Cancer warriors benefit greatly from a regular yoga practice, but many of them must realize that their movements must change to reflect where they are in treatment. Breast cancer combatants often find their movements restricted because of lymphedema, or swelling in the legs and/or arms. Often caused by damage to or removal of the lymph nodes during mastectomy surgery, radiation or the work of cancer cells, lymphedema can make movement painful as well as difficult.

So how does one do an Adho Mukha Svanasana, or Down Dog, when lymphedema occurs in the arm? Well, perhaps one simply doesn’t. This can make it difficult to participate in typical flow-style classes unless the teacher knows how to make the practice accessible. There is no pose required for the completion of a successful asana class, and practicing self-care means ahimsa, or refraining from harm. When a particular pose is painful, adjust it or refrain from it – perhaps move to Child’s Pose and wait until the class has moved on.

Does this mean that Surya Namaskar is prohibited? Far from it! It’s possible to perform a half Sun Salutation keeping both hands on the hips, thereby not engaging the arms at all. For a complete Sun Salutation, someone might go to “Hands and Knees” position instead of Plank, following that with “Cat-Cow-Child’s”(Bitilasana-Marjaryasana-Balasana) instead of Bhujangasana, or Cobra, and Down Dog. Alternatively, one can move to a wall and take the Down Dog against the wall, stretching just enough to elongate the arms without putting pressure and causing pain.

If lymphedema is present in a leg, this is a great time to seek out a Chair Yoga class, where participants perform yoga asana with the support of a chair. If you’ve never tried moving in and out of Trikonasana, or Triangle, while seated, it seems like a tall order – but a trained teacher can show you how to do this successful. Other ideas? Perhaps this is time for a Yin or Restorative practice instead of something more movement- and muscle-oriented.

If you are a cancer warrior prone to lymphedema, you might try a regular home practice of Viparita Karani, or Legs Up the Wall. By bringing your legs above your torso, you encourage lymphatic drainage, which may help with the swelling. Down Dog against the wall can also be helpful in this area. Before you start, however, clear all movements with your physician. Yoga teachers are not medical workers, and thus the final answers rest with the doctor that oversees your particular case.

A final option for practicing yoga while dealing with lymphedema? Focus on the other seven limbs as described by Patanjali. Because of the affect of pranayama and meditation on the parasympathetic nervous system, this might be the ultimate way to work with any anxiety and depression that follow treatment. If you are sitting still and taking slow, even breaths, you are practicing a form of yoga. Allow your conception of yoga practice to expand, knowing that yoga is another tool to help you continue the good fight against cancer.

Disclaimer: I am not a medical professional, and this column is in no way intended as medical advice or treatment. Always check with your physician before beginning any exercise or movement practice.