Upper Extremity Rehabilitation Guidelines

The pri­mary treat­ments for breast can­cer (surgery, radi­a­tion, chemother­apy) con­tinue to lead to sig­nif­i­cant mor­bid­ity for many indi­vid­u­als diag­nosed with this dis­ease.  A num­ber of phys­i­cal impair­ments com­monly result from treat­ments designed to save or pro­long the lives of those affected.  These include impair­ments of upper extrem­ity range of motion and strength, upper extrem­ity and/or breast lym­phedema, pain, fatigue, loss of sen­sa­tion, and reduc­tion in lev­els of phys­i­cal activ­ity and health-related qual­ity of life.

Older woman holding weightsThe fol­low­ing 5 tips can help lower risk of impairments:

  1. Gen­tle range of motion exer­cises the first week after surgery.
  2. Active stretch­ing exer­cises 1 week after surgery, or when the drain has been removed.
  3. Active stretch­ing exer­cises con­tin­ued for 6–8 weeks or until full range of motion is achieved in the affected upper extremity.
  4. Pro­gres­sive resis­tance train­ing can begin with light weights (0.5-1kg) within 4–6 weeks after surgery.
  5. Post­op­er­a­tive assess­ments should occur reg­u­larly up to 1 year after surgery.

This infor­ma­tion is in line with the Insti­tute of Med­i­cine report ‘Clin­i­cal Prac­tice Guide­lines We Can Trust’.

For fur­ther infor­ma­tion on how you can start a pro­gres­sive resis­tance train­ing pro­gramme early please email Marie at murphyprogramme@gmail.com

Know Your METs to Lower Breast Cancer Risk/Recurrence

Exer­cise reduces an individual’s risk of devel­op­ing breast can­cer. Fur­ther­more, in indi­vid­u­als who have already been diag­nosed with the dis­ease, exer­cise reduces the chance of a can­cer recur­rence as well as improves qual­ity of life.

Below is an easy expla­na­tion of the METs pro­gramme which I did for an ini­tia­tive called Choose­ToTri.  June O’Connell started Choose­ToTri  after hear­ing me speak at the Irish Can­cer Society’s Annual National Breast Can­cer Con­fer­ence (2010) when talk­ing about the rela­tion­ship between exer­cise and can­cer pre­ven­tion (METs).

In this video, I explain METs in a clear and easy to under­stand way.

For fur­ther infor­ma­tion on METs please see:

Know Your METs for Pre­ven­tion — Recur­rence of Disease

Cal­cu­lat­ing your weekly METs km

 

Breast Cancer Awareness — 6 Weeks Beginners Course

Breast Can­cer Awareness

Research indi­cates that phys­i­cal activ­ity after a diag­no­sis of breast can­cer improves qual­ity of life, reduces fatigue, and assist with energy bal­ance. Both reduced phys­i­cal activ­ity and the side effects of treat­ment have been linked to weight gain after a breast can­cer IMAG0225diag­no­sis. Stud­ies have found that women who exer­cise mod­er­ately (the equiv­a­lent of walk­ing 3 to 4 hours per week at an aver­age pace (3–4 METs) after a diag­no­sis of breast can­cer have improved sur­vival rates com­pared with more seden­tary women.

6 weeks Begin­ners Course

I will be offer­ing a 6 weeks low to mod­er­ate phys­i­cal activ­ity pro­gramme (Mur­phy METs Pro­gramme) for breast can­cer sur­vivors start­ing Sat­ur­day Older woman holding weightsNovem­ber 1st 10:00am.  The focus of the pro­gramme is to improve flex­i­bil­ity, bal­ance, co-ordination, mobil­ity, strength, mus­cu­loskele­tal func­tion, bone den­sity and con­fi­dence, in addi­tion to hav­ing an impact on car­dio­vas­cu­lar fit­ness, weight man­age­ment and psy­choso­cial well-being.

Mur­phy (METs) Programme

  • Per­son­al­ized train­ing programme

  • Weekly classes

  • Nutri­tional analysis

  • Fit­ness test (1 mile time trial)

  • Mus­cu­lar strength evaluation

  • Body fat analysis

  • Consent/Waiver form

  • Health Ques­tion­naire

  • Nutri­tional Sta­tus Questionnaire

  • Qual­ity of Life Questionnaire

Join Today

To reg­is­ter for the pro­gramme par­tic­i­pants must be 3 months post-surgery with med­ical clear­ance.  Course fee €75.  For fur­ther details please email Marie at murphyprogramme@gmail.com.  All par­tic­i­pants will be accepted on a ‘first-come, first served basis’ (Addi­tional courses will follow).

 

Balance in Our Everyday Lives

Home­osta­sis is an essen­tial part for our health.  But, in order to pro­mote a body in bal­ance our mind needs to con­tribute. Choices we make in regards to stress reduc­tion, healthy nutri­tion and reg­u­lar exer­cise helps keep an imbal­ance at bay.

IMAG0188Focus on what makes you feel calm and in con­trol. Man­ag­ing stress is about tak­ing charge of our thoughts, emo­tions, sched­ule, and the way we deal with prob­lems. This isn’t as easy as it sounds.  Iden­ti­fy­ing our true sources of stress, we have to look closely at our habits, atti­tude, and excuses.

A reg­u­lar diet rich in plant foods, fish, and lean pro­tein boosts over­all health and clearly helps pro­tect against heart dis­ease and dia­betes. How­ever when it comes to exer­cis­ing inad­e­quate nutri­ent intake deprives the body of the energy needed to per­form, the car­bo­hy­drates nec­es­sary for glyco­gen replace­ment, the pro­tein needed for tis­sue build­ing and repair, and the micronu­tri­ents nec­es­sary for nor­mal metab­o­lism and main­te­nance of body homeostasis.

EilishThe health ben­e­fits of reg­u­lar exer­cise and phys­i­cal activ­ity are hard to ignore and the ben­e­fits are ours for the tak­ing, regard­less of our age, sex or phys­i­cal abil­ity. Our body needs reg­u­lar exer­cise, the right food, lifestyle and men­tal atti­tude to achieve its true health potential.

Pic­ture of my sis­ter (sur­vivor) and two of her girls out on a walk yes­ter­day in California :)

Cardiovascular Exercise: Are You Getting Your METs?

To reap all the ben­e­fits car­dio­vas­cu­lar exer­cise (walk­ing, cycling, swim­ming etc.) can pro­vide, you need to be sure that your fit­ness rou­tine is pro­vid­ing you with the right num­ber of METs. Group walk

METs are the rate at which our bod­ies use oxy­gen (meta­bolic equiv­a­lents). If you accu­mu­late >15 METs every week, then you get sig­nif­i­cant ben­e­fits in terms of fight­ing can­cer. Stud­ies have shown as lit­tle as 9 MET/hrs of phys­i­cal activ­ity over a seven day period increases sur­vival rate for breast and bowel cancers.

Your fit­ness level has a direct impact on how many METS you expend per minute. So let’s say it take you 16 min­utes to walk a mile, your pace is 3.75 miles per hour, which cor­re­sponds to 4.3 METs per hour. If you walk 3 ½ hours over a seven day period you will accu­mu­late 15 METs for your week.

I will be giv­ing exer­cise and nutri­tion talks for patients, fam­i­lies, sur­vivors and health pro­fes­sion­als dur­ing breast can­cer aware­ness month as part of my pro-active edu­ca­tional pro­grammes  One of these talks will take place Thurs­day, 16 Octo­ber 7:30pm–9:00pm at Good Coun­sel G.A.A. Club Davitt Road, Drim­nagh, Dublin 12.  This event is spe­cial for me because it takes place in my own home town.

Hope to see lots of famil­iar faces :)

FREE EVENTALL WELCOME Marie Murphy_Breast Can­cer Aware­ness Month_Save the date

Please con­tact Marie at murphyprogramme@gmail.com if you would like a cus­tomised train­ing programme.

Nutrition & Cancer

Healthy SaladA good can­cer diet is sim­i­lar to a can­cer pre­ven­tion diet. The main dif­fer­ences are that peo­ple under­go­ing chemother­apy may have higher nutri­tional needs and poor appetites. It is very impor­tant to eat the most nutri­tious foods you can get. A diet that is high in veg­eta­bles, fruits, whole grains, beans, fish, and low in fat, high in fibre is can­cer protective.

Can­cer treat­ments may decrease appetite and lower the abil­ity to digest food which may inter­fere with the body’s abil­ity to absorb and use nutri­ents. Focus should be placed on get­ting enough calo­ries to keep up strength and eat­ing a healthy a diet as pos­si­ble to boost the immune sys­tem to help deal with pos­si­ble nutri­tional deficiencies.

Think of the Irish Flag ‘plenty of green, white and orange fruits & veg­eta­bles. Make sure your diet con­tains plenty of low-fat pro­tein, such as cold-water fish (salmon, sar­dines, and mack­erel) beans, and white meat chicken or turkey.

Pro­tein rebuilds mus­cle and tis­sue which is par­tic­u­larly impor­tant when your body has under­gone chemother­apy, surgery and radi­a­tion. Good fat such as olive oil and omega 3 oils includ­ing flax seed oil and fish oil are impor­tant, while processed fats and oils, such as Trans & hydro­genated fats in mar­garines and fats used for bak­ing should be avoided.

Keep well

Ireland’s 2014 Report Card

Based on the results from Ireland’s 2014 Report Card on phys­i­cal activ­ity in chil­dren and youth, phys­i­cal activ­ity lev­els remain low in Ireland.Running on sand dunes

  • Over­all Phys­i­cal Activ­ity Lev­els D–
  • Orga­nized Sport Par­tic­i­pa­tion C–
  • Phys­i­cal Edu­ca­tion D–

The esti­mated con­tri­bu­tion of phys­i­cal inac­tiv­ity to the bur­den of dis­ease in Ire­land was esti­mated at 8.8% for coro­nary heart dis­ease, 10.9% for type 2 dia­betes, 15.2% for breast can­cer, and 15.7% for colon cancer.

To see change in these types of sta­tis­tics we need to have Phys­i­cal Activ­ity part of our National Schools cur­ricu­lum.  All chil­dren and youth should have the oppor­tu­nity of a ‘qual­ity’ expe­ri­ence of school-based phys­i­cal activ­ity and sport.  At least 4 hours/week of sport and phys­i­cal activ­ity dur­ing school PE would be acceptable.

Dur­ing my eigh­teen years coach­ing high school track & field and cross coun­try in Cal­i­for­nia; stu­dents join­ing my team first needed to pass the ACSM’s (Amer­i­can Col­lege of Sports Med­i­cine) guide­lines in pre­ven­tion. If they did not pass first time out they trained with the team until they accom­plished the goal and then they com­peted for their school.  At the same time I had con­cerns for the stu­dents who did not par­tic­i­pate; who I knew at 15–17 years of age were not in a state of pre­ven­tion of dis­ease. It took five years in gath­er­ing data on my teams before my school changed its cur­ricu­lum and phys­i­cal activ­ity became mandatory.

We have many of these types of stu­dents here in Ire­land that need to meet the rec­om­mended guide­lines for low­er­ing their risks later in life.  It is up to us to give our chil­dren and youth the best pos­si­ble out­look for their future.  As we all know Health is our Wealth

Let’s get moving!

 

 

Breast Cancer Awareness: 10 Tips in Starting an Exercise Programme after Treatment

  1. Get clear­ance from your Doc­tor before start­ing any fit­ness programme.
  2. Have a qual­i­fied Fit­ness Instruc­tor design/guide your fit­ness programme.IMAG0226
  3. Walk a min­i­mum of 3 days a week (advanc­ing to 5 days).
  4. Incor­po­rate resis­tance train­ing 1 day a week (advanc­ing to 2 days).
  5. Set a goal of 15 weeks to main­tain con­sis­tency and see improve­ments in your fitness.
  6. Aim to achieve 15–20 MET/hrs/week within one year of start­ing your programme.

    Exam­ple:

    5–10 MET/hrs/week 1–4 months

    10–15 MET/hrs/week 5–8 months

    15–20 MET/hrs/week 9–12 monthsIMAG0290

  1. Eat a healthy diet: high in fruits, veg­eta­bles, whole grains, beans, low in fat and high in fibre.
  2. Drink a min­i­mum 1.5 litres of water a day (water is the most impor­tant nutrient).
  3. Keep a record of your train­ing to see your improve­ments and help moti­vate you.
  4. A lit­tle a lot, is bet­ter than, a lot a lit­tle.  (To do some­thing often you have to enjoy what it is you are doing).

How to avoid fatigue during training

Glass of water plus jug

Your daily intake will have a big impact on how you feel. With­out a proper, bal­anced diet you can start to feel slug­gish and are likely to become fatigued– so ensure that you eat healthy meals at the cor­rect times as well as fuel­ing before, dur­ing and after your workouts.

Poor hydra­tion can adversely affect your men­tal as well as your phys­i­cal per­for­mance. Stay­ing hydrated helps pre­vent tired­ness as well as lower your risk of injury. Have a water bot­tle within arm’s reach at all times.

To avoid tired­ness ensure you get enough sleep. Your body needs sleep to recharge and allow you to con­tinue with your train­ing sched­ule as well as repair and rebuild your muscles.

Caf­feine can cause rest­less­ness and sleep­ing dif­fi­cul­ties. Cut­ting down on the amount of caf­feine you drink in the evening will help avoid a rest­less night’s sleep.

Stress is one of the most com­mon rea­sons for feel­ing tired — so the most impor­tant thing to do is iden­tify what is caus­ing your stress in the first place. Tak­ing a few days off or using dif­fer­ent mus­cle groups, can make a big dif­fer­ence to your over­all energy levels.

Fatigue is usu­ally a tem­po­rary sit­u­a­tion brought on by over­do­ing it on a par­tic­u­lar day or group of days. Good lifestyle choices that include a healthy diet, exer­cise, and sleep man­age­ment should elim­i­nate long-term tired­ness, but if fatigue per­sists then seek advice from your doctor.

Exercise & Nutrition Workshop

This past week I was asked to deliver a work­shop on Exer­cise & Nutri­tion for teach­ers of SICCDA’s After­school Pro­grammes which pro­vide daily after­school child­care to approx­i­mately 150 chil­dren liv­ing in the Lib­er­ties area of Dublin 8.

picture of woman's feet walking

Their pro­grammes pro­vide par­tic­i­pants with home­work sup­port, nutri­tious snacks and enrich­ing extra-curricular activ­i­ties in a warm, car­ing, child-centred envi­ron­ment. Camps dur­ing school hol­i­days pro­vide par­tic­i­pants with fun, mean­ing­ful activ­i­ties which pro­vide con­ti­nu­ity for chil­dren, and facil­i­tate child­care needs.

The six­teen teach­ers who attended my work­shop oper­ated from the fol­low­ing schools;

  • Scoil San Sea­mus CBS, Basin Lane
  • St Enda’s National School, White­friar Street
  • Fran­cis Street CBS, Fran­cis Street
  • War­ren­mount Pri­mary School
  • Scoil Treasa Naofa

It was a very pos­i­tive expe­ri­ence engag­ing with the teach­ers over the course of the day. They found learn­ing about the METs very inter­est­ing. All teach­ers took part in doing a fit­ness eval­u­a­tion (1 mile walk) to see how their own fit­ness level mea­sured up to the guide­lines for pre­ven­tion of dis­ease. The sun was shin­ing as we walked along the canal from Basin Lane to Rialto Bridge; all com­plet­ing the course within 14 to18 min­utes. So if see a large group of chil­dren walk­ing briskly along the canal over the com­ing weeks you’ll know teach­ers are mea­sur­ing their METs.