Breast Cancer Survivors: Is it Safe to Work with Upper-body Resistance Training?

There is increasing evidence to support the value of resistance training in building strength and improving functional outcomes for breast cancer survivors (1). Many breast cancer survivors are reluctant to exercise their upper bodies, despite the apparent benefits. This is due to misinformation regarding arm use, fear about lymphedema, and perceived health risks associated with upper-body exercises (2). Breast cancer treatments such as radiation, surgery, and lymph node removal can also cause arm swelling, weakness, and pain, which makes resistance training more difficult (3). When designing resistance training programs for breast cancer survivors, health and exercise professionals must consider these issues and make informed decisions.

Is upper-body resistance training safe?

Lymphedema can occur after cancer treatment. It is a severe concern for many breast cancer survivors. It causes swelling, pain, and discomfort in the arm. This can restrict the range of motion, affect arm function, and increase the chance of infection (4). In the past, lymphedema management guidelines recommended avoiding repetitive and vigorous arm exercises. It was believed this could increase lymph production and cause or exacerbate lymphedema symptoms (5). Over the past 20 years, research has shown that upper-body resistance training doesn’t increase lymphedema risk or worsen symptoms. There is ample evidence to support the positive effects of resistance training, such as decreased arm swelling and improvement in symptoms of lymphedema (7,8). Current research indicates that upper-body resistance training may be safe for breast cancer survivors and can play an essential role in managing and treating lymphedema.

Resistance training is a safe and effective way to help you recover from cancer treatment. Breast cancer treatment can lead to side effects such as a rapid decline in strength, muscle mass, and fatigue. These side effects can last years and adversely affect your quality of life. Resistance training is a great way to combat these side effects and improve your quality of life. Upper-body resistance training is a great way to counteract injuries to the shoulder or arm after surgery. It increases upper-body function and reduces arm pain and disability (15).

Special Considerations in Program Design

While upper-body resistance training can be safe and benefit breast cancer survivors, exercise programs must be designed with breast cancer-specific symptoms in mind. These are some key considerations.

Arm symptoms after breast cancer: Breast-cancer survivors may experience arm pain, weakness, and decreased range of motion. Start with low resistance and a minimum number of repetitions, sets, duration, frequency, and sets. As symptoms develop, monitor them and adjust as necessary. If you have breast cancer survivors, encourage them to wear compression sleeves when exercising.

– Cancer-related fatigue can be expected and interfere with your ability to exercise, do physical activity, and engage in daily life activities. You can monitor your fatigue level during training sessions and adjust the intensity, repetitions, or sets of exercises as necessary.

– Perimeter neuropathy: Peripheral neuropathy can be a side effect of chemotherapy and may cause numbness in one’s hand or foot, weakness of the muscles, and loss of balance (16). Breast cancer survivors with peripheral nerve damage should be encouraged to do upper-body resistance exercises while seated or standing. You can use wrist weights if peripheral neuropathy makes it difficult to hold importance.

It may be necessary for a longer warm-up: To gradually increase the range of motion in the upper body, a longer warm-up with dynamic movements may be required.

– Education: If your client is hesitant about participating in upper-body exercises training, inform them of the safety and benefits for breast cancer survivors. Talk about safety and health concerns. Stress that the program will begin at a low intensity and progress slowly while keeping an eye on fatigue and arm symptoms.

Working with cancer survivors or patients requires specialized knowledge and expertise. You can also become an Exercise Specialist through ACE if you want to improve your skills and education.