You may begin these exercises in the Intensive Care Unit. Complete

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Exercises for Patients After Open Heart Surgery You may begin these exercises in the Intensive Care Unit. Complete the exercises in a sitting position. Sit upright looking straight ahead with your chin tucked and shoulders pulled back. Make sure that you are relaxed and rested before starting. These exercises are not intended to be a difficult workout for your heart. These exercises will speed your recovery. They will prevent pain from developing in your shoulders and trunk. They will also help you with your breathing. It is important you begin these exercises the day after your surgery and do them daily during your recovery. Posture hints: Stand in front of a full-length mirror and check that your head and chin are tall and back. Your shoulders should be back and level with each other. Do not hunch your shoulders forward. Perform the exercises twice a day. Repeat each exercise 10 times. 1) Shoulder Shrugs - Bring your shoulders up to your ears, then relax your shoulders down. Repeat. 2) Shoulder Circles - Sitting upright, roll your shoulders in a smooth motion up, back and down in a circle. Repeat in the reverse direction. Exercises for Patients After Open Heart Surgery 93

3) Trunk Twists - Slowly rotate your trunk to the right, looking over your shoulder. Hold and stretch. Then rotate your trunk to the left, hold and stretch. Repeat sequence. 4) Trunk Sidebending Hold your arms relaxed at your sides and maintain your trunk upright. Lean to your right side slowly. Hold and stretch. Then lean to your left side, hold and stretch. Repeat sequence. 94 Heart Surgery: A Guide for Patients and Their Families Michigan Medicine

5) Chest Stretch - Place your hands behind your head while sitting upright. Move your elbows back until you feel a stretch, hold. Relax elbows forward to rest, then repeat. 6) Forward Arm Raise - Sitting with upright posture, straighten your arm with your thumb facing up. Raise your arm up to the front over your head. Your elbow should be next to your ear. Repeat with your other arm. 7) Side Arm Raise Hold your arm straight out to your side with your thumb up. Raise your arm up to the side over your head, hold and stretch. Repeat with your other arm. Exercises for Patients After Open Heart Surgery 95

8) Backward Reach With your arms relaxed at your side, elbows straight, reach your arms straight backwards. Hold and stretch. Then repeat. 9) Hands behind your back and reach - Grasp your hands together behind the small of your back. Slowly lift your hands off your back. Hold and stretch. Then repeat. 10) Coughing and Breathing Exercises: Remember to use your incentive spirometer 10 times per hour when you are awake. You may use a pillow or blanket to hold over your incision when you cough. This will provide support and decrease pain. 96 Heart Surgery: A Guide for Patients and Their Families Michigan Medicine

Activity Precautions: (until otherwise stated by your doctor) No lifting, pushing or pulling greater than 5-10 pounds with your involved arm(s). This applies when you are climbing stairs, standing up from a chair or getting out of bed. You should roll onto your side before sitting when getting out of bed. Strengthening Exercises: After you have gained full motion in your shoulder(s), progress exercises 6 and 7 by performing them with a light weight in your hand. Start with 1 pound and slowly progress as tolerated. Many objects around the house can be used as weights: a can of soup, tools, a plastic bottle filled with rice or pennies, etc. Important Note: The exercises described in this section should be continued until you: no longer feel tight, stiff or weak in your muscles. have fully regained the mobility in your shoulders and trunk are walking thirty minutes each day Once you have achieved these goals, ask your doctor if it is acceptable for you to participate in a regular aerobic exercise program or a cardiac rehabilitation program Exercises for Patients After Open Heart Surgery 97

Notes 98 Heart Surgery: A Guide for Patients and Their Families Michigan Medicine