Client: Leslie Spencer, PhD
Personal Trainer: Domenick Salvatore, CSCS
Location: Blackwood, New Jersey
Student becomes teacher. Despite being a college professor of health, behavior change and nutrition, Leslie Spencer had limited knowledge of exercise and fitness. When she observed one of her students, IDEA member and personal trainer Domenick Salvatore, CSCS, working in the Rowan University fitness center, she knew he’d make the perfect guide. “I saw firsthand the quality of his work, his intelligence and his ability to work with people.”
“Leslie already lived a healthy, regimented lifestyle when I met her,” says Salvatore. Her exercise program at the time consisted primarily of cardiovascular training. “In the beginning,” he says, “she was only interested in having me teach her how to resistance train properly.”
“It ended up being a fun reversal of roles,” says Spencer. Soon afterward, she decided to train for a figure competition, and Salvatore encouraged her.
A life-threatening setback. Shortly after training commenced, Spencer was diagnosed with breast cancer. “When I first heard of Leslie’s diagnosis, I was floored,” says Salvatore. “There was no family history of the disease; there were no risk factors.” Although it was a devastating blow, Spencer remained undeterred. “I asked Domenick if he would continue training me through my surgeries, chemo and radiation, and he agreed.”
Salvatore immediately began researching and learning as much as he could in order to help Spencer train safely and effectively throughout treatment.
Treatment and training. Almost immediately, Spencer underwent a double mastectomy. Once she was cleared from physical therapy, Salvatore administered postsurgery assessments for shoulder range of motion to determine her limitations. A primary concern, according to Salvatore, is excessive tightness caused by tissue expanders placed underneath the pectoral tissue in preparation for reconstruction surgery. “These can cause slight to severe pain, so you have to be very careful about the exercises you choose,” he warns.
Lifting anything heavy and making movements that place significant stress on the pecs, shoulder girdle and serratus should be avoided, he adds. Using little to no resistance, Spencer worked on movements such as elevation, depression, and internal and external rotation to improve flexibility and mobility.
A tough road. “Getting through cancer treatment was hard,” recalls Spencer. “After I was initially diagnosed, I had over a year of surgeries, chemotherapy and radiation.” Both client and trainer understood that setbacks were likely and there could be no clearly defined goal-achievement date.
“Intensity, frequency and duration recommendations are difficult to make when working with cancer patients,” advises Salvatore. “It varies from day to day what the client may be able to do. In Leslie’s case, she was more fortunate than most since she was already in good shape before she was diagnosed.”
Back on track. Once she had completed her treatments and surgeries, Spencer made it her goal to return to figure competition. Salvatore created weekly programs that involved progressive resistance training. They went over the program together once during the week, and Spencer trained on her own until the following week. Her program consisted of 3 days of full-body resistance training; 3–5 days of cardio; daily flexibility; and 2 days of shoulder girdle mobility.
Often, to meet her goal, Spencer needed to lift heavy resistance, which was contraindicated due to lymphedema. “New research is proving this wrong, thankfully,” she adds. To prevent swelling, she always wears compression sleeves during training.
Keeping the dream alive. Spencer was diagnosed with cancer in April 2009, and she competed in the OCB Women’s Figure Competition on August 28, 2010. “The day of the competition was a sight to behold,” smiles Salvatore. “Leslie stayed positive, fought hard and is now cancer free.”
Spencer credits working with Salvatore and staying focused on her goal for helping her through this challenging time. “Having a dream or goal is a powerful, positive force when you are facing lengthy treatment for a serious illness,” she says. “Believing that my body would heal and achieve an athletic goal did a lot to help me physically heal.”