There are several studies reporting the benefits of exercise for cancer patients. The studies center around maintaining a healthy weight and lifestyle before during and after cancer treatment and surgery. I have long been a proponent of the value of exercise. In this blog I will share what I practice and know about exercises pre and post DIEP flap breast reconstruction.
Taking it to the Streets
The video I share gives an example of some simple, yet effective exercises guided by a trained exercise physiologist. We are filming at the Wolfe Foundation Cancer Wellness Program at the McConnell Heart Health Center in Columbus, Ohio. Whether you are part of an online class or in person class, I encourage breast cancer and breast reconstruction patients to ask their healthcare team if there is a local or online exercise program available in their area.
While some people are incentivized by exercising in a group or with a trainer, others find it quite comfortable and convenient to do them at home. Either way, I absolutely advise you to seek approval from your medical team before you start any new exercise program, especially exercises pre and post DIEP flap breast reconstruction.
Exercising the Core Before and After DIEP flap
I am often asked by those preparing for DIEP flap what they can do to get stronger and prepare for surgery. Not knowing what level of exercise they are at, the ones shown in the video I feel are safe and affective as long as the person doing them doesn’t have any other medical restrictions. Because they are guided by a trained exercise physiologist and the demonstration is done by my friend Mary, who also had DIEP flap, I share these frequently in my breast cancer community. In fact, I often tell people to show their healthcare team the video just to be sure they approve of them for their patients to do.
After my own DIEP flap breast reconstruction, I felt like I could bounce of quarter off my tight abs. With a hip-to-hip incision from my microsurgeon took the flap, I wasn’t sure when I could start back to any type of exercise. He and his nurse were great in responding to my inquiries and told me when I was released to begin exercise. He always instructed me to start out slowly, encouraging gentle yoga and Pilates.
I mention in the video that because of the tightening of the tummy I personally felt a false sense of core strength. In other words, just because they felt tight, did not mean they were strong and being worked. These simple exercises were a good start for me. Keeping your core strong in any circumstances is good for your overall back health and strength.
The Pelvic Tilt Exercise
Laura, the exercise physiologist begins by guiding Mary through this work for the core.
- Lying flat on the floor bring both knees up with feet flat on the floor.
- Bring the belly button to the spine to close the gap between your back and the floor.
- Tighten your abdominal muscles.
- Relax, then repeat steps 2 and 3 for a set of ten.
- You can alter it a bit by gently tilting the pelvis and holding it for 4-5 seconds.
Two Tips from Laura:
- Make sure your shoulders are relaxed and are away from your ears.
- Breath naturally through the nose if you can for all these exercises to work your abdominal muscles even more.
Tabletop Exercise
This would be a next step after you are comfortable performing the pelvic tilt described above. Mary demonstrates for us.
- Bring legs up to a 90-degree position.
- Keep back flat on the floor tightening your core and pulling the belly button into the spine as before.
- Keeping arms straight bring one arm over and above your head alternating each arm back and forth as in a scissor motion.
- An advanced for of this is to place a 3–5-pound weight in your hand, bringing it overhead as performed in step three using both arms at once.
Two Tips from Laura:
- If you feel your back coming off the floor while doing these, to avoid any lower back pain, stop, and check your positioning making sure the lower back is still connected to the floor.
- Check your range of motion. If you cannot place arms all the way over your head, go as far as you can comfortably go.
Advanced Tabletop Exercise
After feeling comfortable with the tabletop instruction above, next steps would be the following:
- Bring knees to a 90-degree angle with back flat against the floor as above.
- Tap one foot on the floor one at a time.
The Bridge for Core Strengthening
The final exercise Mary demonstrates is the bridge. Laura guides her through the following movements:
- Lying flat on the floor with back connected to the mat, bend knees and keep feet flat on the floor.
- Bring your rear-end off the floor and hold and repeat this motion.
Two Tips from Laura:
- Generally speaking she advices beginning with a set of ten. Work up to additional sets as you are comfortable.
- Keep core and gluts (butt muscles) tightened while performing these exercise.
Core Exercise Video: Exercises Pre and Post DIEP Flap Breast Reconstruction
Mary and I have performed these exercises and feel they have helped with lower back fatigue. They are simple yet effective ways of strengthening the core before and after DIEP flap breast reconstruction. Another reminder to check with your surgeon before performing any exercise especially after surgery! Enjoy the video!