Prehabilitation--add a Physical Therapist to your multidisciplinary team for cancer treatment!

“Prehabilitation is the process of enhancing functional capacity of the individual to enable him or her to withstand the stressor of inactivity associated with a surgical procedure” — Wikipedia

What a concept! Not new, but just in recent years getting more attention. I have been advocating prehabilitation since the beginning of my career.

"I use the analogy that people wouldn't run a marathon without training for it," says Tony Brosky, PT, DHS, SCS, a professor of physical therapy and assistant dean of the Lansing School of Nursing and Health Sciences at Bellarmine University in Louisville, Kentucky. “…knowing the patient's range of motion, strength, and function preoperatively, through clinical examination and direct observation, allows the patient and PT to more accurately set realistic postoperative goals."

This makes total sense to me. Many patients are seeking pre-surgical Physical Therapy intervention from us, many are cancer patients, concerned about a side-effects like lymphedema and/or quality of life issues on long term, and returning to the current function and activities as soon as possible after treatment.

How smart to get pre-measurements, to understand status quo of function, range of motion, strength and volume of limb pre-surgery. Base line measurements are key to early detection of problems, reduce anxiety and will improve outcomes. Physical Therapy should be part of the multidisciplinary team to improve quality of life before, during and after cancer treatment.

But we are still far from being included automatically in a multidisciplinary team of treating cancer. San Francisco General Hospital however has been progressive and adding Physical Therapists into the multidisciplinary team in the breast cancer clinic. See article.

Tell your doctor that you want to have a Physical Therapist included to your team of experts in your cancer treatment as early as prior to your surgery, if time allows. Share the article with your doctors.

I am also teaching a informational class hot to reduce risks for lymphedema at CPMC every third Wednesday of the month at 6PM. Please share this information with anybody who has or had cancer treatment or going to have cancer treatment. We are here to help, This class is at no cost, and will give you lots of information.

Read on the newsletter of SFGH in 2011:

If you want to read more about some research of prehabilitation, please check out this link:

CranioSacral Therapy in Big Sur

"It is said when the Eagle and the Condor share the same sky the world will come more into balance," Daniel Bianchetta

Last week I had the pleasure of assistant teaching at a CranioSacral Seminar with the Upledger Institute at Esalen in Big Sur. And I must say, Esalen, the Center for Theory and Research, is a really wonderful spot. When we were not delving into the intricacies of CranioSacral techniques, we had the pleasure of enjoying all the various activities the site had to offer.

I spent my evenings soaking in the hotsprings, enjoying the farm and garden, visiting the art center, and feeling the soothing waft of the ocean breeze. Between discovering the place, the waters, and the land, it felt less like work and more like a rejuvenating vacation.

My favorite part of the seminar was getting to share what was given to me when I began studying CranioSacral Therapy 23 years ago. The gift I gained from working closely under Dr. John E. Upledger, the developer of CranioSacral therapy, was the insight to listen with the touch of my hands. Even after his passing in 2012, his teachings remind me to constantly keep an open mind about the validity of non-traditional medicine, to stay on my path no matter the obstacle, and to make a positive impact on people's lives.

I am so grateful for the knowledge I have gained training with Dr. Upledger. Not only has he given me the tools to succeed in my field, he has also inspired me to learn more and teach this wisdom to other holistic healers and CranioSacral practitioners.

Last week at such a magical site I was surrounded by healers and intellectuals. This week, I can't help but feeling energized. So with this energy I hope to pass on the appreciation for life. Take a moment to ask yourself who has given you wisdom and shaped you into the person you are today. Finish out your week with positivity and have a great weekend!