Program Goals Periodization Do's & Dont's Breathing Exercise Progression Exercise Tips... and More Phase 1 Phase 2 Phase 3 Phase 4 Beyond Phase 4: Abdominals Spinal Stabilization Lower Extremities Adjuvant Treatments Above & Beyond Equipment Sample Pages Contact Order the Book Browse the Book: Excerpts from Beyond Phase 4: Abdominals, Spinal Stabilization, Lower Extremities, and the Adjuvant Treatment Program (not periodized chronologically) Beyond Phase 4 consists of four separate programs that have been scientifically designed for specific physical requirements and conditions. Unlike Phases 1, 2, 3, and 4, which have been periodized chronologically, the exercises in Beyond Phase 4 can often be interchanged and combined with other programs in order to address the needs and goals of the individual person and to accommodate a vast range of people. There are those who will be exercising strictly for rehabilitative purposes and others who, having achieved a more advanced level of fitness, may prefer to participate in a program that is challenging and physically demanding, yet follows breast cancer guidelines. The section offers an expansive choice of strengthening, conditioning, and flexibility exercises and workouts for weight loss, endurance (cardiovascular) training, bone density maintenance, physical rehabilitation, and adjuvant treatments. Details regarding program and exercise choices, modifications, substitutions, adaptations, and recommendations for cardiovascular conditioning are addressed in the book. Some of the requisite exercises will be repeated or modified in some of the programs to maintain a sense of continuity and effectiveness. Others will be specific to the individual program. THE ABDOMINAL PROGRAM and THE SPINAL STABILIZATION PROGRAM This is a series of two separate but complementary programs designed to restore strength, tone, flexibility and stability to the abdominal muscles (with or without TRAM Flap reconstruction), the pelvic muscles, and the upper and lower back. Abdominal and spinal strength, flexibility, and upright posture can often be compromised by surgery or natural physical deconditioning. However with efficient exercises that focus on proper form and involvement of pelvic and torso muscles, strength and posture can often be restored. Certain exercises are more effective when performed with a Swiss ball due to the simultaneous use of the legs, hips, lower back and abdominals, the resulting stability in the muscles of the spine and pelvis, and improvements in balance and coordination provided by the necessity to control and mobilize the ball. The safest and most efficient form of aerobic conditioning for abdominal and spinal stabilization is stationary biking (upright or recumbent). In addition to the cardiovascular and strengthening benefits, lower back pain and stiffness can often be relieved by the motion of the legs and hips, and by improved breathing and increased levels of oxygen within the torso. Several examples of the exercise selections from the Abdominal and the Spinal Stabilization Programs are: Double Leg Curl (with or without Swiss Ball), Trunk Rotation (with or without the ball), Kneeling Torso Rotation (Swiss Ball), Bent Leg Bridging on floor or ball, and variations of other safe, effective Spinal Stabilization exercises (with and without exercise equipment). LOWER EXTREMITY PROGRAM This program has been designed to strengthen the legs and hips and to increase circulation and flexibility in the legs and feet. It is also important to incorporate an aerobic component (walking, gentle stair-climbing, stationary biking, or elliptical climbing and walking) for cardiovascular fitness, and weight-bearing exercises for the prevention of osteoporosis. A few examples of the extensive selection of Lower Extremity exercises are: Seated Hip Adduction and Abduction (Hips/Inner and Outer Thighs), Chair Squats, Seated Single Leg Presses, and Standing Leg Curls. All exercises can be adapted for different levels of fitness and may be modified with body positions and the use of exercise equipment such as Therabands®, ankle weights, and Swiss Balls. This information and exercise adjustments for specific physical conditions are addressed in detail in the book. ADJUVANT TREATMENT PROGRAM This is a series of gentle strengthening and flexibility exercises designed to help prevent muscle atrophy and decrease in physical stamina. The program has also been designed to help alleviate some of the side effects of radiation and chemotherapy, e.g., weakness, fatigue, depression, headache, muscle tension, poor circulation, excessive fluid retention, bone pain, numbness and tingling of the extremities, and muscle cramping. While in treatment it is important to strive to exercise for short durations at moderate intensities whenever your symptoms subside. Do not push yourself when your physical stamina is low and you are feeling particularly depleted. But do take advantage of the "good days" and exercise just enough to achieve an improved sense of well being and to create an energy reserve with minimum effort and maximum benefits. Most of the exercises can be performed in less demanding sitting or lying positions to help maintain and not compromise physical endurance. Gentle cardiovascular conditioning, resting between brief sets of exercises, gentle walks in the fresh air, slow controlled movements, deep breathing, maintaining fluid balance by drinking small amounts of water, and resting after exercising are necessary to protect the body when the immune system is compromised. In order to monitor specific conditions (e.g. fluctuations in blood counts or chemistries) and symptoms (e.g. excessive fatigue) at different stages of treatment, medical clearance and exercise recommendations from physicians, nurses, and physical therapists are particularly important for the safety of individuals undergoing radiation and chemotherapy. In addition to recommendations for mild aerobic conditioning while in treatment, specific guidelines for appropriate exercise techniques are discussed further in the book. A few examples of the extensive selection of exercises from the Adjuvant Treatment program are: Seated Knee Extensions, Lying Overhead Bar Stretch, Seated Foot Circles, and Doorway Stretches. Next Page: Above & Beyond Go to the top of this page. Back to the previous page.

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