Why Rebuilding Strength Matters After Cancer
Your Body Has Been Through a Lot
by Berfin Mahmut, PT, DPT, CLT-LANA, OnCS
After cancer treatment, your body may feel different in ways you didn’t expect. It can take time to adjust to these changes and feel confident in what your body can do again.
You may feel weaker than you did before treatment, or notice that everyday activities that once felt effortless (carrying groceries, climbing stairs, lifting your child, or opening a heavy door) now require more effort. You may have experienced pain, fatigue, swelling, weakness, or changes in sensation. You may have also spent months being told to protect your body while it healed, avoid certain movements, or watch for complications.
If the thought of exercising again leaves you wondering, “How do I know what is safe for my body now?”, you are not alone. After everything you have been through, it is completely understandable to feel uncertain about how much activity your body can handle.
You may have been less active during treatment, and your strength, energy, or endurance may not be where they were before. That does not mean your body cannot become stronger again. It simply means you may need to start from a different place and give your body the time and support it needs to rebuild.
For many survivors, returning to exercise can be safe and beneficial. But that does not mean jumping back into your old workout routine or pushing your body as hard as possible. Rebuilding strength is a gradual process. It means meeting your body where it is now, giving it time to adapt, and gradually increasing the challenge as your strength, energy, and confidence improve.
The goal is not to prove how much your body can handle. It is to help your body discover what it can do now. Your starting point after cancer does not have to look like your starting point before cancer. What matters is finding a level of activity that feels appropriate for you today and building from there.
Research has shown that staying physically active can help you rebuild strength, improve how you move and function, manage fatigue, and improve your overall quality of life. Exercise can also help improve cardiovascular fitness, balance, sleep, mood, and confidence, while helping you stay independent and participate in the activities that are meaningful to you. It can also be a helpful tool for managing some of the side effects that can come with cancer treatment.
Stronger Muscles, Stronger Bones
Building strength is about more than making your muscles stronger. It can also help support your bones. Some cancer treatments, particularly hormone therapies, can contribute to bone loss. This makes bone health an important part of survivorship, especially for people who may be at greater risk for decreased bone density.
Exercise, especially weight-bearing activities, place healthy, controlled stress on your bones. Over time, this provides a stimulus that can help maintain bone strength and support overall bone health.
You do not need to lift heavy weights to benefit. Walking, climbing stairs, body-weight exercises, and resistance exercises can all be part of a bone-healthy exercise program. The right type and amount of exercise will depend on your treatment history, bone health, current strength, and goals.
If you have known bone loss, bone metastases, or other medical considerations, talk with your healthcare team before starting or progressing an exercise program. They can help you determine what types of movement and exercise are appropriate for you.
What About Lymphedema?
If you have had lymph nodes removed or radiation to the lymph node areas, you may have concerns about lymphedema. Lymphedema occurs when the lymphatic system is no longer able to effectively manage fluid, causing protein-rich fluid to build up in the tissues.
For many years, cancer survivors were advised to avoid lifting heavy weights because of concerns that exercise could increase the risk of lymphedema. We now have a better understanding of the relationship between exercise and lymphedema. For most survivors, appropriately progressed strength training is safe and can be an important part of a healthy, active lifestyle. Regular physical activity may also support healthy lymphatic function and may help reduce the risk of developing lymphedema.
The important part is how you progress. If you have not exercised or lifted weights in months or years, you do not need to start where you left off. Begin with an amount of resistance that feels manageable (light) and gradually increase the challenge as your strength improves. Giving your body time to adapt allows your muscles and your lymphatic system to adjust to the increased demands of exercise.
It can also be helpful to pay attention to how your body responds, not only during exercise, but over the following day. If you notice new or persistent swelling, heaviness, or feeling of fullness, talk with your healthcare team or a physical therapist who specializes in cancer rehabilitation or lymphedema.
You do not have to figure it all out on your own. An oncology physical therapist, cancer exercise specialist, or other qualified healthcare professional can help you find an appropriate starting point and create a plan that considers your treatment history, current abilities, symptoms, and goals. The goal is not to be afraid of movement or to push through every symptom. It is to learn how your body responds and gradually build the amount of activity that works for you.
Your body may need a different starting point now: Start where you are.
One of the biggest challenges I see is survivors comparing their current abilities to what they could do before cancer. Your starting point after treatment does not have to be the same as your starting point before treatment.
Maybe you used to run five miles and now walking for 20 minutes feels challenging. Maybe you used to lift 20-pound weights and now five pounds is enough. Maybe you were very active before treatment and now your biggest goal is simply to feel comfortable moving again.
That is okay.
Start with movements that feel appropriate for your current abilities. You do not need a complicated exercise program or heavy weights to begin rebuilding strength. Focus on good technique and controlled movement. Give your body time to adapt before increasing the challenge. As your strength improves, you can gradually increase the resistance, repetitions, or difficulty of your exercises.
Progress is not about returning to your old body as quickly as possible. It is about meeting your body where it is and giving it the opportunity to become stronger from there.
Your body has been through a lot. It deserves patience. But it also deserves the opportunity to become strong again.
Berfin Mahmut is a Doctor of Physical Therapy, a certified lymphedema therapist, and a cancer exercise specialist who specializes in cancer rehabilitation at Mount Sinai in New York, NY.
