Athletes with reconstruction

Hi Climber,

I chose to have a double mastectomy after my diagnosis with ILC.  I had to give up a piece of my pec because the cancer was close to it, so had to have muscle to replace it for reconstruction.  I chose to have the latissimus dorsi reconstruction with cohesive gel implants and came to that decision after researching all reconstructions.  I too was nervous about the idea of implants under the pec but this was ruled out with part of the pec removed. 

With Latissimus dorsi reconstruction, I was concerned about weakness in the shoulder and back due to missing lat muscles.  My plastic surgeon told me that the other muscles in my back would make up for the loss, and that the lat muscle was a helper muscle.  I found that to be true, once I restrenghened all of the back muscles.  The only deficit I have is that my back fatigues when sweeping and mopping floors.  Can you imagine?

I am very active and was very concerned with the weakness issue.  I am a black belt in tae kwon do and although I'm not doing it now, still participate in pilates, yoga, step aerobics, latin dancing, anything I can do to keep the endorphins running high.  In both pilates and yoga, I'm still stretching to get better range of motion for some of the moves.  My arm strenght is doing great, shoulders are strong and back is strong.  I'm able to do pushups so the muscle manipulation has not interfered with that.  But do realize, I've worked very hard to rebuild all muscles after my bc journey.

Best of luck to you in deciding what to do.  I had asked my plastic surgeon if I had implants under the pec, would it weaken the pec muscle.  He told me that the pec muscle would atrophy and thin, which would be no big deal for a non athlete.  I also asked if you worked at strenghtening the pec would it prevent it from happening.  He told me he didn't know.

Best of luck in deciding what will be best for you.  Learn all you can about all of the reconstruction, although some are ruled out if you don't have enough fat.  Never thought I'd have problems with reconstruction by not having enought fat. 

Lisa

Climbergirl,

Good luck on your decision.

I have a pretty eclectic sports background, white water kayaking, road riding, running and sports fishing (Try hauling in fish all day long!).  I am also a PT and work in a climbing/kayaking/mtn biking community and have had the pleasure of working with some nationally ranked kayakers and climbers. Yes there are other muscles that will do the same thing as the lat but a climber needs their lats for scapular stability and postural strength.

I opted for silicone implants and can't say that I miss my optimal pec function but I have had to work hard to regain the strength in my serratus anteriors which are also important for scapular stability in climbers.

There is no easy answer.  All reconstructions effect muscle balance but I think that some deficits are more easily overcome than others.    

Hi. I had a bilateral mast with expanders in June. Still have the expanders - hope to do the swap this winter after chemo finishes. I run (4 marathons) and cycle (3 centuries), and have had no problems athletically with the expanders. I was too thin for the other types of recon, and additionally I didn't want the long recovery times and additional incisions & muscle issues.

My PS gave me permission to resume running 4 weeks after surgery - he just told me to wear a good running bra. I really feel no difference from my pre-surgery self.

My only problem now is the chemo - it's reduced me to a pathetic jog/walk of 3 miles at best. Can't wait 'till it's all over.

Good luck with your decision.

climber - I had a lumpectomy with SNB first - that was the hardest surgery to recover from regarding activity - I had my rotator muscles tweaked from the inside during that surgery. As I explained it, it felt like someone took off my shoulder and didn't put it back on right. Then did chemo.... A month after chemo I did my preliminary Black Belt test in Tae Kwon Do and was already back to doing push ups and had full range of motion. A few days after that did mast with expander. I took it a little slow with rehab after that because I had (ugh, chemo brain, that implanted skin to make the pec longer) and didn't want to tear that out. I also really felt that I didn't want to screw this up by trying to do too much too fast because this healing of the pec was what I had to live with the rest of my life. I chose saline because, between the risk of getting kicked or punched in the chest I also ride (and occasionally fall off of...) horses. I wasn't comfortable, knowing the likelihood of the implant rupturing, going with silicone. I was pretty much back to full strength by the time of the exchange surgery and didn't lose much more than a beat after that surgery.

That was in January. I've spent this year working hard on my strength since I'd worked on the range of motion so well from the beginning. (Even threw my arm up over my head as soon as I woke up from the exchange surgery just for them to come in a half hour later and tell me not to do it. It did a lot for my morale to know that I could do it!) I've been training hard at TKD and working out at the gym religiously all summer in preparation for my Black Belt test a couple of weeks ago.  I'm doing nautilus and definately am weaker thru the pec than the other areas but in real life it doesn't matter. I'm back to 75 pushups and have all the strength I need.  Range of motion is perfect. I thought that was pretty good for this old (51) bod.

Probably the most important reason that all this happened so well for me was that I was working with a fabulous physical therapist from after the first surgery. She did alot of manual work that helped with the range of motion and guided me on the strength stuff - starting with the weakest of the therabands.  I can't even believe I found those difficult!

I see no reason at all why you shouldn't be able to get back to full activity in yoga or in climbing (I'm not a climber - tried it once and frieked out when I was closer to the ground than I am on a horse! - but my husband is so I have a sense of what's involved) after an implant. I did a yoga class the other night and it was my sprained ankle that I had trouble with, not my shoulder/chest.

Good luck with your decision. I hope that helps.

Hey climbergirl,

I climb, too! And am facing  bilateral mastectomies with some kind of recon. If I can do the implant/expanders, I will. I had rads 5 years ago to the left side, so I'm hoping this is still an option for me.

No way would I do TRAM or lat flap procedures. As you know, those muscles are critical for climbing.

I'd do DIEP if it was my only option. But the length of surgery and recovery, not to mention having to go out of state for it, do not thrill me.

Please keep me posted on your decision.

Anne

I think Jorf has got it down.

If you have any breast surgery and sit around for 6 weeks afraid to move your arm because it is a bit sore then you will lose strength and motion.

If you have breast surgery, listen to your physician, and keep moving then you're likely to be nearly as good as new before too long.

We've been doing "Wheel" in Yoga, and I will say that I notice it more on the implant side the next day, but it never stops me from doing it again the next week

Anne, you'll be climbing again before you know it! All the best with your surgery next week...

AnneW - Did I ever tell you the address of my favorite post-op site? www.stayingabreast.com

It's an easy program that is quite specific about what to do. I followed the schedule by week and never had a problem. I think we get into trouble when we start jumping ahead of ourselves. 

Jorf - I think a lot of success in Yoga is attributable to the teacher. It's not all brute strength, it's getting yourself warmed up and positioned right.  I could never be a Yoga teacher because you have to talk all the time

I am hoping to find more athletes (and recent updates) who have gone through reconstruction. What has your experience been like?

My UMX was last week, with immediate reconstruction. I play roller derby. I'm very fit (which is why I think my recovery is going so quickly), and eat rather cleanly. The hardest part about the whole cancer process is resting post-op. I so badly want to work out. 

My docs say that I should still be able to play my contact sport, but I can't imagine getting back to the track for a while. Anyone else out there young, fit, athletic, and getting/ received recon?