Strength After Breast Cancer: What the ABC Program Is, Why It Matters, and How We Use It at Thera

Apr 2

After breast cancer treatment, most patients are told two things: that treatment is over, and that they should be grateful. And they are. But underneath that gratitude, many women are quietly dealing with something nobody warned them about — the loss of strength, mobility, and function in their arms, chest, and upper body.

At Thera, we are proud to be certified providers of the Strength After Breast Cancer (Strength ABC) program — an evidence-based rehabilitative exercise program developed by Kathryn Schmitz, PhD, MPH, FACSM, and delivered through the Klose Training certification program. This isn’t a generic exercise plan. It is a rigorously researched, clinically validated program specifically designed for breast cancer survivors, including those with or at risk for lymphedema.

If you’ve finished treatment and feel like your body just isn’t the same, you’re not imagining it. And more importantly, it doesn’t have to stay that way.

What Is the Strength ABC Program?

The Strength After Breast Cancer program was developed by Dr. Kathryn Schmitz, a professor and distinguished researcher in exercise oncology whose work has been published in the New England Journal of Medicine, JAMA, and the Journal of Clinical Oncology, among other peer-reviewed journals. Dr. Schmitz is also a former president of the American College of Sports Medicine (ACSM) and a leading voice in making exercise a standard part of cancer care.

The program is grounded in the Physical Activity and Lymphedema (PAL) Trial — a landmark randomized controlled trial that studied the safety and benefits of slowly progressive weightlifting for breast cancer survivors with or at risk for lymphedema. The results were groundbreaking:

Decreased lymphedema exacerbations by 50%
Reduced the onset of lymphedema by 70% in women with five or more lymph nodes removed
Improved body composition and body image
Prevented the physical decline commonly seen in breast cancer survivors

For decades, women were told to avoid lifting anything heavier than a few pounds after breast cancer surgery. Dr. Schmitz’s research reversed that guidance entirely. Carefully supervised, progressive strength training is not only safe — it is one of the most protective things a breast cancer survivor can do for her body.

Our Certification: Klose Training Strength ABC Program

The Strength ABC program is taught and certified through Klose Training and Consulting, one of the most respected lymphedema and oncology rehabilitation education programs in the country. The certification was developed in collaboration with Dr. Schmitz and is designed specifically for licensed physical and occupational therapists.

Our team at Thera has completed the Klose Training Strength ABC certification, which means we are equipped to safely screen patients, assess lymphedema risk, design individualized progressive resistance programs, and guide breast cancer survivors through every stage of their recovery. You can learn more about our full breast cancer rehabilitation services on our website.

This certification is not a weekend workshop. It requires licensed healthcare professionals to demonstrate competency in lymphatic anatomy and function, safe exercise progression, symptom monitoring, and patient education. When you work with our team, you’re getting clinicians who have been specifically trained and credentialed in this program.

What the Strength ABC Program Addresses

Breast cancer treatment affects the entire upper body — arm function, posture, chest wall mobility, and lymphatic health. The Strength ABC program is built to restore all of it, systematically and safely.

Arm Strength and Functional Recovery

Surgery, radiation, and lymph node removal all affect the arm on the treated side. You may notice weakness when lifting, reaching overhead, or carrying everyday items. Some women avoid using that arm entirely, which only makes things worse over time. The Strength ABC program rebuilds arm strength gradually and safely, restoring functional use of the arm without increasing lymphedema risk.

Body Mechanics and Posture Restoration

When something hurts or feels tight, the body naturally compensates. After mastectomy, lumpectomy, or reconstruction, many women unconsciously round their shoulders forward and guard the chest wall. Over weeks and months, this creates a postural pattern that leads to neck pain, back tension, and whole-body fatigue. We address this directly — restoring the muscle balance and movement patterns that support an upright, pain-free posture.

Chest Wall Mobility and Scar Tissue Health

Radiation can cause fibrosis — a stiffening and thickening of connective tissue. Surgery creates scar adhesions that restrict how the skin and underlying layers move. Left unaddressed, all of these changes reduce your range of motion and ability to move freely. Our hands-on scar management and tissue therapy works alongside the Strength ABC exercise program to restore chest wall mobility and tissue health.

Lymphedema Prevention and Management

This is where the Strength ABC program is uniquely powerful. Unlike generic exercise recommendations, this program was designed specifically with lymphedema in mind. Our Certified Lymphedema Therapists (CLTs) oversee the program to ensure it is safe for every individual — whether you’ve already been diagnosed with lymphedema or are working to prevent it.

Why Breast Cancer Rehabilitation Matters:

Many oncologists and surgeons focus — appropriately — on the cancer itself. Post-treatment physical rehabilitation isn’t always part of the discharge conversation. And so patients go home, get the all-clear, and assume that time alone will restore them to normal.

Sometimes it does. Often, it doesn’t.

Without targeted rehabilitation, the long-term consequences can include:

Chronic shoulder pain or frozen shoulder (adhesive capsulitis)
Axillary web syndrome (cording) — tight, cord-like tissue running from the armpit down the arm
Lymphedema — chronic arm swelling that is manageable but not curable once it develops
Radiation fibrosis — progressive tightening of chest tissue
Persistent postural dysfunction and chronic neck or back pain
Difficulty returning to work, exercise, or daily activities

Most of these complications are preventable — or significantly reducible — with early, consistent, evidence-based rehabilitation. That’s exactly what the Strength ABC program is designed to do.

What to Expect at Thera: Your Strength ABC Program

Every program at Thera starts with a thorough one-on-one evaluation. We assess your arm and shoulder mobility, lymphedema risk, current strength, posture, scar tissue, and functional limitations. From there, we build a program that follows the Strength ABC framework — structured, progressive, and tailored to exactly where you are in your recovery. Learn more about how things work at Thera.

The Program Includes:

Initial evaluation with lymphedema risk assessment
Supervised sessions to teach safe, progressive resistance training
Education on self-monitoring and how to progress safely at home
Hands-on therapy for scar tissue, chest wall tightness, and cording as needed
Coordination with your oncology team as appropriate

The program can begin at any point in your cancer journey — before surgery (pre-hab), during treatment, or months and years after. It is never too early, and it is never too late.

Is the Strength ABC Program Right for You?

You may be a great candidate for the Strength ABC program if:

You’ve finished treatment but still can’t raise your arm fully or regain your strength
You have tightness, pulling, or cording under your arm or down your arm
You’ve been told you are at risk for lymphedema, or have already been diagnosed
You want to return to exercise but aren’t sure what is safe
You’re about to have surgery and want to prepare your body first (prehab)
You simply want to feel strong and like yourself again

You Went Through a Lot. Your Recovery Deserves the Same Effort.

Breast cancer treatment is hard. The people who go through it are strong. But strength after cancer isn’t something your body automatically reclaims — it’s something you rebuild, with the right support and the right program.

At Thera, we are certified Strength ABC providers, trained through the Klose Training program, and dedicated to giving every breast cancer survivor the evidence-based care they deserve. Our clinic is located in Midtown Manhattan at 115 W 30th Street, steps from Penn Station and accessible from across the Tri-State Area.

If you’re ready to start getting your strength back, book a consultation with our team today — we’re here.

Thera Physical & Occupational Therapy | 115 W 30th Street, Room 502B, New York, NY 10001

Certified Strength After Breast Cancer (Strength ABC) Providers | Klose Training Certified

Specializing in Breast Cancer Rehabilitation, Lymphedema Therapy, and Cosmetic Surgery Recovery in Midtown Manhattan.

Frequently Asked Questions:

Yes — when it is done correctly, under clinical supervision. The PAL Trial demonstrated that slowly progressive weightlifting is not only safe for breast cancer survivors but also actively reduces lymphedema risk. The key is a structured, supervised program like Strength ABC — not unsupervised gym workouts.
The program can begin at any point: before surgery (prehab), during treatment, or well after treatment ends. There is no “too early” or “too late.” Your therapist will complete a thorough evaluation first to tailor the program to where you are in your recovery.
Axillary web syndrome — also called cording — causes tight, rope-like tissue to form under the arm and down toward the elbow or wrist after lymph node removal. It can be painful and limit arm movement. The Strength ABC program, combined with hands-on manual therapy, directly addresses cording as part of a comprehensive recovery plan.
No referral is required to begin. New York State allows direct access to physical and occupational therapy for up to 10 visits or one month without a physician’s script. Learn more about our services and how to get started.
The Strength ABC program follows a specific, evidence-based protocol developed through the PAL Trial. It is designed specifically for breast cancer survivors, accounts for lymphedema risk at every stage, and is delivered by Klose Training-certified clinicians. General exercise programs — including those at commercial gyms — are not designed with these factors in mind and can inadvertently increase risk if not properly supervised.

Megan McCarthy