Pectoralis Major Repair

PHASE I – 0-4 Weeks

• Sling Immobilizer: Worn at all times – sleep with pillow under elbow to support the operative arm
• Range of Motion: Supported pendulum exercises under guidance of PT
• Therapeutic Exercises:
• Hand exercises
• Elbow and wrist active motion (with shoulder in neutral position at the side)
• May ride stationary bike with arm in sling

PHASE II – 4-6 Weeks

• Sling Immobilizer: Worn at all times – sleep with pillow under elbow to support the operative arm
• Range of Motion: AAROM in the supine position with wand – Goal: Forward Elevation to 90 degrees
• Therapeutic Exercises:
• Hand exercises
• Elbow and wrist active motion (with shoulder in neutral position at the side)
• Shoulder shrugs/scapular retraction without resistance
• May ride stationary bike with arm in sling

PHASE III – 6-8 Weeks

• Sling Immobilizer: May be discontinued
• Range of Motion: AROM only in the pain free range – No PROM. AAROM (pulleys, supine wand, wall climb) – Goals: Forward Elevation to 120 degrees and Abduction to 90 degrees, ER to tolerance
• Therapeutic Exercises:
• Hand exercises
• Elbow and wrist active motion (with shoulder in neutral position at the side)
• Submaximal isometrics

PHASE IV – 8-12 Weeks

• Range of Motion: AROM and AAROM only in the pain free range – No PROM. Goals: Full ROM
• Therapeutic Exercises:
• Light Theraband (ER, ABD, Extension), Biceps and Triceps PREs, Prone Scapular Retraction Exercises (no weights), Wall Push-Ups (no elbow flexion >90 degrees)

PHASE V – 3-6 Months

• Range of Motion: Full ROM
• Therapeutic Exercises:
• Theraband (ER, ABD, Extension) with increasing resistance, may start light weight training at 4 months post-op (no flies or pull downs), Regular Push-Ups
• Return to sport at 6 months post-op

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