Safely exercising can be helpful for bone mets patients.

3 Safety Principles for Exercising with Bone Mets

When asked about the value of exercise, most people will bring up the cardiovascular benefits of aerobic exercise, the pumped-up look and strength of muscles—or the fashion-minded person may address how a toned body makes any outfit look better. It’s the rare person who will immediately bring up the fact that bones need exercise, too. According to the American Academy of Orthopedic Surgeons, “Exercise is important for building strong bones when we are younger, and it is essential for maintaining bone strength when we are older. Exercise works on bones much like it works on muscles — by making them stronger. Because bone is a living tissue, it changes in response to the forces placed upon it. When you exercise regularly, your bone adapts by building more cells and becoming more dense.”ⁱ

No matter how old you are, exercise helps maintain bone health. Both weight bearing exercise (e.g. hiking, jogging, dancing, playing sports, etc.) and strength training offer the most value for strengthening bone. The problem for bone mets patients, however, is that for cancer to grow in the bones it acts like a parasite, stealing the bone’s own resources and using them for to promote the cancer’s ability to thrive at the expense of its skeletal host. This means that the bones are weakened to the point where breakage is a constant threat.

This sets up a dilemma for bone mets patients: to exercise or not? And if so, what are safe ways to proceed? When diagnosed with bone mets, many patients who already have an exercise program may be apprehensive about continuing it; and those who are not currently exercising regularly may fear doing so even if it’s recommended to support overall bone health.

The decision of whether or not to exercise should be made with your cancer care team, especially your oncologist and a specialist such as a physical therapist. What matters most is whether you personally desire to add some type of workout to your week. Remember that physical activity offers bone mets patients improved quality of life as well as bone health. Patients experience better energy, stress management, sounder sleep, uplifted mood, self esteem, and sense of happiness.

Here are three safety principles to keep in mind as you consider a commitment to exercise:

1. If your care team gives you a green light, they will be your best source of information and insights. There are many exercise methods, so get their advice on tailoring a program that’s right for you. The location, type and extent of bone damage due to mets will determine your “menu” of exercise choices. As you exercise, stay in good communication with your team so they can adapt your program if your needs change.
2. The American Cancer Society cautions bone mets patients to avoid using heavy weights or doing exercises that put stress on your bones. Low impact exercises such as yoga or tai chi are not only weight bearing but also contribute to balance and coordination which helps avoid falls.
3. Ease into exercise slowly. Take time to warm up with easy stretches and slow movements, then aim for strengthening large muscles and gently increasing your heart rate as you gradually sustain it for longer periods. Non-weight bearing exercise such as cycling or swimming can build aerobic stamina. Always stretch more deeply immediately after you work out, then reward yourself with a relaxation break.

Living with bone mets means it will take time and the support of your cancer care team to create a workable exercise structure. There may be long stretches when exercise must take a low priority compared to other aspects of being a cancer patient. Don’t let discouragement get the upper hand. Do as much as you can, take breaks when you need to, and above all heed your doctor’s guidelines.

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ⁱhttp://orthoinfo.aaos.org/topic.cfm?topic=A00674