Physiotherapy is a powerful yet often overlooked area of cancer care. In this interview, OMPRN spoke with Jodi Steele, a leader in oncology rehabilitation and the founder of Canada’s first cancer and exercise program.
With over two decades of experience, Jodi shares how physiotherapy supports individuals at every stage of their cancer journey, from pre-habilitation and active treatment to recovery and palliative care. Her insights shed light on how personalised exercise and rehabilitation can improve quality of life, manage side effects, and, ultimately, become a standard part of cancer treatment across Canada.
Interview conducted by Leigh-Ann van Strijp, over email on May 15, 2025.
Jodi, can you please tell us a bit about your professional journey on becoming a physiotherapist.
Certainly, I earned my kinesiology degree in 1997 and my physiotherapy degree in 1999 from McMaster University. In 2001, a colleague and I opened Cancer Rehab: The Next Step, the first cancer and exercise program in Canada. In 2005, I founded Cancer Rehab Inc., a not-for-profit centre aimed at improving the lives of individuals living with cancer. I recognized that those undergoing cancer treatments often experience side effects such as lymphedema, fatigue, mobility issues, and depression. Until 2009, the clinic provided exercise-based rehabilitation services previously unavailable in Canada.
In 2009, I designed, developed, and launched Wellspring’s Cancer Exercise Program. This program, similar to what was offered at Cancer Rehab Inc., is now available at five locations throughout southern Ontario. I continue to work with Wellspring Niagara as a program leader for both in-person and online exercise classes. I am also a professor at Niagara College, where I teach in several programs, including Fitness, PSW, OT/PT Assistant, Massage Therapy, and Nursing.
I first taught Rehab Techniques in Oncology in 2007, which was aimed at educating health care professionals on the importance of exercise after a cancer diagnosis. In 2017, I began offering additional professional education courses online through Embodia, a digital healthcare platform.
Can you describe the role of a physiotherapist in the care of someone diagnosed with cancer?
A physiotherapist plays a key role in supporting individuals diagnosed with cancer across all stages of the disease and recovery. We help in managing physical side-effects of cancer and cancer treatment such as fatigue, pain, neuropathy, muscle weakness, joint stiffness, and reduced mobility that often result from surgery, chemotherapy, or radiation. We are also trained to assess and treat lymphedema, which is a common complication, especially after lymph node removal or radiation, using techniques such as manual lymph drainage, compression therapy, exercise, and education.
We restore function and mobility through tailored exercise programs that assist patients in regaining strength, balance, endurance, and coordination, which may decline due to prolonged bed rest, deconditioning, or treatment-related issues. By reducing physical limitations, physiotherapists support patients in maintaining independence, returning to daily activities, and improving overall quality of life and emotional well-being.
We also provide pre-surgical assessments and exercise plans to prepare patients for cancer treatments (“prehab”), as well as post-operative rehab to promote healing and prevent complications. I am also passionate about educating patients and caregivers about safe physical activity, pain management, energy conservation techniques, and long-term self-care strategies.
If you would like to read up on the different roles of other members of your healthcare team, view the ‘support professionals in cancer care’ page for a breakdown here.
Walk me through a typical day as a physiotherapist
Wellspring is a very busy place. Every hour, we have about 15 clients with a variety of cancers who exercise in a special facility. We have a minimum of 3 staff (physiotherapist, kinesiologists and exercise specialists) available at any given time. I allocate about 3 – 4 hours a day for clients participating in the 12-week program for the first time, they are taken through a progressive interval training program, designed for their specific needs. Two of those hours are reserved for our maintenance program—graduates of the 12-week interval training program.
As the lead physiotherapist and designer of the program, I complete 3 assessments daily, which include full medical history and several subjective and objective measurements. Then I design their exercise program. The rest of my day is spent treating clients who will benefit from manual therapy techniques, lymphedema management and counselling.
How did you get involved with Wellspring Canada?
Funny enough, they found me. I was operating my own not-for-profit clinic in Hamilton, and they approached me with the idea of bringing my program to their already established resource centers. By 2009, we had my cancer exercise program in three locations in the Greater Toronto area (Wellspring Westerkirk House, Wellspring Birmingham Gilgan House and Women’s College Hospital), one program in Brampton (Wellspring Chinguacousy) and Wellspring Niagara. Wellspring offers over 50 programs, with cancer exercise being the largest program.
At what point in a cancer journey do patients typically start seeing a physiotherapist, and why?
Patients can start seeing a physiotherapist at any point in their cancer journey, and earlier involvement often leads to better outcomes. Ideally, physiotherapy begins at diagnosis during the “prehabilitation” phase, where the focus is on preparing the body for upcoming treatments like surgery, chemotherapy, or radiation. During this phase, physiotherapists assess baseline function, introduce exercises, and provide education on breathing techniques, energy conservation, and lymphedema prevention to build resilience and reduce the risk of complications.
Throughout active treatment, physiotherapy helps manage common side effects such as fatigue, neuropathy, pain, and mobility limitations, enabling patients to stay as active and independent as possible. After treatment, in the rehabilitation phase, physiotherapists support recovery by rebuilding strength, improving mobility, and addressing lingering issues such as scar tissue, pain, or swelling. Even in the advanced or palliative stages of cancer, physiotherapy plays a valuable role in maximizing comfort, managing positioning, preventing falls, and supporting caregivers.
What are some common physical challenges cancer patients experience that physiotherapy can help with?
Patients with cancer often face a range of physical challenges, many of which can be effectively addressed through physiotherapy. One of the most common is fatigue, which can be overwhelming and persistent, making even simple daily tasks difficult. Physiotherapists help manage this through graded exercise programs that build stamina without overexertion. Pain and stiffness, especially after surgery or radiation, can limit movement; targeted stretches, manual therapy, and mobility exercises help restore function and comfort. Lymphedema, a type of swelling that often occurs after lymph node removal or radiation, can be managed with specialized techniques such as manual lymphatic drainage, compression therapy, and specific exercises. Neuropathy, or nerve damage from chemotherapy, may cause numbness, tingling, or weakness, particularly in the hands and feet—physiotherapy can help improve balance, coordination, and fine motor skills. Deconditioning and muscle weakness from inactivity or prolonged bed rest are also common, and physiotherapists provide safe strength training to rebuild physical capacity.
Are there any misconceptions patients have about what physiotherapy can offer during or after treatment?
Yes, there are several! One of the biggest is the belief that physiotherapy is only for injuries or after orthopedic surgery, not realizing its vital role in cancer care. Many assume it’s just about exercise, when in fact it also includes managing pain, fatigue, swelling (like lymphedema), neuropathy, and even breathing difficulties. Another misconception is that rest is better than movement during treatment, leading some patients to avoid physical activity altogether. While rest is important, physiotherapists guide patients through safe, tailored movement that can reduce fatigue and improve recovery. Some patients also think they have to wait until treatment ends to start physiotherapy, but early intervention can prevent complications and support better outcomes. Additionally, those in advanced stages may believe physiotherapy has nothing to offer them, when in reality it can enhance comfort, mobility, and quality of life.
Do you typically work with other healthcare professionals?
Yes, physiotherapists are an essential part of the multidisciplinary team in cancer care and routinely collaborate with other healthcare professionals: oncologists and surgeons. Nurses and occupational therapists are also key partners. Dietitians and social workers have been instrumental in cross-referrals to Wellspring.
Have you noticed changes in how physiotherapy is integrated into care plans as personalized or molecular-based treatments have become more common?
Yes, these targeted therapies, while often more effective and with fewer broad side effects than traditional chemotherapy, still come with unique physical challenges—such as fatigue, joint pain, or neuropathy—that require tailored rehabilitation approaches. As cancer care becomes more individualized, physiotherapy is also evolving to be more personalized, focusing on each patient’s specific diagnosis, treatment profile, and functional goals.
There’s greater recognition now that physiotherapists need to understand not just the type of cancer, but also the biological behaviour and treatment impact, for example, how immunotherapy or hormone therapies might affect endurance, bone density, or inflammation. This shift has encouraged closer collaboration between physiotherapists and oncology teams, earlier referrals, and the development of customized exercise prescriptions based on the patient’s molecular profile and expected side effects.
The unfortunate reality is that we do not have enough people trained in both oncology and physiotherapy. I have attempted to integrate more oncology curriculum in several universities and colleges. That is why I have delivered my courses across Canada to help train more people. As I am getting older, just turned 50, I find my online courses are the most effective way to get the knowledge out there.
To read more about targeted therapy, consult our lesson on ‘how does targeted therapy work?’.
How do you tailor physiotherapy for patients living with advanced or metastatic cancer?
Tailoring physiotherapy for patients living with advanced or metastatic cancer requires a highly individualized approach that focuses on symptom management, maintaining function, and enhancing quality of life rather than aiming for full recovery. The main goals are to alleviate pain, reduce physical limitations, and support independence in daily activities, all while considering the patient’s medical condition and prognosis.
Earlier in my career, I focused on palliation and was a regular visitor to many of the hospices in Hamilton, Burlington and Oakville. I also dedicated many years as a home care therapist specializing in palliative care and lymphedema management. This was one of the most rewarding parts of my 26-year career.
To understand more about how cancer spreads and metastasis, consult our ‘how does cancer spread’ resource.
Is it safe for a patient to exercise during chemotherapy or radiation?
Yes, in most cases, it is safe—and often beneficial—for a patient to exercise during chemotherapy or radiation, as long as the exercise program is tailored to the individual’s condition, treatment stage, and energy levels. Research consistently shows that appropriately guided physical activity during cancer treatment can help reduce side effects such as fatigue, nausea, depression, anxiety, and deconditioning, and may even improve treatment tolerance and overall quality of life.
That said, safety is key. A physiotherapist plays an important role in evaluating the patient’s medical status, blood counts (like low hemoglobin or platelet levels), and any treatment-related complications (such as neuropathy, bone metastases, or cardiotoxicity) before recommending exercise. The intensity, type, and duration of exercise are carefully adjusted for each patient.
There are some situations where extra caution or modifications are needed. For example, if a patient is immuno-compromised, group exercise settings may be avoided. If there’s a risk of fractures from weakened bones or metastases, weight-bearing exercises are modified.
“The most compelling research I have read suggests 90 minutes of moderate exercise per week after a cancer diagnosis can decrease the chance of recurrence and improve survival. That says it all.”
What advice would you give to someone newly diagnosed with cancer about staying physically active or maintaining mobility?
If you’ve just been diagnosed with cancer, one of the most important pieces of advice I can offer is this: stay as active as you can, in a way that feels manageable for you. Physical activity—no matter how gentle—can play a powerful role in helping you cope with treatment, manage side effects, and maintain your independence and confidence throughout the cancer journey.
The most compelling research I have read suggests 90 minutes of moderate exercise (60 to 80 percent of your max heart rate, there is an amazing formula we use) per week after a diagnosis of cancer (not all cancers have been researched but: breast, lung, prostate, colon and some of the hematological cancers) can decrease the chance of reoccurrence and improve survival. That says it all! My question is… when will exercise and rehabilitation become a standard of practice in the treatment of cancer across Canada? I have been working on this for 25 years!
Conclusion
As cancer care becomes increasingly personalized, physiotherapy is evolving as well, offering individualized, evidence-based support for managing physical challenges and restoring function. Jodi Steele’s pioneering work in oncology rehabilitation highlights the urgent need to integrate physiotherapy into standard cancer care. Her passion for education, collaboration, and improving patient outcomes continues to shape the future of supportive care in oncology, one tailored exercise program at a time.
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