Customized Exercise Programming for Prostate Cancer

I started by compiling my own notes and breaking everything down for Jim one step at a time.

1. Because Eric underwent a radical retropubic prostatectomy, he is flexed forward at the hips due to scar tissue and adhesions in the abdominal area. He is also very likely to lose some of his lean muscle mass and have a difficult time building new lean muscle due to the reduction of testosterone.
2. Because he had a retroperitoneal lymph node dissection 2 months ago, he has another four weeks before full recovery can be expected. Since he is two months out, however, he can begin to lift weights. He is at risk for lower extremity lymphedema also, with the risk increasing due to the pelvic radiation.
3. Eric has regular bouts of vomiting/diarrhea, typically the day after chemotherapy. On days when he has vomiting/diarrhea, he should be advised to stay home and refrain from exercising for 24-26 hours. He needs to drink plenty of water and replenish his electrolytes. If he is struggling with chemo brain, you should keep the exercises very simple and exercise in an area with minimal distractions. 
4. Long-term side effects of chemotherapy and radiation include diabetes, heart and lung damage, osteoporosis, and an increased risk of future cancers. He should work up to 150 minutes of low to moderate intensity, or 75 minutes of high-intensity cardiovascular exercise to strengthen his heart and lungs and incorporate strength training to prevent osteoporosis and improve his body composition.
5. Because of the extreme fatigue he is dealing with from the radiation and chemotherapy, his goal should be to exercise only 20-30 minutes 3-4 times per week. He should be encouraged to do this incrementally on days that he can’t do 20-30 minutes. He should never leave a session feeling more exhausted than when he started.
6. Because of the upper-crossed syndrome, Eric needs to stretch both his pecs and lats while strengthening the scapular stabilizers to help correct round shoulder syndrome and the winged scapula. He should avoid pushing exercises like push-ups and chest press and focus on shoulder retraction/depression, rowing, and maybe reverse flys.  He should do shoulder protraction exercises like ceiling punches or wall push-ups for his winged scapula. 
7. Because of forward flexion at the hips, he should stretch his abdominal area and perform exercises that incorporate back extension.
8. Because of the neuropathy in his feet, Jim should avoid high-impact activities and those with the risk of falling.
9. Jim is recommending that Eric be fitted for running shoes that will cater to his over-supination. He will also include exercises that will include stretches for the plantar fascia, calves, and achilles tendons.
10. After Jim completed the Modified Thomas Test on Eric he was able to determine  that both his left and right IT Bands are tight. Therefore, he would need to focus on hip adduction and avoid hip abduction-type exercises.
11. Because Eric wants to get back into running long distances, but he is at risk for lower extremity lymphedema, he must regularly perform lymph drainage exercises and slowly and gradually progress both cardio and strength training for his lower body.