“I have rotator cuff issues, no overhead presses for me.”
“Planks exacerbate my lower back pain.”
Are these, or some form of them, true for you? Me too. I can’t do regular push-ups on my toes. Even modifying them by using my knees, I’m lucky if I can do ten.
My post-breast cancer reconstruction surgery involved permanently repositioning my pectoral muscles. Since the pecs are the primary movers for push-ups, doing them requires other muscles in my arms and back to do most of the work. Because those muscles aren’t meant to perform that movement, it feels like I’m doing push-ups with a 50 pound weight on my back. It also means push-ups aren’t a very productive exercise for me. My limitation requires me to work all those muscles – the pectorals, shoulders, arms and upper back – using exercises other than push-ups to strengthen and improve the functional movement of my upper body.
If you have limitations, especially if they involve a joint, you may have to avoid certain exercises. What you don’t want to do is avoid all exercise involving that joint.
If, for example, you have a chronic knee problem that prohibits you from lunging or squatting, you shouldn’t let that serve as an excuse to do no leg strengthening at all. On the contrary, if your knees are problematic, it’s imperative to strengthen the muscles involved in knee movement – the thigh and lower leg muscles – in order to best support your knee and to reduce further knee degeneration and risk for injury to neighboring joints, like the hip and ankles.
Here are the most common limitations and work arounds for strengthening your problem areas. Click on the exercise to link to detailed visual and written instructions from ACE Fitness.
Post-Mastectomy Exercise Substitutions
Push-ups are great because they require no equipment and work several muscle groups all at once. But if, like me, they aren’t feasible for you, you’ll need to replace them with a few different exercises. Namely, you want to strengthen the upper arms and shoulders (triceps, biceps, deltoids), chest (pectorals) and upper back (rhomboids, trapezius). In this case, it would be beneficial to invest in a few sets of dumbbells (such as 3lbs, 5lbs, 8lbs and 10lbs). Start with the lowest weight and work your way up to heavier weights. The last few reps should be challenging. If you get to sixteen reps and feel like you can do more, it’s time to move up to a heavier weight:
Triceps Kickback: Upper Arms (triceps, biceps)
Chest Fly: Chest & Shoulders (pectorals, deltoids)
I Y T W O: Upper Back & Shoulders (rhomboids, trapezius, deltoids)
Some breast cancer survivors have limited range of motion in their shoulders. If that’s the case for you, follow the substitutions for those with rotator cuff injuries (below) to strengthen the shoulders and back without lifting arms above the head.
Rotator Cuff Injury Substitutions
Most rotator cuff injuries preclude one from lifting weights overhead. That means omitting the overhead press which primarily strengthens the shoulders (deltoids) and secondarily the middle back (latissimus dorsi, or lats). Fortunately, the lateral raise serves the same function, albeit a little less efficiently. To achieve similar gains to an overhead press, use the heaviest dumbbells you can (without losing form), keep a minimal bend in the elbow and perform a minimum of four sets.
Lateral Raise: Shoulders & Back (deltoids, lats)
Knee Injury Substitutions
The beauty of squats and lunges is they efficiently and effectively work all the muscle groups of the hip and legs. The problem is they can be dangerous to do if one has injury or limited range of motion in the knees. Although, I have had some of my clients with knee issues perform mini squats using a chair for support in very slow, controlled motions. However, I wouldn’t recommend that if you’re exercising without professional supervision. In that case, you’ll want to work the muscles of the hips (hip flexors, glutes), thighs (quadriceps, hamstrings), calves and shins in a way that won’t put undo stress on the knees:
Calf Raises: Calves
Lower Back Pain Plank Alternatives
The keys to combating low back pain not caused by structural spinal issues are flexibility in the hamstrings and hip flexors (back of thighs and front of hips, respectively) and a strong core (abdominal and back muscles). And, the best way to strengthen the core is to do planks. But, many people who already have lower back pain and a weak core tend to find the traditional plank painful.
Those in that category should aim to work up to a traditional plank by gradually building strength in the core muscles with alternative exercises. My video offers several options for performing a plank. See if one of these versions works for you:
If not, perform birddog and side planks two to three times per week until you can perform one of the front plank options without discomfort:
Birddog: Core (abdominals, back)
Side Plank: Core (abdominals, back)
But, strengthening the muscles around your trouble areas is only half the battle. Remember, it’s just as important to keep those areas flexible. When you’re done making your muscles stronger with these alternative exercises, stretch them (30 seconds per muscle group, 1-2 times each) to get the best results.