5 Ways to Maintain Sternal Precautions

If you have had open heart surgery and are participating in cardiac rehab, your physical therapist will work with you to help you recover fully and return to your previous level of functional mobility. He or she will likely prescribe exercises to help improve your strength and endurance and teach you how to monitor your exercise and activity level.

Picture of a chest scar after open heart surgery.
Image Source/Getty Images

Your healthcare provider may want you to maintain sternal precautions after open heart surgery. Sternal precautions mean that you must limit the amount of force and motion around your shoulders and arms. This prevents your sternal incision from separating and keeps the risk of infection at a minimum.

Your physical therapist can help you learn the best ways to get around and manage your mobility if you are under sternal precautions.

How to Maintain Sternal Precautions

Here are a few ideas for you to use to help you maintain your sternal precautions. Be sure to check in with your healthcare provider or physical therapist if you have any questions about your precautions or if you are unsure about how to maintain them.

  1. Use your legs to stand up from a chair. Many people push with their arms when rising from a seated position. Doing so may disrupt your healing sternal incision. When rising from a chair, use your legs. Simply slide your heels back so your feet are positioned well under your knees, and place your hands on your thighs. Lean forward with your nose over your toes, and rise up, taking care not to push or pull with your arms.
  2. Roll your shoulders to stretch. There's nothing like that first stretch in the morning when you place both arms overhead. But if you do this after open heart surgery, you may be breaking the rules of your sternal precautions. Instead of reaching overhead to stretch, try rolling your shoulder blades forward and back with your arms by your side. This helps to prevent excessive separation of your breastbone and your chest incision.
  3. Use a pillow to splint yourself when coughing. Coughing can be painful after open heart surgery, and coughing forcefully can place stress and strain through your sternum. Place a pillow over your chest and hug it tightly if you feel the need to cough or sneeze after your open heart surgery.
  4. Ask for help when lifting items. Lifting heavy items is a no-no after open heart surgery. If your healthcare provider has you under sternal precautions, make sure you ask for help when lifting items. Don't worry—there will be a time when you are able to lift things again, but you must wait until your practitioner allows you to do so.
  5. Use the log roll technique when getting out of bed. When rising from bed, many people use their arms and hands to pull themselves up. If you are maintaining sternal precautions, you must not do this. To rise from bed, use the log roll technique. Simply lie on your back, and then roll onto one side. Allow your legs to fall slowly off the edge of your bed, and allow their momentum to help your upper body rise up, taking care not to push or pull with your arms.

Cardiac rehab and the recovery process after open heart surgery can feel like a long journey. Maintaining sternal precautions may be a necessary part to ensure that your sternal incision heals properly with minimal risk of infection.

A Word From Verywell

Work closely with your physical therapist and healthcare provider to understand your sternal precautions and to devise ways to prevent breaking the rules when maintaining those precautions.

4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Saint Luke's. After bypass surgery: getting up and out of bed.

  2. University of Michigan Medicine. Exercises for patients after open heart surgery.

  3. Genesis Healthcare System. Heart pillows: pressure can reduce pain for cardiac patients.

  4. University of Washington Medical Center. Activities of daily living after heart surgery.

By Brett Sears, PT
Brett Sears, PT, MDT, is a physical therapist with over 20 years of experience in orthopedic and hospital-based therapy.