Stay Active after Breast Cancer

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Stay Active after Breast Cancer

In the early 1990s there was a scarcity of interest, research, funding and support available to breast cancer survivors for improving their fitness and well-being. Beauty and fashion industries hadn’t woken up to the call.  However, the grass roots support group SHARE in NYC was at the ready.  After a thorough screening by their gatekeepers, I began creating and delivering fitness programs to their members, who were eager for help.

It made sense to me that simple exercises could help a woman improve her function and quality of life after surgery, chemo and radiation. We could begin by relaxing the tight areas, relieving pain and stiffness, then increase range of motion to improve posture and alignment, and gradually move forward to condition the muscles.

Here are my seven simple steps of exercise for recovery:

1)         Proceed at your own pace. The normal progression is to begin to increase cardiovascular stamina slowly and steadily by walking daily, building up to 30 minutes most days of the week.  Continuous activities using large muscle groups can promote lymphatic as well as general circulation.  Work to your comfort level; just try to be consistent and keep moving, even on low-energy days.

2)         Count the minutes.  Build activity into your day. If you can’t find 30 continuous minutes, accumulate the total in smaller increments of 10- and 15- minute segments. Make every minute count – walk down the hall to speak with a colleague at work instead of emailing, walk or bike to work, use the stairs rather than the elevator. Put some energy into your daily affairs.

3)         Add steps to your day.  Step up your level of activity.  A pedometer, app or tracking device provides a good reality check and can motivate you to higher numbers. A recent study at Brigham and Women’s Hospital in Boston dispelled the notion that 10,000 steps per day is the benchmark for good health and longevity. The study, which included 17,000 older women of the average age of 72, found that 4400 steps per day increased chances of longevity, and that the benefits of walking maxed out at 7500 steps per day. In other words, women who walked more than that saw no additional boost in longevity.

            Set your own goals.  See how many steps you’re currently accumulating and create a goal based on that.  When you’ve reached the first goal, set another one, and continue to build, step by step.  Tangible progress creates incentive and enhances self-esteem while you’re building physical stamina.

4)         Watch your weight.  In postmenopausal women the main source of estrogen is from fat cells since the ovaries are no longer producing estrogen. Reducing body weight and body fat with exercise decreases the amount of circulating estrogen that could stimulate breast-cell growth.   Being overweight increases your risk by as much as 40%.  One study showed that women who gained more than 20 pounds after age 18 had a higher risk of postmenopausal breast cancer than women who gained no more than 5 pounds.

5)         Stretch it out.  Perform gentle stretches to regain full range of motion around the surgical site and counteract the tendency of scar tissue to contract. Use slow, controlled movements in a comfortable range of motion. Upon momentary discomfort, hold the position you are in, breathe deeply and exhale slowly.  Stop if you feel persistent pain or fatigue.

6)         Realign the spine. Take a good look in a full-length mirror, from the front and from the side. Increase your awareness of how neutral alignment looks.  Ask for help from a friend or health care professional torecognize how treatment may have affected your posture.Stand up straight to overcome the tendency to slump as a protective action.  Work to re-align your neck and shoulders by a combination of stretching the tight muscles and strengthening the weak ones.

7)         Strengthen your muscles.  With your doctor’s permission,once pain free range of motion has been restored and the wound is healed, you can begin gentle strengthening exercises. Recent studies show that strength training exercises prepare women to return to their normal day-to-day activities, reducing the risk of developing lymphedema by creating better muscle tone and endurance. Be sure to check with a health care professional for guidance on how to begin a program of gradual intensification appropriate to your current starting level.

You don’t have to join a gym, run a marathon or buy fancy equipment. You have all the equipment you need right within your own body.  Practice moderation; avoid the extremes.  There is no need to “protect” yourself by doing less than you are capable of, BUT, do not rush or push yourself too hard.  Consistency is more important than intensity.

The information in this article should not be construed as medical advice.  It is not intended to replace consultation with your physician or healthcare provider. Always check with your doctor before beginning an exercise program or becoming much more physically active.

For expert guidance on strength training techniques, step by step photos depicting how to perform the exercises and a selection of well-rounded workouts please check out Joan’s book Strength Training Exercises for Women at

(c) Copyright – Joan L. Pagano. All Rights Reserved Worldwide


  • Joan Pagano is the author of best-selling fitness books, including the new release Strength Training Exercises for Women (DK, 2014), an informational speaker on health and fitness topics and the owner of Joan Pagano Fitness in New York City. Former trainer to Jacqueline Onassis and Caroline Kennedy, Joan has specialized in strength training for women since 1988. She is an authority on the benefits of exercise for women's health issues such as menopause, osteoporosis and breast cancer, as well as strength training through the decades. Joan is the proud finisher of seven marathons and a member of the Shaker Heights High School Alumni Hall of Fame. Visit Joan at:

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