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  1. Medical Information
  2. Exercise Training Manual (PDF document, pages 16-25 of the AIAB Team Manual)
  3. Exercise & Breast Cancer
  4. Health Links
  5. Dr. Tamara Shenkier - Ten Years Abreast Presentation

1. Medical Information

Articles about the medical history of Abreast In A Boat in the Canadian Medical Association Journal:
August 1998 | September 2002

Lymphedema is an obvious concern and for this reason compression sleeves are strongly recommended for all paddlers. We suggest that these should be worn at every workout. The first portion of each training session emphasizes flexibility and this is followed by specific resistance exercises to develop strength in the upper arm, back and shoulder areas. These activities prepare you for the paddling activities. There is likely a higher risk of developing lymphedema during this initial phase of increased activity, relative to the paddling phase. We cannot emphasize enough, the need to progress in a slow, gradual fashion.

Too rapid an increase in any activity is the main factor in the development of musculoskeletal injury or a change in your lymphedema status. By introducing paddling with low intensity but a progressive fashion, we gradually improve the ability of the upper extremity to do more intense exercise. It is the graduated focus of the program that allows adaptation to this activity. We do have an excellent track record in avoiding lymphedema and there are some very good reasons to believe that a supervised, graded exercise program is an important part of the prevention or treatment of this condition.


2. Exercise Training Manual (pages 16-25 of the AIAB Team Manual)

PDF version of the AIAB Exercise Training Manual

  

3. Exercise & Breast Cancer
Why the Dragon Boat Experience is Important for Women Living with Breast Cancer
by team member Susan Harris

Approximately 2 million women in North American are currently living with breast cancer. As part of the medical management of this disease, the vast majority of these women had had lymph nodes surgically removed from their underarms in a procedure known as axillary dissection. The goal of that procedure is to find out if the cancer has spread to the lymphatic system. Many of these women have also undergone radiation therapy to the breast and/or underarm. These two procedures dramatically increase a woman's risk of developing chronic lymphedema - a permanent, irreversible and sometimes incapacitating swelling of the involved arm and chest area. Lymphedema can develop at any time following breast cancer surgery - from within one month after treatment to 30 years later.

Well-meaning physicians and physiotherapists often caution these women to refrain from lifting more than 10-15 pounds with the involved upper extremity; to avoid certain sports, such as canoeing, water-skiing and specific swimming strokes, such as breast stroke or butterfly; and to refrain from repetitive activities, such a knitting or raking. The "contra-indications": limit both the quality and enjoyment of life for women who otherwise feel and look quite healthy - and there is, as yet, no research to suggest whether or not these activities actually lead to lymphedema.
Dragon boat racing is a very strenuous, repetitive physical activity that stresses the muscles of the trunk and upper extremities. To prepare for this activity, the coaches for Abreast In A Boat (a sports medicine physician, a physiotherapist and a nurse) outlined a six-week, three-pronged training program for the Team members – including stretching, progressive upper extremity strength training and aerobic exercises - to be carried out in advance of our training in the dragon boats themselves. In addition, some of the women were measured for and wore special compression sleeves on their involved arms to minimize the threat of lymphedema.
To assess whether arm swelling was occurring, arm circumference measurements were taken for all team members prior to beginning the on-water training mid-way through the six-week training, and just before the final races. Two team members with pre-existing lymphedema were also monitored carefully in this manner.
Not only did Abreast In A Boat (the only all-women's team in the Novice Division and probably the only team with five grandmothers!) make a very respectable showing at the World Championship Dragon Boat Festival in Vancouver in June, 1996, but we were also awarded the David C. Lam Award for our community/team spirit.
Furthermore, not one woman on the team showed any ill effects from this very strenuous sport. There were no increases in arm circumferences (i.e. no lymphedema for the women without previous problems and there were no adverse changes in the women who had pre-existing lymphedema) 1. To quote Dr. Don McKenzie, sports medicine physician and exercise physiologist at the Allan McGavin Sports Medicine Centre at the University of British Columbia and the originator and driving force behind this unique team:
"It was a small medical miracle...these women demonstrated the benefits of exercise, both physically and emotionally, in their success at dragon boat racing." 2

'The "success" of our dragon boat adventure sends a loud and clear message to the millions of women currently living with breast cancer - that you can partake in a fun-filled and strenuous athletic activity, providing you undergo progressive exercise training prior to competition'. 3 It is our dream to spread this good news message by competing in other dragon boat races throughout the world and by challenging other breast cancer survivors to compete against us, thus sharing the true camaraderie and joie de vivre we have experienced as the first-ever dragon boat team composed entirely of breast cancer survivors.

  1. Harris SR, Niesen-Vertommen SL. Challenging the myth of exercise- induced lymphedema in breast cancer: A series of case reports. Journal of Surgical Oncology. 2000;74:95-99
  2. McKenzie DC. Abreast In A Boat - A race against breast cancer. Canadian Medical Association Journal. 1998;159:376-378.
  3. Harris SR, Hugi M, Olivotto I, & Levine M. Clinical practice guidelines for the care and treatment of breast cancer. 11. Lymphedema. Canadian Medical Association Journal. 2001; 164:191-199.
 Susan Harris is a physiotherapist and Professor in the School of Rehabilitation Sciences at the University of British Columbia. Since her initial breast cancer diagnosis in 1994, Susan has become an avid researcher in examining safe levels of exercise for women living with breast cancer. She is the primary author of the recently published clinical guidelines on management of breast cancer-related lymphedema in the Canadian Medical Association Journal ( January 2001 ). As part of the Dragon Boat experience, Susan has greatly enjoyed watching "the joy of training and competing with many women who were previously non-athletes".
 
  
4. Health Links

Breast Cancer:

  1. Canadian Breast Cancer Foundation
  2. Canadian Breast Cancer Research Initiative
  3. Canadian Breast Cancer Network
  4. Breast Cancer Society of Canada
  5. BC Cancer Agency

Lymphedema:

  3. Canadian Medical Association Journal   
    (Clinical practice guidelines on lymphedema are found in the Jan 23, 2001 back issue of: )