Vanessa* is a 66 year old woman with metastatic breast cancer, who was seeking support for being physically active with spinal metastases.

In 2012, she originally underwent curative treatment (chemotherapy, a right mastectomy with lymph node clearance and implant reconstruction, followed by radiotherapy) and made a good recovery.

In 2023, Vanessa developed new lower back pain; her scans showed brain and spinal metastases throughout the lumbar spine, including a pathological fracture at L2. She was treated with palliative radiotherapy, chemotherapy, targeted therapy and bisphosphonates.

Following treatment, Vanessa was highly motivated to regain her fitness, with a main goal of safely returning to playing her favourite sport - golf. She had received conflicting advice from medical professionals and was looking for a clear, personalised rehabilitation plan to get her back on the green.

We had 8 online sessions over 8 months, which were founded on clear and transparent professional communication, to manage expectations and ensure safety. Standard advice around spinal metastases is to minimise risk of fracture by avoiding twisting, shearing and bending motions; this can be very challenging in daily life and physical activity. Finding safe ways to exercise and rehabilitating the body to tolerate movement is essential.

We started with focusing on bone health education, alongside balance and deep core stability exercises. We closely monitored symptoms and gradually progressed the exercises to include limb strengthening. Vanessa started personal training sessions alongside physiotherapy and I regularly liaised with her trainer to provide clear safety guidance. Over time, we progressed to functional rehabilitation exercises, mimicking golf-related movements and monitoring the outcome.

Over several months, Vanessa’s scans remained stable and she was able to reintroduce golf into her routine, starting with putting, before progressing through 9 to 18 holes. At the time of concluding our work together, Vanessa had surpassed all her goals, by comfortably playing 10 days of golf on holiday by the Indian Ocean!

*Name changed for confidentiality. Case study has been shared with client’s consent.

If you or a loved one require physiotherapy support, to work through new physical barriers associated with cancer and treatment, I would love to work with you to achieve your goals (big or small!).