Returning To Sport Post Breast Cancer Treatment

Returning To Sport Post Breast Cancer Treatment by Megan Oster, Lead Oncology Physiotherapist at Six Physio Chelsea

One of the most common questions I get asked is “can I ever go back to playing sport after treatment”. The answer, YES,  within reason. In fact, cancer care specialist physiotherapists strongly encourage return to physical activity/sport as soon as possible because it is associated with some incredible benefits. We know physical activity reduces many of the side effects associated with treatment and can prevent recurrence in some breast cancers by 35%! 

Before returning, here are my take home messages: 

Seek an oncology physio ‘MOT’ assessment during or post completion of treatment, prior to returning into sport. 

  • Cancer treatment is associated with many side effects. A Cancer Care Physiotherapist can help assess and appropriately treat these to ensure a safe and enjoyable return. These include:
    • Cancer related fatigue 
    • Post surgical pain, loss of range and subsequent reduction in function 
    • Scar tissue or radiotherapy associated skin and muscular tightness
    • Cording through the arm or tummy
    • Tightness around the scar and/or reconstructed breast 
    • Loss of muscle mass and strength 
    • Reduced balance

Consider the side effects of ongoing hormonal treatment

  • If indicated, some women are placed onto hormonal treatment (such as Tamoxifen or Letrozole) for up to 5-10 years post the completion of their primary treatment. These have some associated side effects which specific exercises can help to minimise injuries.
    • Osteoporosis (bone weakening)
    • Loss of muscle tone and strength; particularly your stabilising muscles
    • Joint pain

Exercise is safe and recommended for people with lymphoedema or at risk of lymphoedema

  • Research has shown us that any form of exercise (aerobic or resistance) does not exacerbate volumes or symptoms!
  • Cancer Care Physiotherapists encourage participation in exercise/sport as it helps with symptom control
  • Of note, do try and remember to avoid any sudden strenuous movements or repetitive activities with your at risk/affected limb

Consider the sport/activities you build into your routine to target the specific side effects of treatment. Different activities will have many different benefits for your body: 

Swimming:

  • Great for people suffering from lymphoedema as the water pressure together with the muscle contraction aids in fluid return
  • Allows whole body movement, taking joints and soft tissue through a full, gentle range. This can help reduce the tightness associated with surgery or radiotherapy
  • Eases the weight of the body on joints, making it more comfortable for people to exercise when they have joint pain 
  • Can be a good aerobic challenge for the body 

Tennis:

  • High intensity with a good aerobic challenge for your body 
  • Moves shoulder through full range of motion 
  • Challenges balance and coordination

Pilates:

  • Incorporates exercises (targets your stabilising muscles) to maintain and regain muscle strength, posture and flexibility.
  • Assists in improving overall body flexibility 
  • Assists with the management of osteoporosis with ‘weight bearing’ exercises
  • Improves balance

Yoga:

  • Incorporates whole body movements, allowing joints and soft tissue to be gently stretched
  • Flows and positions involve ‘weight bearing’ loading, improving bone health
  • Assists with breathing control and creating a calm state for mind & body 

It might feel daunting or like the last thing you feel like but start small and the effects can be fantastic on your body, energy, mood and mind.  Find a physio that you can share the initial process with, who can be by your side and support your path back to fitness (on the good and bad days). 

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