Breast Cancer Survivors Rebuild Strength with Pilates

As more health club operators look to small group training for specific populations to increase ancillary revenue, one program that some operators are implementing is Pilates for breast cancer survivors.

Joseph Camp, a master Pilates instructor at Pilates Athletic Center in Los Altos, CA, discovered the power of Pilates for this group after his studio partnered with Stanford Hospital for a three-year program. The hospital paid the center a discounted rate of $25 per person per twice-a-week session for breast cancer patients and survivors. He had four people come in twice per week. Even though he made just $200 per week on the program, he says that through the Pilates classes, his students improved emotionally, physically and cognitively, and they showed an increased level of energy.

Research studies support Camp’s findings. In one study by the University of Missouri-Columbia, researchers found that the benefits of exercise outweigh the risks for breast cancer survivors, who often are fearful of exercising after having a mastectomy because they have a limited range of motion, fatigue and a shattered self image. As such, they may find traditional group exercise classes and gym workouts too intimidating, causing them to curtail their exercise routine altogether.

Not doing the proper stretching and arm movements, however, can lead to a host of problems, including frozen shoulder, a painful condition that limits range of motion and causes stiffness. In addition, survivors can develop lymphedema, which is swelling that can cause their arm to double in size, become heavy, inflict severe pain and lead to loss of function.

These side effects, however, can be completely prevented or minimized through a proper combination of exercise and stretching, says Andrea Bruno, president and founder of the Cancer Exercise Training Institute, which aims to bridge the gap between the hospital and fitness center by teaching fitness and medical professionals how to properly work with patients and survivors through a 16-hour, $369 certification course. Bruno launched the program in 1996 after her mother developed frozen shoulder after breast cancer surgery and had to endure months of painful physical therapy.

“It’s needless suffering,” Bruno says. “To some degree, there is negligence on the part of the doctors because they’re not recommending exercise as a part of recovery.”


Often, doctors are so focused on eradicating cancer and saving women’s lives that they do not think about how to return a patient to a high level of fitness after surgery, says Dawn-Marie Ickes, a licensed physical therapist, Pilates instructor and owner of Evolve Integrated Wellness and Physical Therapy centers in Orange County, CA. Then six months later, the breast cancer survivors find that their back hurts, they have scar tissue and they cannot sit up straight due to postural deviations. If they had begun a flexibility and movement regimen earlier, however, they would be on a faster road to recovery.

To help women post-surgery, Ickes offers two classes, Big or Small: Save Them All and BC Embody for Life. At one time, breast cancer survivors comprised 10 percent of her patient load, but now they make up 60 percent because she has gotten more physician referrals. Ickes says that through Pilates, her clients have experienced less back, neck and shoulder pain after surgery.

Although Pilates can help survivors minimize pain and rebuild physical strength, it also can help participants to become more resilient emotionally by sharing their experiences with others, says Niece Pecenka, a Pilates instructor at Gainey Village Health Club and Spa, Scottsdale, AZ. In Pecenka’s restorative Pilates class, the women often create long-lasting friendships and start to feel less like a patient and more like a person, she says.

Gainey Village charges $25 per session and opens the classes to members and nonmembers with a cap of six participants per class. Some insurance companies cover the cost of the classes. Participants must complete a series of private sessions before signing up for the six- to 12-week program. During the class, Pecenka focuses on what the students can do rather than what they cannot do.

“It can be exhausting to always be reminded not to lift your arms over your head, nor do any heavy lifting, twisting or inversions,” Pecenka says. “In our program, we lead the participants in a way that is positive.”

Pecenka is one of three instructors in Arizona certified by the Pink Ribbon program, which is a post-operative exercise program for breast cancer survivors.

Before club operators introduce programming for this group, they must ensure that their Pilates instructors are well trained to work with this special population and are able to individually assess the participants’ postural deviations and range of motion, Bruno says. Pilates instructors often start their clientele in private sessions before moving them into a small group apparatus class.


Fully equipped Pilates studios often have all the equipment needed to train breast cancer survivors. Pecenka trains her clients using reformers or towers, and Ickes starts survivors on the trapeze table.

Connie Borho, a Peak Pilates teacher trainer and owner of Balance Pilates and Yoga Centers, Bradenton, FL, uses an instep barrel system, which builds range of motion into the arms and shoulders, she says.

“Pilates equipment can adapt to a survivor’s needs, immediately post-operative, post-rehab, post-reconstruction, and for continued strengthening as time goes on,” Borho says.

Not all fitness equipment, however, is safe for breast cancer survivors, Borho says. Fitness professionals should avoid using equipment that incorporates gravity or additional weight with breast cancer patients and survivors.

Free weights and weight machines can pull the client’s body out of safe alignment and into an unsupportive range of motion, Borho says.

By using the proper equipment and becoming well trained, Pilates instructors can help clients regain their physical, emotional and mental strength, Pecenka says.

“I truly believe that movement heals,” she says. “The Pilates apparatus is extremely beneficial when it comes to restoring the body back to health. The benefits and possibilities are endless.”

For details about how to create an exercise program for breast cancer survivors, read this article by Andrea Bruno.

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