Muscle Strength and Grip Strength During and After Cancer Treatment: What is the Link?
- 5 days ago
- 5 min read
Being diagnosed with cancer and undergoing treatment can have a significant impact on your physical health and quality of life. While everyone’s experience will be different, the most common breast cancer treatments - including surgery, chemotherapy, radiation therapy, and hormone therapy - can affect the way your muscles feel and function. Understanding how to maintain your muscle strength can play a crucial role in your well-being, treatment outcomes and recovery.
The Link Between Breast Cancer and Muscle Strength
Muscle strength is the ability for a muscle to produce maximum force; this is dependent on muscle size, the number of slow or fast twitch muscle fibres and your nervous system's ability to activate those fibres.
Here's how different breast cancer treatments can affect your strength:
Cancer cells: Use more metabolic energy compared to other cells, due to rapid growth and division which can result in loss of weight and muscle mass.
Surgery (e.g., Mastectomy, Lumpectomy): Can lead to pain, reduced activity or range of motion in the arm and shoulder, or complications such as lymphoedema, which may directly impact upper body strength.
Chemotherapy: Commonly causes fatigue, general muscle weakness (myopathy) and nerve damage (peripheral neuropathy) which can result in leading to muscle loss (sarcopenia).
Radiation Therapy: Can cause generalised fatigue and localised tissue changes that may affect upper body muscle function and muscle mass.
Hormone Therapy: Low oestrogen levels can result in joint pain, stiffness, and muscle weakness, contributing to changes in activity and overall deconditioning.
Targeted Therapy & Immunotherapy: While often more specific, these treatments can have systemic side effects that impact muscle health.
What is Global Muscle Strength and Why Does it Matter?
Global muscle strength refers to the overall contractile force produced by all the skeletal muscles in your body. It reflects your systemic physical capacity, not just individual muscle group power. Our body composition refers to the amount of muscle, fat and bone that you are composed of. Sarcopenia is a condition characterised by loss of muscle mass, strength and function, while cachexia is a complex metabolic condition related to underlying illness characterised by loss of muscle mass with or without loss of body fat. Research suggests there is a correlation between global body composition and how well you tolerate treatment side effects, in addition to the below functions:
Functional Independence: It's essential for everyday activities like walking, lifting, carrying, and maintaining balance.
Metabolic Health: Muscle tissue is metabolically active and contributes to better glucose metabolism, insulin sensitivity, and fat regulation.
Bone Health: Muscle contractions put force on bones, promoting bone density and reducing the risk of osteoporosis.
Injury Prevention: Strong muscles stabilise joints, reducing the risk of sprains, strains and falls.
Health Resilience: Higher global muscle strength is linked to better treatment outcomes, improved treatment tolerance, accelerated recovery and an enhanced quality of life.
A decline in global muscle mass and strength during cancer treatment is an important concern, potentially leading to:
Increased fatigue and lower energy levels.
Decreased ability to participate in daily and physical activity.
Higher risk of sarcopenia (muscle loss) and cachexia (complex metabolic syndrome).
Impaired quality of life and psychological well-being.
Potential for poorer treatment outcomes and increased treatment-related toxicity.
Higher risk of falls and fractures.
The Role of Grip Strength Testing
Grip strength is the maximum force you can exert with your hand and forearm muscles when squeezing an object, typically measured with a hand dynamometer - but why is it so important?
Overall Muscle Strength Indicator: Many studies show a strong correlation between grip strength and overall muscle strength throughout the body. This means that generally the stronger your grip, the stronger your overall body strength.
Predictor of Health Outcomes: Grip strength is a significant predictor of health outcomes in general and specifically in cancer patients.
During cancer treatment, grip strength testing can be invaluable:
Baseline Assessment: Helps monitor your physical condition before, during and after treatment.
Monitoring Treatment Effects: Provides early indications of deconditioning or sarcopenia.
Identifying At-Risk Patients: Low grip strength can identify individuals at higher risk of:
Developing treatment-related toxicities.
Experiencing significant muscle loss (sarcopenia).
Having a longer recovery period.
Requiring more intensive rehabilitation.
Simple and Practical: It's a non-invasive, quick and repeatable tool.
Strong grip strength also offers numerous benefits:
Better functional movements (e.g. deadlifts, rowing).
Improved daily activities (e.g. opening jars, carrying bags, holding objects).
Reduced risk of upper limb injury/impairment.
Reduced mortality risk (e.g., cardiovascular health, depression).
Reduced morbidity risk.
How to Assess Your Grip Strength
The best way to assess your grip strength is using a hand dynamometer.
Sit or stand comfortably, holding the dynamometer with your elbow at a 90-degree angle.
When ready, squeeze with maximum force and hold for 3-5 seconds.
Relax and note the measurement.
Repeat 3 times on each hand, resting as needed.
Take the highest value for each hand. It can be interesting to note if your dominant hand is stronger or if either hand fatigues more quickly.
Similarly to weight, it is not advisable to test your grip strength too regularly or overanalyse the results. It can, however provide an objective measure at periodic intervals for identifying a general trend, to give you more autonomy over managing your physical health, i.e. are you getting stronger, weaker or maintaining your baseline?
Exercises to Improve Your Strength
To maintain and improve your muscle strength while living with and beyond breast cancer, consider incorporating a combination of general strengthening and specific grip strength exercises.
Here are some types of exercises you can try:
Endurance activities: Walking, running, swimming, rowing.
Functional exercises: Farmer's walk, deadlift, kettlebells, bar hang, plate hold.
Specific hand grip exercises (if required): Squeezing a stress ball, resisted wrist and forearm exercises.
In Summary
Cancer and treatments can significantly compromise your global muscle strength, affecting your physical function, quality of life, and treatment outcomes. Grip strength is a simple and accessible way to measure your overall muscle strength. Maintaining muscle strength during cancer treatment aims to optimise your treatment tolerance, aid your recovery, and improve your long-term quality of life.
Recommendations:
Engage in regular exercise to maintain and improve your muscle strength while living with and beyond cancer.
Talk to your healthcare team about the possibility of integrating routine grip strength assessment into your clinical management, from diagnosis through survivorship.
Use grip strength measurements, alongside other assessments such as 1 minute sit-to-stand test, to identify risk of muscle weakness.
Request a referral to local specialist physiotherapist if you feel you require further support or advice.
If you have any questions or would like to book an online appointment with a specialist cancer physiotherapist, please contact me on hannah@strongerthan.co.uk or visit my website www.strongerthan.co.uk. It would be a privilege to support you during and after your treatment.
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