The Pink Ribbon Program. Some studies on the effects of Pilates on BC survivors on PubMed here:

"This one," the older of the two, is a very small (brief) study of Breast Cancer survivors:

Clin J Oncol Nurs. 2012 Apr;(16(2):131-41. doi: 10.1188/12.CJON.131-141. Pilates for breast cancer survivors. Stan DL, Rausch SM, Sundt K, Cheville AL, Youdas JW, Krause DA, Boughey JC, Walsh MF, Cha SS, Pruthi S.

"This one" was larger, and was limited to Breast Cancer survivors who had been diagnosed with lymphedema:

J Breast Health (2013). 2017 Jan 1;13(1):16-22. doi: 10.5152/tjbh.2016.3136. eCollection 2017 Jan. Effects of Clinical Pilates Exercises on Patients Developing Lymphedema after Breast Cancer Treatment: A Randomized Clinical Trial. Şener HÖ1, Malkoç M2, Ergin G3, Karadibak D3, Yavuzşen T4.

HTH,

LisaAlissa

SillyMe0114

I have been able to restart my yoga practice, including a few arm balances, after axillary lymph node disection (removal), without having any problems with lymphadema. I have a sleeve, but only wear it for flying and acclimating to higher elevations, such as mountains. I couldn't live the way my surgeon recommended. I tried for about 2 weeks. So, with a lot of fear, I very slowly and gingerly resumed all of the activities of my life. I started with 1 pound weights, and even nothing held by a pin when training with machines, and I started for months with gentle, beginner, and restorative yoga. The beauty of yoga is that I have been able to go to my more advanced classes, and adjust as I need to. Things continually improve, with noticeable improvements after 3-4 weeks. This was back in 2001 and 2002 with my first diagnosis, and again in late 2016 after my second diagnosis. My second diagnosis resulted in a uni MX. I had 2 reconstruction procedures that included fat grafting, which did not go as well as I hoped. Once I had 6 weeks of yoga, pilates, weight training, stretching, and light running as part of my recovery, it was very hard to think about another surgery. So I am a recon failure. Going through recon was harder on my body than I expected. If you are considering recon, there will be recovery related issues with that. The main advice I can give is to go slow. Start off gently, slowly increasing your level of difficulty, and listen to your body. I routinely elevate my affected arm to let it "drain", and I have a tiny squishy ball that I squeeze whenever my arm starts to feel "full", heavy, or buzzy. For me, my arm gets an uncomfortable sensation when I drive or sit at a computer for long hours, with it bent and close to my body. Movement and muscle activity, with some occasional short periods of elevation have helped it. So far, so good. Lily

LeesaD

LisaAlissa- Thank You!

Sillyme0114- Thank You for sharing! Awesome to hear it can be done! It's the fear right now. I know what my body was capable of prior but yes there's fear based on what my doctors have told me and all I've read. It's just such a contradiction to me as I think strength and muscle and exercise are such a benefit but not knowing what can trigger a lymphedema episode is scary. I currently have expanders in and they are fully expanded but I'm not going to have exchange until I complete my radiation which right now looks like early September. Just had first chemo treatment last week. I'll start slow and see what happens. Thank You so much!

muska

All my specialists encouraged me to exercise, lift weights, etc but do it slowly. Based on my experience exercise does help with circulation. I have some edema in my left foot that is the result of taxol. That foot is always better after any exercise and especially after yoga.

vlnrph

Our cancer center started free yoga sessions shortly after my LE began so I had excellent guidance in learning modified positions. When trying classes at other facilities, I always tell the instructor about my limitations. Most of them need to to become educated but are usually understanding.

The only real problem I've had was during a fitness evaluation when the uncomprehending trainer said "let's see how many push-ups you can do!" right after I explained why my arm was swollen. I refused.

My favorite exercise is in water where the hydrostatic pressure seems to be therapeutic.

livebig

thank you all for responses! So encouraging to hear

ksusan

With LE risk, the issue seems to be taking the time to build up your lymphatic capacity over time. Start slow, don't push it, stop if anything is painful or doesn't feel right. Monitor your hands, arms, and torso for swelling. If the room is hot, consider wearing compression garments (yeah, I know, not fun in a hot room). If you haven't already, learn some manual lymphatic drainage techniques, and do them plus gentle stretches before and after exercise. As vlnrph said, immersion in a pool (not hot tub) with gentle movement of arms and legs provides even compression on the limbs and moves lymph toward your abdomen. If you're going to be touching surfaces like the floor or a community mat, wash your hands with soap afterward.

For what it's worth, Down Dog isn't recommended. I wouldn't start with any movements that potentially cause lymph to pool in the extremities. You ought to be able to evaluate this over time.

I now do 2-3 hours a week in a warm, salt water pool, and 4-6 Zumba classes. I find lifting low weights really boring, but I'm trying to do some every week in order to gradually increase my capacity. You might want to see if there's a LiveStrong option at a YMCA near you. They seem to get it.

ruthbru

I had 11 nodes removed, no lymphedema (so far, knock on wood), and got back into the activities I did before including all yoga poses, lifting light weights, Zumba, Step, pilates etc. etc. The key is to build up very, very, very slowly and not push it. Stay at one level until your body is ready for the next, don't try to rush things along. I'd say it took at least a year post-treatment (probably more like two) to get back to square one. But now, I am glad to report, I am even more active than I was before BC. (And I love, love yoga! Namaste)

LeesaD

Namaste ruthbru! Thank You and everyone for your responses. They are all so very helpful and encouraging!

Outfield

Leesa, I have lymphedema so maybe my input doesn't count, but it's very well managed and didn't come on in response to anything I ever identified. It certainly wasn't yoga because I hadn't really started doing yoga yet when my lymphedema came on, shortly after I finished radiation, and it wasn't any new or increased activity. It just appeared.

I'm 7 years out from cancer diagnosis and more than 6 out from diagnsois of lymphedema, and there is no activity that I avoid because of lymphedema. I have never seen a correlation between activity and lymphedema flares with one exception - long hikes with my arms dangling, shortly after I was diagnosed. Those don't seem to matter anymore. The only yoga poses I avoid are those that could potentially put pressure through my neck, and that's nothing to do lymphedema.

In the few studies that have been done of exercise and lymphedema risk, people progressed slowly and gradually to greater challenges. I expect that is what you will be able to do.

I did not have reconstruction so I don't know how the changes to the pec figure into that.

ruthbru

Leesa, if you want; check out the "Let's Post Our Daily Exercise" thread on this fitness forum. A great group of ladies at all stages of treatment & beyond & with a variety of exercise interests and goals. Some have LE and manage an excellent exercise program despite of it. Others, like me, feel that exercise has reduced our LE risk. One of our ladies teaches a pilates class for women recently diagnosed with BC, and is also very into yoga and Tai chi. I could give you her name & you could PM her for advice if you'd want to.

LeesaD

Outfield- Thank You so much! Your input is very helpful and very appreciated. The more info I have the better especially from people who have lymphedema and can provide insights re exercise and if they see any correlation. Thank You again.

Ruthbru- I will check out that thread thank you. I will see if I can find the Pilates instructor and if not yes it would be great if you could give me her user name. Thank You so much.

ruthbru

Leesa, I am sending you a PM.

EastcoastTS

I did plank last week in YMCA Livestrong program. I'm really trying not to go with any specific pec exercises. I was not an exercise junkie before but do love yoga. And light weights, etc.

Already had planned to avoid push-ups and things like that. So plank is out? I always loved that one and it felt fine. (I'm still in tissue expanders.)

ruthbru

I do 'girl' pushups on my knees. Eventually you will be able to plank; start with a half plank on your knees, then maybe elbow planks for awhile. It will take more time than you want to give it, but you can come back.

Icantri

Hi Leesa, I hope you are feeling a little better about things given the positive feedback you have received so far. I just want to chime in to help build you up.

I went to occupational therapy after umx and 5 nodes removed. Everything I learned suggested that we want should use our upper body, but gradually. What we can start with will depend on where we were before. You have no doubt lost some strength, but will have more than someone who didn't exercise as much.

I understand it that the stronger we are, the less likely we are to overdo it when life calls us into action beyond normal activities (painting the house, etc.) It is just so important to take it slow, as others have said. Also, I was told not to do two days in a row of upper body strengthening exercises. On the off day evaluate for any issues, weird feelings in your arms, etc. And lots of stretching.

I did weights for a couple months and then switched to swimming twice a week because, like ksusan, weights just bore me.

You will find your nitch. I know even without cancer, as we age athletes sometimes have to modify and adjust. I remember years ago a lady I trained with told me she was mourning the loss of being able to run due to knee issues or something. My point being that the mental struggle is real when we aren't able to do everything we used to when exercising, whether from cancer or other cause, so I understand your identity crisis and hope you can find peace and patience in adjusting to your new normal.

ksusan

FWIW, I was cleared to plank as long as I built up to it gradually (e.g., 10 second planks -> 15 second planks, etc.). PT had me start with planks on a balance ball and gradually roll myself further out so more weight was on my arms. Same slow buildup for pushups, though I can only manage shallow ones because I'm inconsistent about doing them.

LilacBlue

Although I don't have LE, can so relate to wanting to working back to where we were. Dolphin pose can work rather than downward dog. Check out this link for free videos for cancer yoga and you can see the dolphin pose in action: http://www.cwellness.com/video/yoga-for-breast-cancer-chapter-7-dolphin-pose/ and http://www.cwellness.com/contributor-profile/denise-hopkins/ I think this link is a great, free resource.

I also think it's a great idea to seek out specialist cancer classes in your area, either for yoga, Pilates or general fitness. There are instructors out there who are wanting women like us to come and take part and really worth your time, and what better way to workout with other women (and men) who know, who have been where we have been and know how we feel.

Kneeling forward planks work the same core muscles as full plank, a modification that is easier on LE arms:

This morning was our local Pink Pilates and have numerous women attending with LE issues, many wearing sleeves and gauntlets and one with truncal lymphedema. When it's time to get on all fours, the modification is to stack up yoga blocks on the sleeve side about 4 blocks high to bend at the elbow, rather than having the arm straight down, holding the weight. The same principal of doing a dolphin, rather than a downward dog. It took me 9 months to do a downward dog again after surgery and mainly with frozen shoulder complications. The key is consistency. Don't give up, slow, little and often; it will build over time.

ShetlandPony

"Breast Cancer-Related Lymphedema and Exercise -- What you should know for a smart, safe workout"

http://www.stepup-speakout.org/Handout%20doc%20for...

Page 6 has specific guidelines for yoga.

EastcoastTS

Thanks, all! Very helpful!

LeesaD

THANK YOU ALL for all your responses! I'm going to read through all of the links today as I'm so ready to get back to my fitness. I feel good between my chemo sessions so after next session I'm going to work my way back slowly. Thank You again and you have all been so very knowledgeable and encouraging. So appreciative!

Lillanysan

Thank you all! I have hit rock bottom since dx in feb. With allthis I'm redy to start yoga again. Due to picc-line for chemo and instructions to avoid this and that I became passiv and could only see problems. End of that now!! Thank you all!

LilacBlue

Side plank pose/vasisthasa

From Ask The Expert: http://www.breastcancer.org/tips/ask_expert/2006_01/question_04

Cor: What specific exercise limitations are there with a PICC (peripherally inserted central catheter) line? I was told watch "heavy lifting" and "repetitive movement" but couldn't get any clear answer regarding what that actually meant.
Answers -Julie Gralow, M.D. The main thing is that you don't want to be doing a bunch of jarring motions that could potentially move the line up and out of the body. Obviously the PICC line is there to make it easier to draw blood and receive the chemotherapy. PICC lines can be put in different places, but they usually come out in the upper or middle arm. It's a bit of a cop out to say "use common sense," but I would not use that arm vigorously. With a PICC line in place, I wouldn't try to lift. But I would discourage complete disuse of the arm. If you really protect it a whole lot, that would also not be a good thing if the muscle atrophies. I know you were asking for specifics, but just avoid very vigorous activities or things that hurt.

MamaOz

leesad and lillianysan

Hello girls, I am always on look out for those with similar dx

I had my chemo prior to surgery because tumor was infiltrating pec. But chemo reduced it enough to do surgery with out complications of going into muscle

Had bmx my choice and glad i did as post op pathology found the beginnings of new tumor too small to detect yet in my left ... scary shit

I opted for no recon .. I am 3. Weeks post surgery and have just started therapy for getting my range of motion back in arms my right the one 29 lymphs were removed has some cording that ouch needs working thru and mld

How are you girls doing with your range of motion? Any PT?

My radiation will start in July providing I can get my right arm over my head

Currently, i walk each day and have been doing leg exersises and mild yoga stretches and my PT arm movements like finger walking up the wall perhaps after radiation I can think about upping my arm exersise unless the PT says I can do during rads

Im more paranoid about getting lymphedema so I plan to take it slow

Did read that using a rebounder is good for lymph flow

Research shows that Something about the vertical motion helps the flow better than horizontal walking / running so I do plan on trying that as soon as Im cleared for it

Hang in there girls and good luck with the chemo.

GenevaC

super useful thread - thank you everyone. I’m 7 weeks post MX and 2 rounds into AC but this week I’m starting to think about getting active again. I’ll go slow but regular.