Weights and Strengthening

Hi Sloyd66,

We're sure you'll have some really helpful answers from the other members here shortly. In the meantime, you may be interested in checking out the main Breastcancer.org site's page on Lymphedema and Exercise for some good tips on staying safe!

We hope this helps!

--The Mods

Hello Sloyd66!  I started working with a trainer and weightlifting in the 11 weeks prior to my bmx/diep, hoping to build strength and cardio endurance to have a stronger heart through the long surgery, and to help with recovery afterward. I distinctly recall thinking 'bless the squat' during the first few days when I realized I could use my legs to do a lot of work and reduce my need to use my painful core.  I was so looking forward to returning to my workouts when given PS permission!  And then...lymphedema diagnosis, which I thought would put an end to lifting weights.  

Fortunately, I learned here about the PAL Protocol, guidelines and precautions worked out during the PAL (Physical Activity and Lymphedema) study. The PAL Trial demonstrated that we can enjoy the health benefits of strength training while reducing--not eliminating--our risk of triggering LE or of worsening existing LE because of the weight lifting.  Lifting weight we're not accustomed to signals stress to our lymphatic system, even for people with healthy lymphatics. But for those of us missing nodes, or with scar tissue around the nodes after rads, that stress sends a surplus of lymph fluid 'to the rescue' to our arm and torso, which may not be able to handle the load--hence, swelling.  The PAL trial and a good body of subsequent research have shown us that building strength slowly and gradually can allow our arms and torsos to become accustomed to lifting or pushing heavier weights, reducing the chance that the body's stress signal will unleash lymph that our log-jammed lymphatic system cannot handle.  

So--following the PAL precautions means waiting until any existing LE is stable, and then starting with incredibly small weights --1 little pound, in fact. It means adding weight in very small increments only every other week or so. It means avoiding body-weight exercise such as push-ups and planks, because it's not possible to measure the amount of resistance, let alone add it in small, measured increments. Precautions include wearing a compression sleeve and hand protection (either glove or gauntlet).  And for me...it has worked!

I continue to work with a wonderful trainer who was willing to learn about the PAL Protocol as soon as I brought it up. I organized a workshop in my area for personal trainers, with some funding support from two hospitals and a community foundation, bringing in the lead trainer for the PAL Trial. She teaches the trainers about LE, and she works with them for a full day on how to deliver safe weight training to women who have or are at risk of LE after BC treatment. My trainer hosted the workshop at his gym, and all the effort to bring in the workshop has paid off hugely.  It's been two and a half years since I was able to start my PAL-guidelines workout after surgery, and I'm stronger that I ever dreamed I might become. With the trainer I do a pretty balanced workout, for strength training, core work, and flexibility.  We find that even after all this time, I do need to pay attention to shoulder mobility and range of motion that were affected by the surgery, and I continue to build strength so that I have no fear of lifting heavy-ish weight in daily life.  For me, that means lifting grandchildren, moving heavy rocks while working on our landscaping, etc.  My LE arm gets super tired and heavy feeling after a workout, but I have never had a bout of post-workout swelling--I think that the weight lifting simply wears my arm out in ways that my non-LE arm doesn't notice.  And the strength training has given me the confidence to kayak long days, for five or six days in a row, which I've measured (strapping a pedometer on my paddle) at about 19,000 strokes each day.

Oh dear, I've written a huge commercial for strength training with proper precautions.  Can you tell I'm a believer? Sloyd, if you haven't discovered the step-up site yet, here's a link to a document you can give your trainer, all about weight lifting and other exercise for clients with or at risk of LE:

http://stepup-speakout.org/Trainer%20doc%20for%20S...

Also, the woman who gives workshops for trainers can be located here:

http://www.cancersurvivorfitness.com/about.html

...just in case your trainer has colleagues who might get together to learn together.

I hope you're lifting safely and that your trainer is either knowledgable or game to learn what he/she needs to know about LE to keep your workouts safe.