​One in four cancer survivors will experience persistent pain after ending cancer treatment. In our exploration of chronic pain among cancer survivors, evidence shows time and time again that physical activity plays a vital role in alleviating symptoms and improving quality of life.

More and more initiatives promote physical activity within and after cancer rehabilitation, such as '1000 km tegen kanker' (1000 km against cancer) or the climb of the Mont Ventoux with Think Pink. It is great to see these initiatives that help create a physical activity routine, because the biggest struggle with physical activity is that it requires adherence. Many barriers hinder the uptake and consistent effort of engaging in physical activity behaviour. There are many aspects to take into consideration, but in this blog post, I want to focus on the ​social aspect of physical activity.

When asked about ways to facilitate behaviour, many survivors highlight the importance of social support in sticking to their exercise routines.

Imagine having a friend cheering you on during a workout or joining a group where everyone shares the same journey. This sense of comradeship makes physical activity more than just a task; it becomes a shared experience. Being among others with similar experiences helps in feeling at ease when starting a new habit. A safe environment to exercise can be created with peer-groups that have had similar experiences but also, by having instructors with knowledge of cancer rehabilitation.

Of course, social support encompasses more than the exercise environment. It is also the support of their community: family, friends, partners, and even health care providers. Positive social support contributes to motivation, making it easier for survivors to stay committed to their exercise plans. However, the influence of social dynamics isn't always straightforward. 

While positive support can be a driving force, negative influences also exist. Social control differs from social support in the way that support is there to assist and to offer comfort to the other. Social control involves actions, norms, or expectations that influence or regulate an individual's behaviour within society. For example, the reason why you don’t chew with your mouth open or why you get dressed to come into the office and not in your pj’sare social rules indicating that this is the way to behave. It is important to look at the societal expectations of physical activity after cancer. The idea that ‘you need to rest, take it easy’ can be a reason why cancer survivors don’t engage in physical activity. Next to that, social control, whether intentional or unintentional, can hinder survivors' autonomy and create a certain resistance. It can feel very belittling when someone else controls the way you engage in physical activity, taking away the autonomy of the individual.

Acknowledging these nuances is crucial for us as part of the cancer survivors’ social network, either as researcher or clinician. It prompts us to develop interventions that not only harness the positive aspects of social support but also address and minimize potential challenges, creating a positive and supportive environment. There is no one-size-fits-all when it comes to designing and supporting physical activity. Again, the need for an individualized approach in pain management takes centre stage. 

I’ll end this blogpost with an inspiring quote:

If you want to go fast, go alone. If you want to go far, go together.

Sophie Van Dijck 

My clinical experience as physiotherapist has showed me the complex problems of chronic pain. It pushed me to find solutions for problems like the challenge of physical activity and pursue a PhD in this topic. Check out the Pain-DetAct study, a study that looks at the determinants of physical activity in chronic pain: https://www.facebook.com/paindetact. 

2024 Pain in Motion

References and further reading: 

McDonough MH, Beselt LJ, Daun JT, Shank J, Culos‐Reed SN, Kronlund LJ, et al. The role of social support in physical activity for cancer survivors: A systematic review. Psycho-Oncology. 2019;28(10):1945-58.

https://link.springer.com/article/10.1007/s11764-020-00963-y

Ungar N, Wiskemann J, Weißmann M, Knoll A, Steindorf K, Sieverding M. Social support and social control in the context of cancer patients' exercise: A pilot study. Health Psychol Open. 2016;3(2):2055102916680991.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5546267/

Picture by Steven Lalhem via Unsplash.com