We had the privilege of getting to know an expert in the field of occupational therapy for breast cancer survivors. After discovering Pilates and its benefits, she started incorporating the method into her work with her patients. Being that October is Breast Cancer Awareness Month, a Q&A with her seemed very timely.
Naomi Aaronson is a co-author of the book “Pilates for Breast Cancer Survivors – A Guide to Recovery, Healing, and Wellness. One of her articles is listed as a reference in the study Effects of Clinical Pilates on Patients Developing Lymphedema after Breast Cancer Treatment: A Randomized Clinical Trial. She has extensive knowledge in a subject of great importance and we are grateful for the opportunity to work with her on this piece.
PP: Please tell us a little about yourself, and how you got interested in Pilates?
NA: I’ve been an OT for 29 years working in outpatient, geriatrics, hands, breast cancer, and school based practice. In addition, I am a Cancer Exercise Trainer certified by ACSM. I started seeing BC clients at the city hospital that I worked at. At that time, exercise was not recommended due to lymphedema risk. Now exercise is highly touted due to more recent research. I got into Pilates after I was offered it as part of my PT after a car accident. My therapist asked me if I wanted to try it and I said yes. I really liked how it brought me in touch with my body alignment and posture. My Pilates teacher was actually a PT, and she became my mentor. I began using it with my breast cancer patients and they really responded to it. That inspired me to learn more about the method and undergo Pilates training. I met the co-author of our book Pilates for Breast Cancer Survivors: A Guide to Recovery, Healing, and Wellness at a breast cancer conference and the rest is history as they say.
PP: What kind of training and certification have you obtained to establish your education in Pilates?
NA: I am certified in mat/Reformer through Balanced Body. I also went through the Pink Pilates program. I have also received continuing education through rehabilitation based courses in lymphedema and breast cancer management.
PP: What does Pilates offer breast cancer survivors?
NA: Pilates offers survivors a way to reconnect to their bodies. The Pilates principles are so important here as you can offer exercise that stimulates the mind /body connection and activation of the core musculature.
Some of the benefits include:
- Stimulating the lymphatic duct/thoracic duct to promote lymphatic drainage through deep breathing and activation of the TA
- Performing Pilates in many different positions
- Strengthening the core; TA, diaphragm, multifidus, and pelvic floor
- Providing a gentle intro or re-intro to exercise
- Pilates breathing helps to ease tension and stretch tight areas
- Improving kinesthesia and proprioception
- Increasing one’s ability to perform ADLs i.e. supine to prone, side lying <> supine
- Helping with bladder control issues
- Taking the focus off “damaged” areas and emphasizing what can be done with the whole body
- Increasing scapula stability and control
- Improving posture
PP: Is there evidence for the use of Pilates for breast cancer survivors?
NA: Yes
Alpozgen. A.Z. Effectiveness of Pilates Based Exercises on upper extremity disorders related with breast cancer treatment (2016) Pilates intervention better than HEP ,Pilates as effective as combined approach for pain, function, and strength improvements when compared to exercise (ROM) and home exercise programs
- Limitations: Only 8 week duration
Sener, O. et al. Effects of Clinical Pilates Exercises on Patients Developing Lymphedema after Breast Cancer Treatment: A Randomized Clinical Trial (2017)
- Pilates had positive effect on the amount of lymphedema, function, QOL. Pts. Wore sleeves. Pts. Awareness and unity of body and mind increased and effect on spinal stability were said to be factors
Kapila, T and Palekar, T. (2017) The Effect of Pilates Exercises and Conventional Therapy on Upper Limb Function and Quality of Life in Post Mastectomy Women: A Comparative Study
- Non- randomized clinical trial 2 groups
- Pilates showed better results than conventional therapy on pain and function
Espindula, RC. Et al. Pilates for breast cancer: A systematic review and meta-analysis (2017)
- Pilates group (5 studies only considered) experienced great improvement compared to home based exercise. Pilates 3x/week for 8-12 weeks
PP: How does Pilates help meet occupational therapy goals?
NA: Occupational therapy is a profession that addresses the whole person. We look at how a person is functioning psychologically, cognitively, physically etc. OTs work on goals that can increase function in areas that are meaningful and important to clients such as dressing, bed mobility, or transfers , which are all difficult after undergoing breast cancer surgery / breast cancer reconstruction, radiation or chemotherapy. After treatment, survivors may have to deal with pain, limited range of motion, cognitive dysfunction, peripheral neuropathy, among many issues as well. Occupational therapy can offer ways to manage all of these challenges with modifications or recommend equipment .Additionally, the Pilates principles encourages one to work holistically with a focus on the mind/body connection, breathing, and proper alignment/form.
PP: What advice would you give to a breast cancer survivor to help with their healing process?
NA: Be kind to yourself. Do deep breathing and some exercise daily while listening to your body. Ask for a consult for occupational therapy if you are finding difficulty performing your daily tasks. When using weights, start slowly with light weights if at lymphedema risk and wear a sleeve. Ask for help if life seems unmanageable. There are many organizations that can help you with household tasks such as cleaning, getting wigs or prostheses, wellness services and even financially.
PP: Here at Pilatespal, we desire not just to have a community, but build a Pilates family. That, in part, comes from learning about our members and providers. So to let our Pilatespal family get to know you; would you be willing to share something personal about yourself people may not know?
NA: I love adventure and my favorite place is Costa Rica. I’ve been there 4x and I am going back in February 2020. My last trip was to a Pilates retreat in the jungle. Pilates daily, along with fresh juices, a beautiful beach and wonderful food. What more could you ask for? So relaxing; just there were no monkeys this time! By the way, this summer I worked on perfecting my split. I finally can do one in my 60s after being unable to at 15!
PP: Any closing thoughts? What would you like the Pilatespal community to know about you and your Pilates work?
NA: Pilates has so many benefits. I wish that it was accessible to more people like yoga is. Also, I think it’s important to walk the walk and be a role model for your clients both professionally and personally. Give back to your community by sharing Pilates.
Naomi Aaronson MA OTR/L CHT Occupational therapist/Pilates Instructor/ Certified Hand Therapist is the founder of Recovercises and co-author of the book Pilates for Breast Cancer Survivors: A Guide to Recovery, Healing, and Wellness. Naomi seeks to educate both survivors and professionals about the importance of rehabilitation in recovery. Her writing can be found in the OT ADVANCE, Women and Cancer, and IDEA Fitness Journal. Pilates Style featured her Pilates Chair Exercises in the October 2017 Breast Cancer issue.
Pilates for Breast Cancer Survivors: No matter where you are in treatment, what side effects you are experiencing, or general fitness level, Pilates is a safe and effective way to help you regain flexibility, power, and endurance while helping to relieve treatment side effects such as fatigue, peripheral neuropathy, upper extremity impairments, and pain. This in turn can help in restoring quality of life.