Exercise after a tram flap

Last Modified: January 26, 2003

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Dear OncoLink "Ask The Experts,"
I'm interested in knowing how tram flap breast cancer survivors handle exercise and muscle toning. I am a 5-year survivor with a tram flap and have gained 100+ lbs. and am now getting back in to the exercise mode and want to know what kind of exercises will help with my bending motion.  


Lora Packel MS, PT, Coordinator of Cancer Therapy Services for the Hospital of the University of Pennsylvania, responds:

The tram flap (transverse rectus abdominus myocutaneous reconstruction) uses a piece of the abdominal musculature (rectos Abdominus) to recreate a breast. Although there are other lateral (on the side) abdominal muscles, people tend to feel weakness or back pain with activity.

Exercise, as prescribed by a trained physical therapist, can address weakness through a core stabilization program. This program focuses on body mechanics, posture and strengthening the lateral abdominal muscles and back muscles. This program should be created by a trained therapist who understands that you cannot do abdominal or stomach crunches, as there isn't a muscle to "crunch" in patients who have had a bilateral TRAM procedure.

Penn Therapy & Fitness, the outpatient physical therapy satellites associated with the Hospital of the University of Pennsylvania, has experience with rehabilitating people after the TRAM procedure. To complement a lifestyle change that includes exercise, you should consider an evaluation by a nutritionist who specializes in oncology.

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