Sternal Precautions following Open Heart Surgery
Have you had open heart surgery? Here are some things you need to know as you begin your recovery process.
Many of you will have been given information from the hospital or your doctor after you were discharged from hospital. Commonly this advice tells you not to lift anything more than 5 pounds, and restricts you from doing many of your regular activities. As much as this advice is common practice, it unfortunately unfairly restricts many of you, and in fact may slow down your recovery process.
In an effort to keep you safe, this statement of “lift no more than 5 pounds” is a blanket statement given to everyone, no matter your age, health status now, or what you were capable of doing prior to having this surgery. For many women, their purse itself weighs more than 5 pounds, in fact simply opening your car door to leave the hospital generates more than a 5 pound force! So the 5 pound rule is simply unrealistic, and based on research over the past number of years, is unnecessary.
Here is a simplified timeline of what you can do.. with of course close follow up from your doctor and listening to how your body feels. There are numerous videos on our site with exercises for each stage. We encourage you to follow along and to contact us with any questions.
Weeks 1 – 4
Take time to heal. Rest. Your body has been through something major. Open heart surgery is not for the faint of heart. This is a tough surgery on your body, so allow your body to rest and recover.
With that said, no movement is not good either. Gentle range of motion exercises within a pain free range will start to bring fresh, oxygen rich, and nutrient dense blood to the healing areas to help them heal. No popping, cracking, or pain however.. movements are gentle and pain free. Follow along with the gentle videos specific to this timeframe I have put on our site if you wish!
Try to think about your posture. The tendency is to round your shoulders forward to protect the surgery site. Try to gently encourage those shoulders back, and take deep slow breaths. Be mindful of not pushing with one hand to get up and out of bed or a chair. We don’t want any shearing forces on the chest just yet. If you pick up something, hold it close to you & use two hands. No one handed lifting anything above your head.
Your lower body is fine, (other than being mindful of any grafting that took place in your legs) and is a great way to keep the circulation pumping without causing any irritation. Gentle calf raises, squats, seated leg extensions and light walking are all great exercises to do at this point. There is also a gentle lower body exercise video for you to follow on the site as well.
Weeks 5 – 8
If you have been keeping up with your range of motion exercises, and your incision site, and overall chest/ back muscles have been feeling ok, look to keep expanding your range of motion. The goal is to have full range of motion with no pain. At this point you can start adding in some weights. The weights should be relatively light, (but pose a comfortable challenge) and movements kept in a pain free range. Start easy your first go around, and adjust from there. Try to complete 1 – 2 sets of 10 repetitions. Monitor how your body feels the next day. If you are a little sore, you need to lighten up the weight.
The movements we want you to caution you of right now are lifting any weight above shoulder height, and certainly no one handed lifting over your head. No aggressive chest exercise like pushups on the floor, bench press, shovelling snow or dirt just yet. Be mindful of yard work & house renovations, and lifting those heavy objects. There are a number of exercises using your biceps, triceps, shoulders, back and chest that are fantastic for this stage. See our site for videos to follow. Even some wall pushups would be ok. Just start easy. Keep up with the controlled strength training so you can get back to doing all the daily life jobs safely.
Remember to keep going with your leg exercises too!
Weeks 9 – 12 & Beyond
Your sternum is “typically” (remember not everyone is typical) fully healed in 12 weeks. So this phase is all about steady progression. Keep expanding your range of motion, and increasing the weight you are using.
It is however very individual and based a lot on what you were doing prior to the surgery, and how you are feeling now. Always maintain a pain free range of motion, and listen to how your body feels.
Start mimicking some of the movements you want to be able to do in your exercise routine.. such as swimming, kayaking, or even that golf swing! We want you to feel comfortable and safe before stepping up the tee to take your first swing. So start with putting, and some short chip shots first before getting out your driver. This concept goes for all your activities you are wanting to get back to.
Like anything, consistency is the key. If you keep up with your range of motion exercises, listen to your body, and progress slowly, you are more likely going to succeed!
If you have any questions please feel free to reach out. There are a number of videos on our site in the exercise section, but also there is a great talk in the education section as well discussing in more detail the timelines above. Have a look!
Pulse Cardiac Health