Hey, remember last week when I said I wanted Brady to throw for 500 yards? I didn’t figure it would come in the first game of the season. This could be a ridiculous season!! If I played in a Fantasy Football draft, and picked him, I would definitely be sitting at home with my feet up on a table and crossed at the ankle, leaning back in a chair with my hands folded behind my head and smiling ear to ear, possibly while smoking a victory cigar.

Now that that’s said and done, I want to share a little story with you. Yesterday I had a consult with a woman who was a recent breast cancer survivor. After spending the past 8 months going through surgery including removal of 14 of the 16 lymph nodes in her right armpit, 6 rounds of taxotere chemotherapy (Note: It’s a mean bugger), and 6 weeks of radiation, she was looking to take control of her body again and get to a stage in her life where she felt strong, healthy and in control. I always have to slow clap someone for getting to this determination. (I should also say that all medical records are kept confidential, so even those who work with me wouldn’t know who this person is). She’s keen to get started, and is ready to do whatever it takes to make sure she’s healthy.

Now one of the downsides of breast cancer and the subsequent chemotherapy is the internal hormonal environment is shaken around like a snow globe in an epileptics hands. Estrogens are now the enemy, thyroid hormones are thrown for a big loop, cortisol is on full release, and the end result is a loss of almost their entire immune system, weight gain, stomach disturbances, and some other fun things.

Here’s some of her testing results:

Stiffness in the surgically repaired arm (left side), but not remarkably so. Point tenderness through biceps tendon, weakness in rotator cuff through external rotation, limited cervical rotation ROM looking left, but not looking right. No history of shoulder or neck trauma.

weak core, with a predominance to using hip flexors and diaphragm without concomitant use of transverse or external obliques. limited strength through hip flexion and hip extension.

Squat pattern was poor, as was bilateral balance through single leg forward flexion.

I could have done a lot of other testing on this individual, but it would have all pointed in the same direction: she needs to get moving, and taught how to move properly.

Remember, her main goal was to lose the weight from treatment and to feel in control of her body again, so spending time focusing on how much hip internal range of motion she didn’t have or her ability to produce a graded contraction of her left erector spinae weren’t needed, especially since she wasn’t in pain.

So what should we do to get her going? Start with some Fran-type Crossfit workouts and break her in half? Work on spinal segmental stabilization exercises to ensure proper core function? Work on the rotator cuff issue to get it ready for other exercises?

In the words of Dan John: The goal is to keep the goal, the goal.

We’re going to work on weight loss and overall health, as measured by follow-up blood test results with her oncologist.

Step one will be a dietary analysis to see if there are any foods that would be considered estrogen-promoting. Foods like soy and certain herbals and considered in this group, and if consumed regularly there is an increased rate of  estrogen production in the system, which can increase the rate of estrogen-dependent breast cancer cell production. This is backed by medical research too, for all those who decide that soy is the next great miracle food, just check HERE to see the research.

Vitamin D and calcium supplementation is also commonly prescribed after chemo as a bone-sparing supplement. Interestingly, there doesn’t seem to be a protective effect of high dosages of vitamin C and E in preventing recurrence or first diagnosis of breast cancer. A diet high in processed carbs and saturated fat is correlated highly with cancer risk, but a diet high in fruits and vegetables, beans and legumes has been found to reduce overall risk.

Once diet is figured out, we’re going to start with a basic workout program, which will help get her used to working out and teach her basic movement patterns to get her body moving in the most time-efficient way possible. The workouts will focus on moderate rep ranges, resistance used will not be to failure as her connective tissues will still be recovering from the therapies used. One of the things that happens with chemo and radiation is the once moist and flexible fascia and connective tissues become stiff, brittle and dehydrated, so the muscle soreness of an intense workout will be magnified until the tissues become adapted to the stress.

We’ll still focus on specific mobility work and strength training for weak areas, as well as energy system development, but they won’t be the main meal, simply the individual ingredients that make the entire thing sizzle.

Sure, there are a thousand potential directions that we could go with a training program, but the best place to start is usually at the beginning, with introductory exercises that can be considered staples of future programs, and help her to develop strength, endurance, mobility and a sense of control all at the same time.

For more information on how to get the most bang for your buck when programming for a cancer survivor, check out my Ultimate Cancer Survivors Guide to Exercise.

 Now it’s your turn to be the trainer. What would you do with a client like this if they came to you looking to get fit and healthy after everything they’ve been through? Leave a comment below and let’s create a discussion.