Dr. Anthony A. Schepsis

Coastal Orthopedics
Beverly, MA
Professor of Orthopedic Surgery
Boston University School of Medicine

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Pectoralis Major Repair


                                   POST-SURGERY INSTRUCTIONS: PEC MAJOR REPAIR


Anthony A. Schepsis, M. D.

Coastal Orthopedics

Beverly-Lahey Health

978-927-3040978-927-3040

You may shower in one week.  Do not remove your bandage. We will change your dressing next week in clinic.

Expect some swelling, discomfort, and ecchymosis (bruising).  This is normal. The swelling can last from several days to several weeks depending on the type of surgery you have had.

Ways to lessen the amount of pain and swelling:

Rest

  • Use ice for the first 48-72 hours. If using regular ice, then apply for 20-30 minutes, four times a day.
  • Keep arm in sling and swathe at all times for 6 weeks even when sleeping.
 You have been given a prescription for pain medication.  It is very important to take it as prescribed to help with the post op pain. You should stop the pain medication when you feel comfortable.

Other medications you may take for breakthrough pain:
  • Tylenol 500mg (extra strength) two tablets every 3-4 hours
  • Advil 200mg two tablets every 4 hours with food
The pain medication may cause constipation. You were prescribed Colace, which should help with this. Drink plenty of fluids. If you do not have a bowel movement within 5 days then drink ½ a bottle of magnesium citrate, which is sold over-the-counter at your local pharmacy.

Sleeping is difficult for the first few weeks, pain tends to increase at night, this is normal. Use the medication.

You have been prescribed an antibiotic,to prevent infection. Notify me if you develop a fever > 101° F, with increase pain, redness, and warmth.  Report any pus or unusual drainage immediately to our office.

You need to call 978-927-3040978-927-3040 to schedule your follow up office visit for 7 days from the date of surgery.

Rehab Protocol below:

REHAB PROTOCOL FOR REPAIR OF PECTORALIS MAJOR

 PHASE ONE

0-    6 WEEKS

IMMOBILIZE TO ALLOW FOR REPAIR TO HEAL

SLING AND SWATH AT ALL TIMES (DAY AND NIGHT)

ICE COMPRESS:  (CRYOCUFF) CONTINUOUSLY FOR 1 WEEK THEN REGULARLY 20MIN FOR 3- 5 TIMES DAILY AS NEEDED

AT 4 WEEKS MAY START PASSIVE ROM AVOIDING ABDUCTION AND EXTERNAL ROTATION TILL 6 WEEKS

 

PHASE TWO

      6 WEEKS- 8 WEEKS

            PASSIVE ROM- INITIATE THE FORWARD FLEXION AND INTERNAL ROTATION

            INITIATE ACTIVE ASSIST/ACTIVE MOTION

                        PENDULUMS

                        ACTIVE AND PASSIVE FF

                        START ABD WITH ARM IN IR

                        START ER WITH ARM ADDUCTED

                        DO NOT COUPLE THESE MOTIONS

            DC SLING

 PHASE THREE

            8 WEEKS

            START ISOMETRICS OF PECTORALIS & OTHER SHOULDER GIRDLE MUSCLES

            10 WEEKS

             CAN COUPLE ABDUCTION AND ER MOVEMENTS WITHOUT RESTRICTIONS

            12 WEEKS

                        START LIGHT RESISTIVE EXERCISES

PHASE FOUR

            4 MONTHS (16 WEEKS)

           INITIATE HEAVY RESISTIVE STRENGTHENING PROGRAM

            PREPARE TO RETURN TO CONTACT SPORTS AT 5 – 6 MONTHS

            HEAVY WEIGHT LIFTING AT 6 MONTHS            

            

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