Patient education: Exercises after open heart surgery (The Basics)

When will I start to exercise after open heart surgery? — Your doctor will have you start moving around as soon as you can after surgery. Next, you will start some gentle exercises to help get back motion and strength.

Eventually, your doctor might want you to go to a cardiac rehabilitation, or "rehab," program a few times a week. During cardiac rehab, a physical therapist works with you to develop a safe exercise program. These programs include exercises to help you tolerate activity better.

What precautions should I take? — If your breastbone was cut, you need to take extra care in how you move for 6 to 8 weeks. This protects your breastbone while it heals. Your doctor or nurse might give you specific instructions, but for most people, the precautions include:

●Take deep breaths. Hold a pillow to your chest to help you take deep breaths more comfortably.

●Do not push or pull with your arms. This means that you should not use your arms to help you get up from bed or chairs. Try to hold a pillow to your chest when you get up. This helps you remember not to push or pull with your arms.

●Do not lift anything over 10 pounds (4.5 kg).

●Avoid too much reaching or twisting. Move slowly if you have to reach or twist slightly.

●Avoid activities that involve lots of shoulder movement. Examples include tennis, baseball, and golf.

Will it hurt to exercise? — After open heart surgery, you might have some pain and stiffness in your chest, arms, and shoulders. Your legs might also feel stiff. This is all normal. You might have some slight discomfort when you exercise. You can also have some slight pulling around your cuts (incisions). Stop exercising right away if you get sharp pain.

What strengthening exercises should I do? — Below are some examples of strengthening exercises to keep your muscles strong and improve flexibility. The doctor will tell you when it is OK to start these exercises, often within 4 to 6 weeks after surgery.

Most of these exercises can be done sitting up straight in a chair. Start by doing each exercise 2 to 3 times. Work up to doing each exercise 10 times. Try to do the exercises 2 to 3 times each day. Do all exercises slowly, and stop exercising if you get sharp pain.

●Shoulder blade squeezes (figure 1) – Pinch your shoulder blades together on your upper back, and hold for 3 to 5 seconds. Sit with good posture, and make sure that your shoulders do not raise up when you do the exercise. Relax.

●Shoulder circles (figure 2) – Sit with your back straight. Raise just your shoulders up toward your ears. Move your shoulders back, down, and then forward in a circle. Repeat, but now move your shoulders up, forward, down, and then back in a circle.

●Elbow touch (figure 3) – Reach up, and clasp your hands behind your head. Bring your elbows together like they are going to touch in front of your face. Return to the starting position.

●Trunk twists (figure 4) – Cross your arms over your chest so your hands are on the opposite shoulders. Keeping your lower body still on the chair, turn your upper body to 1 side so you are looking over your shoulder. Now, turn the other way.

●Diagonal chops (figure 5) – Clasp your hands together, and bring them over 1 shoulder. Slowly twist your trunk and make a chopping motion ending at the opposite hip. Next, do the motion over the opposite shoulder, chopping down to the opposite hip.

●Arm raises (figure 6) – Start with your hands crossed at your knees. Raise your hands up, and uncross your arms. Squeeze your shoulder blades together. Hold for 3 to 5 seconds. Lower your arms to the starting position.

What else can I do? — Practice good posture. Try to sit up straight or lean slightly back. This helps your breastbone heal.

Walking is one of the best forms of exercise after surgery. Make sure that you feel steady enough to walk alone. If you do not feel safe, have someone walk with you. Start slowly, and walk for a short distance. It is OK if you are a little tired after your walk, but you should not be exhausted. Slowly increase the time and distance you walk each day until you walk 30 minutes at least 5 times a week. Remember to warm up and cool down. Stretching is a good way to do both.

Cardiac rehab programs can supervise exercise after cardiac surgery. They also teach you other ways to keep your heart healthy. These include:

●Improving your diet

●Avoiding smoking

●Reducing stress

●Helping you understand and take your medicines as directed

When should I call the doctor? — Call for emergency help right away if you think that you might be having a heart attack (in the US and Canada, call 9-1-1).

Symptoms of a heart attack can include:

●Severe chest pain, pressure, or discomfort with:

•Breathing trouble, sweating, upset stomach, or cold and clammy skin

•Pain in your arms, back, or jaw

•Worse pain with activity like walking up stairs

●Fast or irregular heartbeat

●Feeling dizzy, faint, or weak

Call your doctor for advice if:

●You are more tired than normal or have more trouble breathing with activity.

●You have pain, clicking, or popping in your breastbone.

●You feel like each side of your ribs moves separately when you breathe.

More on this topic

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Patient education: Exercise (Beyond the Basics)