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Pectoralis Major Rupture Rehabilitation Protocol

PHASE I - IMMEDIATE POST-SURGICAL PHASE (DAYS 1 - 14)

Goals:

  • Maintain integrity of the repair
  • Gradually increase passive range of motion(PROM)
  • Diminish pain and inflammation
  • Prevent muscular inhibition

Days 1-14:

  • Sling
  • Pendulum exercises 4x daily (flexion, circles)
  • Elbow/hand gripping & ROM exercises
  • Cryotherapy/Ice for pain and inflammation - 15-20 minutes every hour
  • Sleeping - sleep in sling or brace

Precautions to be maintained through Week 6:

  • Maintain arm in brace, remove only for exercise
  • No lifting of objects
  • No shoulder abduction, forward elevation or external rotation
  • No excessive or aggressive stretching or sudden movements
  • No supporting of body weight by hands
  • No bimanual activities (pulling on pants/socks, etc.)

PHASE II - PROTECTION PHASE (WEEKS 3 - 6)

Goals:

  • Allow healing of soft tissue
  • Do not overstress healing tissue
  • Decrease pain & inflammation
  • To increase PROM

Weeks 3-6:

  • Continue sling through Week 4(through Week 6 if repaired under tension)
  • Continue pendulum exercises
  • Continue use of cryotherapy/ice as needed if still swollen
  • Begin physical therapy(PT)
  • PROM forward elevation to 130° with arm in adduction

PHASE III - INTERMEDIATE PHASE (WEEKS 7 - 12)

Goals:

  • Attain full ROM
  • Normal scapulo-humeral rhthym

Weeks 7-12:

  • Continue PROM
  • Start active-assisted ROM(AAROM) exercises (ie. pulleys, etc)
  • Work on scapulo-humeral rhythm, peri-scapular strengthening program(no push-ups plus)
  • May use arm for light activities of daily living(ADL's)
  • May begin gentle active ROM(AROM)
  • Isometric exercises (avoid shoulder adduction, internal rotation and horizontal adduction)

PHASE IV - ADVANCED STRENGTHENING PHASE (WEEKS 13 - 23)

Goals:

  • Maintain full non-painful ROM
  • Enhance functional use of upper extremity
  • Improve muscular strengthen & power
  • Gradual return to functional activities

Weeks 13-23:

  • Continue ROM & stretching to maintain full ROM
  • Pectoralis Major strengthening is begun
    • Single arm pulleys and bands
      • Horizontal adduction
      • Internal rotation
      • Forward elevation
      • Shoulder adduction
  • Rotator cuff(RTC) strengthening
  • Continue peri-scapular strengthening(may begin push-ups plus against wall)

PHASE V - RETURN TO ACTIVITY PHASE (WEEKS 24+)

Goals:

  • Gradual return to strenuous work activities
  • Gradual return to recreational sport activities

Weeks 24-25:

  • Continue stretching, if motion is tight
  • Begin floor push-ups
  • Dumbbell bench presses with light weight and high repetition

Week 36:

  • Full activitie
  • HIGH-WEIGHT, LOW-REPETITION BARBELL BENCH PRESSING DISCOURAGED INDEFITINELY!

Please use the link provided to learn more about pectoralis major rupture rehabilitation.

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