Exercise Promotes Survivorship: Tips for Working with Fitness Trainers
In September, Sally received a right lumpectomy with a sentinel node biopsy, then radiation followed by chemotherapy. She now wants to get back to her previously enjoyed activities which includes tennis. However, she is feeling fatigued and has gained weight. The Aromatase Inhibitors that she is on makes her fingers and toes stiff.
The good news is that exercise has been recommended both during and after treatment, and that it promotes your survivorship! Sally would like to start an exercise program because she knows that it’s good for her, but how? What kind of exercise? How many times of the week? Should she strength train?
If you are considering hiring a fitness professional to help you on this journey, here are some tips to guide you in selecting someone who can provide a safe and effective program. Generally, a fitness program should meet you where you are at and gradually increase in length, intensity, and number of times/week. The best exercise is the one that you will do! However, a good program addresses your cardiovascular status, strength, balance, and flexibility. The American Cancer Society recommends 150 minutes of moderate cardiovascular exercise/week and strength training 2x/week to all of the major muscle groups. It’s important to find a qualified person to work with you, as well as getting the go ahead from your health care team.
Tips When Hiring Fitness Professionals
- Do they have any type of fitness certification? Trainers are not licensed, so make sure that they minimally have a certification from one of the industry leaders such as ACE (American Council on Exercise) or ACSM (American College of Sports Medicine).
- Have they taken any courses on cancer fitness or do they have any special certifications such as the ACSM cancer exercise trainer? They should have education in cancer and the implications of cancer treatment on mind, body, and spirit.
- Do they have any experience with cancer survivors? Have they worked with clients who have had a breast cancer diagnosis? They should know how to proceed with clients who may have lymphedema, fatigue, weight gain, peripheral neuropathy, osteoporosis, and/or Chemotherapy Related Cognitive Dysfunction which are all important concerns. Does the trainer have a rehabilitation professional to consult when there are problems beyond their scope of practice?
- If working in your home, do they have liability insurance?
- What will their initial assessment include? Do they ask about the type and timing of the surgery, treatment, and if breast reconstruction was performed? What about any other medical conditions? This information is important as it is a guide as to where to start, the intensity of the workouts, the type of the work-out, if lymphedema is a concern and if any other modifications are necessary. If you have lymphedema, you can still strength train with your affected arm, but should wear a sleeve and gauntlet if recommended by your lymphedema specialist. Strength training to the affected arm should start slowly with light weights to assess the effect to the lymphatic system.
- What types of exercise do they include in their program? A warm up is essential especially to the neck, shoulders, back and core musculature after treatment.
- Do they ask if you have received a DEXA (Dual Energy X-Ray Absorptiometry)? This test measures bone density at the hip and lumbar spine and will determine what activities are safe. For example, a very low bone density with an osteoporosis diagnosis especially after age 65 would determine that back strengthening is very important. However, a program that includes jumping (which increases bone density) would not be safe for that client.
This list is a start, and I hope that it helps you feel more confident on your way to enjoying better health. Note that exercise greatly helps with fatigue, so try not to let fatigue be a barrier to starting your new program. What is most important is that you are consistent with exercise. You should make “yourself” a priority, and exercise should be included as part of your survivorship plan.
Stay tuned for my next piece on ways to fit exercise into a busy schedule.