Reconnecting Through Pilates

Posted on February 5th, 2009 by

Breast cancer leaves many women feeling disconnected from their bodies and wary of exercise. Pilates offers a gentle method to venture back toward physicality and emotional health.

By Naomi Aaronson, MA, OTR/L, CHT

You may have heard of Pilates, but what is it exactly—and how do you pronounce it? Pilates (“Puh-LAH-tees”) is a mind/body exercise technique that stretches and strengthens the body through a series of flowing movements. It is unique because many of the exercises are performed supine (lying faceup), prone (lying facedown), or in side-lying positions, which allow the body to be centered and the spine to be aligned, putting less stress on the neck and the back.

So What Is Pilates?

In the 1920s Joseph Pilates created the more than 500 original exercises from which today’s Pilates classes have evolved. Influenced by Joseph Pilates’s experience with yoga and tai chi, the exercises are based on the concept of “controllogy,” which aims to coordinate mind, body, and spirit. Proper breathing techniques and body mechanics are strongly emphasized as are control and precision. Joseph Pilates believed that it was the quality of the movement that was important, not the quantity. And because he believed that the center of the body and the spine were the true indicators of one’s health, every exercise is an abdominal exercise. There are also exercises created for scapular stabilization (the winged bones in your back) that are important for shoulder mobility and strength.

Pilates has evolved considerably since the exercises were created more than 80 years ago. The original classic style has been modified in many ways as practitioners have developed their own styles of using the exercises. In addition, occupational and physical therapists have taken the techniques and used them to aid in the physical rehabilitation of various conditions, including back pain, Parkinson’s disease, and even autism.

How Does Pilates Address the Issues That Breast Cancer Survivors Face?

Recently, breast cancer survivors have also been benefiting from Pilates. Survivors face many physical challenges after undergoing breast cancer surgery and treatment, which are often compounded by the emotional stress that results from living with a life-threatening condition. Pilates provides an exercise technique that can help both mind and body recover and rehabilitate slowly.

Fatigue

Fatigue, both during and after cancer treatment, is the biggest issue many breast cancer survivors face. Many women feel unable to function and perform daily activities while undergoing chemotherapy or radiation treatments, and this fatigue can be overwhelming as treatments are combined and surgery is added to the mix.

Pilates offers a gentle, low-impact reintroduction or first-time introduction to regular exercise that can help one regain strength and endurance. To perform Pilates exercises correctly, you must concentrate. The benefits will be obvious if you keep at it and gradually build up by performing the exercises at least two days a week.

Pain/Range of Motion

Pain and loss of range of motion in the shoulder and the chest are other common issues for survivors who are considering exercise after treatment. Because many Pilates exercises are performed in the supine position, the neck and the back are supported, making it easier to feel which muscles are working in the back and to ensure that you’re using the right ones (trapezius and rhomboids). In addition, the exercises help return strength to the shoulder girdle in a safe, comfortable manner, which helps in regaining correct muscular balance.

Posture

Posture is another area of concern for many survivors after surgery. Often a woman’s back will become rounded following surgery, and her shoulders and head will be flexed forward. Pilates teaches you to resume an erect posture with a neutral spine and then works on restoring strength. Because the exercises demand that you concentrate on how your body feels when it is correctly aligned, each exercise is performed efficiently and with control.

There are also specific Pilates exercises—such as body extension and “swimming”—that can help stretch the tight chest muscles while strengthening the back. These exercises help in regaining proper muscle balance and strength in the back. Many Pilates practitioners use mental imagery to help you connect your mind and body to the exercise. For instance, an instructor might suggest that it is helpful to bring your shoulders down and press those “wing bones into your back pocket” while performing an exercise. This unique approach is used to help students perform the exercises correctly.

Lymphedema

Lymphedema is another concern. Many women who have had lymph nodes removed as part of their breast cancer treatment are warned about not exercising the arm vigorously and told to protect the arm from trauma and repetitive use. They may also be told not to lift heavy weights. Consequently, the arm becomes weaker, and survivors are often unable to perform daily activities or engage in previously enjoyed leisure pursuits.

It is important to strengthen the arm gradually. Because many Pilates exercises are abdominal, they are a natural fit for women concerned about lymphedema. In addition, muscular contractions performed in a specific sequence help propel lymphatic fluid into an area where it can more easily drain. You use inhalation to prepare for the exercise and exhalation as you perform it. This emphasis on breathing works the deep transverse rectus abdominal muscles, ensures that the body is stable, and promotes relaxation.

Choose to Reconnect with Your Body

Joseph Pilates said, “Concentrate on the correct movements each time you exercise, lest you do them improperly and thus lose all the vital benefits of their value.” Pilates, and this philosophy, will be a shift for many women returning to exercise. It’s not about quantity (how many sit-ups) but about the quality of the exercises you perform. When practiced correctly, Pilates allows one to reconnect with a body that has been traumatized and which might seem foreign.

Pilates can be a useful tool in rehabilitation for breast cancer survivors. With the help of a trained instructor, it can help a woman reclaim her physical confidence and reestablish a connection with her body.

Important Tips to Consider Before You Begin

  1. Always obtain your doctor’s clearance before participating in Pilates or any exercise program.
  2. Be sure to obtain a baseline DEXA (bone density test) to see if you have bone thinning or low bone density (osteopenia or osteoporosis).
  3. Trunk flexion and trunk rotation (bending and twisting of the spine) are not recommended if you have bone thinning or low bone density. Many Pilates exercises use these movements, but they can be modified if you have bone-density issues.
  4. Work with a Pilates practitioner who has experience with the special issues faced by breast cancer survivors. It is important to seek someone who can adapt or change the exercises to meet your specific needs.
  5. There is no regulation of Pilates instructors, so make sure that yours is qualified. Occupational therapists and physical therapists are learning Pilates in greater numbers and are oriented toward proper body mechanics and rehabilitation.
  6. Take individual sessions before joining a Pilates class. It is important to learn the basics—such as neutral spine, breathing, and control—before embarking on group sessions, where you may not get as much supervision.
  7. Nothing should be painful. If a movement hurts, speak up so that the exercise can be modified to suit your body!
  8. Release unwanted tension from your body prior to each session. Pilates should be relaxing, yet you should feel energized, alert, and stronger after participation.
  9. If you have undergone reconstructive surgery, including implant or TRAM flap procedures, lying prone may be more difficult. Please first see a physical therapist to ensure safety.
  10. Pilates takes mental focus, concentration, and physical work to do correctly, so it can be challenging at times. Don’t give up! You will see that the benefits are well worth the time and the effort as you become stronger and more confident through your Pilates practice.

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Tags: Breast Cancer

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