What are the best abdominal exercises for a client who has had a TRAM flap procedure?
This client is several years post breast reconstruction. Her abdominal strength is very weak and I am concerned she will develop distention on the side where they took her abdominal Erectus muscle. She, obviously, can not do crunches, but she is also terrible at planks and other core exercises. Should I be focusing more on obliques and transverse training to strengthen her core?
Discuss this issue with her Physical Therapist, follow his or her guidelines
I would also be sure to get clearance from all the doctors and ask about past physical therapy.
What does she do when she has to cough or sneeze? If coughing is not a problem, doing isometric contractions similar to coughing may help for now.
Does she stand well on her own? Balancing on one leg will also work the core.
Once you know that then you can progress those specific movements. The fact that she had the intervention several years ago suggests that she is post-rehabilitation (at least from my perspective).
As long as she has been given medical clearance, I personally think she is safe to train.
Following are some movements she might be able to perform.
1. Bird dog
2. Trunk extension on a stability ball or on a BOSU ball
3. Trunk rotation
4. Supine bridge with a stability ball, a foam roller, or on a mat
5. Ball wall squat
Hope this gives you some ideas.
I just saw this post. It is integral to focus on the TA with Pilates exercises after a TRAM Flap due to concerns with the back and hernias. I have a manual that recommends a specific plan which incorporates pre- Pilates exercises for pelvic stabilization. It shows a 3 phase program from bridges to modified hundred that gradually progresses the client.Caution is advised for weight bearing exercises such as planks if she has received lymph node removal and/ or radiation as she is at lymphedema risk. Proceed cautiously and slowly.
Naomi Aaronson MA OTR/ L CHT CET CPI