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 Phase 4 These exercises are a sampling from Phase 4. (10 weeks post-surgery) Timing of each phase is dependent upon the physical condition of the individual, the length of the healing process, the type of surgery involved, the courses of adjuvant treatments, and the recommendations of physicians, nurses, and specialized physical therapists. Many variables may exist that will effect particular exercise choices at given times. Everyone should begin with Phase 1 in order to practice optimal postures and techniques. Be certain to obtain as much information as possible to prevent the onset of Lymphedema, which can occur spontaneously and indefinitely. (Refer to Links page for related Lymphedema web sites.) Phase 4 includes more active aerobic activities such as stationary biking, slow, gentle stair-climbing, and a more aggressive walking or swimming program. Focus is on endurance, strength and flexibility exercises for entire body. Use of Therabands, Swiss balls, light dumbbells, and dowel sticks may be recommended with permission from health care practitioners, dependent upon patient's recovery and state of health. When exercises become less challenging, do not increase number of repetitions. Instead, increase number of sets. For example, it is safer and more beneficial to perform 2 sets of 10 repetitions with a short rest in between sets, as opposed to performing 20 repetitions. It is important to progress gradually and to pace yourself according to your physical condition. Upper body repetitions will always be limited to a maximum of 3 sets of 10. Remember to breathe. Before and after exercising, warm up and cool down, and perform several mild stretches. Single Leg Raises: (for abdominals, low back, and lower extremities). Lie on back (with small cushion or rolled towel under head) on firm bed or floor, with spine straight from top of head to tailbone. Neck straight and chin down. Arms at sides, below shoulder level. Press back of waist down, lift tailbone very slightly into a slight pelvic tilt, and pull in abdominals to support lower back. One knee is bent with foot flat on floor in front of pelvic bone, and other leg is extended straight up toward ceiling with flexed foot. To begin, inhale, slowly lower straight leg down to barely touch floor. Then exhale, pull abdominals in, slowly raise leg 1/2 way up to knee level, and repeat. If you experience discomfort in low back or abdominals, keep the working leg slightly bent, and only lower it 1/2 way down. Start with 6 repetitions on each leg and work your way up to 2 sets of 8 on each leg. Rest. When exercise is completed, bend both knees up toward chest, wrap arms around legs, and hug legs toward body to stretch lower back. Then rock lower body very gently from side to side to increase stretch. Eventually, you will be able to add 1 lb. ankle weights with permission from your physician. Prone Butterflies (for posterior shoulders): Kneel on floor with Swiss ball in front of you. Lie over ball (on a thick towel for cushioning) with hips down and abdominals pulled in for spinal support. Continue to kneel during the exercise with toes tucked under for balance. (If feet cramp, release toes). Neck is straight, and eyes are focused downward to prevent tension in neck and shoulders. Arms are hanging straight down, palms facing inward, wrists and hands straight. Exhale and lift both arms slowly out to side (like airplane), squeezing shoulder blades together. Hold. Inhale and slowly lower arms. Start with 6-8 repetitions and progress to 2 sets of 10. If you don't have a Swiss ball, you may sit in a chair and place 2 thick pillows on lap. Lean straight forward and support torso with pillows, following above directions for proper form. The ball, however, offers the best support and will also contribute to the strengthening of abdominals and spinal muscles. Next Page: Beyond Phase 4: Abdominals-Spinal Stabilization-Lower Extremities-Adjuvant Treatments Go to the top of this page. Back to the previous page.

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