Pilates for Breast Cancer Survivors

Two experts in breast cancer rehabilitation share their insight into the benefit of this safe, effective form of exercise.

By Naomi Aaronson, MA, OTR/L, CHT, CPI, CET, and Ann Marie Turo, OTR/L 

Why Pilates For Breast Cancer?

Pilates is a gentle form of exercise that engages the mind, body, and spirit. The various Pilates exercises help develop muscular flexibility and strength while increasing me­tabolism and promoting lymphatic, respiratory, and circulatory func­tion. They improve balance and co­ordination and also help you relax and “get centered.” Pilates is able to meet you where you are, and it can be done throughout your life and wherever you are, even while seat­ed. For these reasons it is an excel­lent approach to healing for breast cancer survivors.

The Pilates method was first developed by Joseph Pilates to strengthen muscles, increase flex­ibility, and improve overall health. It is a mixture of yoga, martial arts, and gymnastics. He first taught his method as “Contrology,” a mash-up of Eastern and Western philoso­phies and techniques, to a small group of devoted teachers and stu­dents in the United States after emigrating from Germany follow­ing World War I. Years later, in the 1950s, Pilates used his techniques to rehabilitate dancers at his studio in New York City without receiving much recognition for his method.

One of Pilates’s first protégés was Eve Gentry, whom he rehabilitated after a radical mastectomy. Eve was able to regain full use of her arm and torso, which is remark­able because all of her lymph nodes and chest muscles, as well as breast tissue, had been removed. Doctors could not believe the success that she had obtained with Pilates’s method. He was a man ahead of the times. Research is now being con­ducted that documents the benefits of the Pilates method for breast cancer recovery.

What Are The Benefits Of Pilates?

Beth Mast, an occupational thera­pist and Pilates practitioner, used Pilates to recover from breast can­cer and is now using the method on her journey through living with metastatic cancer. She says that Pi­lates has always been available to her, even on really bad days. It was the only exercise she could tolerate after going through chemotherapy and becoming increasingly ane­mic, unable to stand even to brush her teeth. Here are the specific benefits Beth has found with her Pilates practice.

  • You can do Pilates in many different positions: supine (on the back), prone (on the stomach), side-lying, standing, and seated.
  • The exercises and equipment can be modified for any level.
  • You will be able to use the affected arm(s) more easily and naturally because Pilates is a whole-body exercise system that includes the arms and legs in the movements.
  • The principles help you live in the moment by keeping you focused on moving properly, with control and without momentum.
  • Deep rib cage breathing and the multidimensional breathing patterns help ease tension, encourage lymphatic drainage, and stretch tight areas affected by scars.
  • Pilates provides a gentle introduction or reintroduction to exercise.
  • Pilates increases muscle strength, especially in the back of the shoulders and the middle back, where you need it after breast cancer surgery.
  • Pilates increases your ability to perform activities of daily living as you build core strength, allowing you to more easily roll over and move from different positions.
  • Pilates improves muscle proprioception (the reception of stimuli) and kinesthesia (awareness of the position and movement of the parts of the body by means of sensory organs) in the muscles and joints; these sensations are often lost after surgery, when nerves and muscles may have been inadvertently cut.
  • Pilates strengthens the transverse abdominis, a muscle that is very important for back stability and strength after a TRAM (transverse rectus abdominis myocutaneous) flap or DIEP (deep inferior epigastric perforator) flap breast reconstruction procedure.
  • Pilates can help with bladder control problems such as stress incontinence, a common complication of menopause.

Many treatments for breast cancer can induce menopause in women who are not yet meno­pausal. Pilates helps by strength­ening the pelvic floor muscles, which are responsible for bladder control.

Pilates takes the focus off the damaged areas of your body and what you cannot do and rein­forces what you can do. You will appreciate all the movement your body is capable of, no matter how small or limited at first, and its capacity to heal.

References

  1. Kushi LH, Doyle C, McCullough M, et al. American Cancer Society guidelines on nutrition and physical activity for cancer prevention. CA: A Cancer Journal for Clinicians. 2012;62(1);30–67. doi: 10.3322/caac.20140.
  2. Keays KS, Harris SR, Lucyshyn JM, MacIntyre DL. Effects of Pilates exercises on shoulder range of motion, pain, mood, and upper-extremity function in women living with breast cancer: A pilot study. Physical Therapy. 2008;88(4):494-510. doi: 10.2522/ptj.20070099.
  3. Eyigor S, Karapolat H, Yesil H, Uslu R, Durmaz B. Effects of Pilates exercises on functional capacity, flexibility, fatigue, depression, and quality of life in female breast cancer patients: A randomized controlled study. European Journal of Physical and Rehabilitation Medicine. 2010;46(4):481-87.
  4. Stan DL, Rausch SM, Sundt K, et al. Pilates for breast cancer survivors. Clinical Journal of Oncol­ogy Nursing. 2012;16(2):131-41. doi: 10.1188/12. CJON.131-141.

American Cancer Society Recommends Regular Physical Activity for Breast Cancer Survivors

The ACS Guidelines on Nutrition and Physical Activity for Cancer Prevention1 recommend that breast cancer survivors avoid inactivity and return as soon as possible to normal activities after surgery and during radiation and adjuvant treatment (chemotherapy, hormone therapy, and/or targeted therapy). The guidelines recommend regular physical activity and strength training at least twice a week, aiming for 150 minutes of exercise per week.

Physical activity offers additional benefits for breast cancer survivors:

  • Boosts positive mood
  • Improves physical condition and movement
  • Improves body image
  • Increases sexuality
  • Decreases depression
  • Decreases fatigue
  • Maintains bone health

We know that exercise is good for us. We just need to start somewhere and feel safe. Pilates is a gentle, safe place to begin.


What Does the Research Say?

The first study on the benefits of Pilates for breast cancer survivors was completed by physical therapists in 2008.2 It was a pilot study with only four participants, so the conclusions we can draw are limited. The researchers found that Pilates increased the flexibility of the affected arm after a 12-week program during which participants exercised three times a week.

Another study, done in 2010, examined the effects of Pilates exercises on functional capacity, flexibility, fatigue, depression, and quality of life in female breast cancer patients.3 Pilates was performed three times a week for eight weeks. After participation in the exercises, improvements were noted in the subjects’ levels of fatigue, flexibility, quality of life, and performance on a six-minute walking test. This study proved that Pilates was safe and effective for breast cancer survivors.

The most recent study, published in 2012, found that after 12 weeks of Pilates 13 participants improved their shoulder and neck flexibility.4 Improvements were noted in mood, body image, and quality of life. Although volume increased on the affected arm (a sign of lymphedema), one must note that this program did not modify the exercises for the class and that the sessions increased in frequency over the 12-week period.

Adapted with permission from Pilates for Breast Cancer Survivors: A Guide to Recovery, Healing, and Wellness (Demos Health, 2014; $21.95), available for purchase here.