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The Osteoporosis and Cancer Connection part 2


In addition to cancer survivors being at high risk for osteoporosis due to chemotherapy and cancer medications, balance issues are common. Balance can suffer after surgical procedures and treatments. Poor balance is of particular concern to those with brittle bones. This is especially acute with the TRAM flap procedure where the rectus abdominus is altered. Poor core strength, caused by the change in placement of the rectus abdominus, has a negative effect on balance. After a TRAM flap operation, it is necessary to learn how to compensate for this change of muscle placement through a series of exercises designed to strengthen the remaining muscles such as the obliques. Balance exercises can counter some of the effects of muscle imbalances and body asymmetry after surgery.


Some of the chemotherapies can affect balance. Neuropathy, a common side effect of chemotherapy, can make the feet numb and affect balance. Falls and fall-related injuries, such as a hip fracture, can have serious consequences. Balance and strength exercises can help prevent falls by improving the ability to control and maintain body position whether in motion or stationary.


Fear of falling and fracturing, might cause one to withdraw from daily activities and decrease quality of life. Stability exercises can help to enhance both steadiness and leg strength. Balance exercises will help one regain function and mobility for activities of daily living and are a key component for recovery after cancer treatments.


In addition to balance changes, cancer surgery may lead to faulty body posture. After surgery, cancer survivors have a tendency to protect the area where they had the surgery. For example, the chest area can feel tight and the cancer survivor may compensate by rounding the shoulders. Muscles are shortened because of the surgery and there is scar tissue. Nerves may be irritated, which can result in numbness and tingling. It is important to learn the essential stretches for the pectoral muscles and shoulders. Eventually incorporate strength training with an emphasis on strengthening the upper back muscles. This will help decrease the chance of developing round shoulders with a forward head posture.


Some of the reconstruction processes also change muscle placement, which may affect the posture of a cancer survivor. Whenever there is a change in muscle placement, it is advisable to have a postural assessment. In addition, abdominal surgery can

result in abdominal tightness, which in turn creates an initial tendency to walk leaning forward. The good news is that most posture issues due to surgery and treatments are easily corrected with proper stretching and strengthening exercises.


Postural exercise is important. A goal is to decrease the risk of rounded shoulders and spinal fractures. Posture exercises can help proper body alignment and can be performed a few times per day. The body needs to always be aligned properly so there is less stress on the spine. This will help one to maintain good posture, which can help improve kyphosis. Keeping muscles strong and flexible will also help with spinal stability.


Bone loss is a common finding in patients with breast and prostate cancer. Prevention of osteoporosis is key and exercise, diet, and lifestyle changes should be emphasized to help prevent bone loss. Osteoporosis is typically less prevalent in people who are active, and exercise may also prevent osteopenia from becoming osteoporosis. Proper body mechanics should be used throughout the day and during exercise sessions that include strength training, weight bearing, stress reduction, posture, and balance exercises.

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