Keep on the move – exercise

Exercise is recommended to help breast cancer patients recover from treatment and surgery. With that we look at the role of a physiotherapist and biokineticist in your treatment plan.

Day one

A physiotherapist’s involvement should begin from day one of diagnosis. The surgeon or oncologist will hopefully refer you to see a physiotherapist, who will explain the importance and benefits of physical activity while going through treatment.

Most would believe this to be difficult during treatment, such as chemotherapy, but there are activities you can do, to maintain your strength and fitness. These activities have been shown to reduce treatment side effects.

Once you have completed treatment, the most important thing to do is to maintain a healthy body weight and to exercise regularly every week. One hundred and fifty minutes of moderate intensity exercise every week can reduce the risk of a breast cancer recurrence by up to 40%.

The duty of a physiotherapist

A physiotherapist assists by going through the treatment side effects that can be expected and explains what exercises are appropriate at each of the initial stages.

The physiotherapist involved needs   to have the necessary training and experience with oncological conditions, and will prescribe a detailed exercise programme that is appropriate and goal orientated for you.

Once the physiotherapist is happy with your achieved outcomes, they will then recommend a biokineticist.

A biokineticistís duty

A biokineticist’s helps you exercise correctly, and teaches you what exercises to avoid as certain cancer treatments affect bone health, cause low immunity, and may cause certain peripheral neuropathies.

Walking and cycling are both beneficial. Other exercise modes that involve large muscle groups, such as swimming or hydrotherapy, are also recommended.

The strength training with a biokineticist can begin once the ideal range of motion in the affected shoulder is achieved and your physiotherapist is happy with your progress.

Optimal range of motion

Exercise programmes for breast cancer patients should aim to achieve: the optimal range of motion in the chest and the shoulders; maintain optimal weight and psychological functioning;  decrease lymphoedema; and lower osteoporosis risk as a result of the hormonal medication. Exercise also reduces the oestrogen level in the body, assisting the oestrogen-blocking medication, tamoxifen.


Baseline measurements will be taken at your first appointment. This is particularly important in patients who are at risk of developing lymphoedema (chronic swelling); it can involve limbs, head or neck, genitals, or breasts.

Primary lymphoedema occurs when a person is born with it, or predisposed to a lymphatic problem and they may develop swelling in one or more limbs at some stage of their life.

Secondary lymphoedema is caused by a direct trauma to the limb, or surgery to the lymph nodes, e.g. the axillary lymph nodes in breast cancer. The incidence of breast cancer-related lymphoedema varies depending on the number of lymph nodes removed during surgery as well as radiation therapy and complications developing.

Start ASAP

A physiotherapist should see you on day one after surgery to ensure you start the appropriate exercises as soon as possible. This will help to regain full shoulder movement at a steady pace over six to seven weeks, and hopefully prevent complications from developing.

Axillary web syndrome (AWS)

A common complication is axillary web syndrome aka cording. This is a tightening of the affected lymphatic/venous structures in the axilla. It can be very painful and distressing for the patient if he/she doesn’t know what it is or how to treat it. Manual therapy can have wonderful immediate effects; the exercises aim to prevent these cords from forming.

Progressive resistive exercise programmes 

Consult your physiotherapist or biokineticist before beginning any progressive resistive exercise programmes. If you experience any pain or difficulty with any exercises, stop and consult your physiotherapist or biokineticist.


Hayleigh Heslop (biokineticist), Candice Kuschke (physiotherapist) and Gwen Castley (biokineticist).

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