Pec Major Tendon Acute 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:

 Elbow
 and
 wrist 
active
 motion 
(with
 shoulder 
in 
neutral
 position
 at
 the
 side),
 hand 
exercises,
 patient
 may 
ride 
stationary 
bike
 with 
operative 
arm 
in 
the
 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
 Flexion 
to 
90 
degrees

• Therapeutic
 Exercises :

Elbow
 and 
wrist
 active 
motion
 (with
 shoulder 
in
 neutral
 position
 at
 the 
side), 
hand
 exercises, 
shoulder
 shrugs / scapular
 retraction 
without
 resistance.




Phase 
III : 
6­-8
 Weeks


• Sling 
Immobilizer:
 May 
be 
discontinued

• Range
 of
 Motion:

 AROM
 in
 the
 pain
free 
range
–
 No
 PROM, 
AAROM 
(pulleys,
 supine 
wand,
 wall
climb)
 –
 Goals:
 Forward
 Flexion
 to 
120
 degrees
 and
 Abduction 
to 
90
 degrees,
 ER
 to 
tolerance ,
IR 
and
 Extension 
(wand
 behind 
the 
back)

• Therapeutic 
Exercises:

 Elbow 
and 
wrist 
active 
motion
 (with
 shoulder
 in
 neutral
 position
 at 
the 
side),
 hand 
exercises,
 submaximal 
isometrics


Phase
 IV : 
8­-12 
Weeks



• Range
 of
 Motion:
 
AROM 
and
 AAROM 
in 
the 
pain
free 
range
– 
No
PROM,
 Goals:
 Full
 ROM

• Therapeutic
 Exercises: 

Light
 Theraband
 (ER,
 Abduction,
 Extension),
 Biceps
 and
 Triceps 
PREs, 
Prone 
Scapular
 Retraction 
Exercises
 (without
 weights),
 Wall
 Push‐Ups
 (no 
elbow 
flexion
>
90
degrees) 

Phase 
V: 
3-­6
 Months


• Range 
of
 Motion: 
Full
 ROM

• Therapeutic 
Exercises:

 Light 
Theraband
 (ER,
 Abduction, 
Extension)
 with 
increasing
resistance,
 May
 start
 light
weight 
training
 at
 4.5
 months 
post‐op 
(no 
flies
 or
 pull
downs),
 Regular
 Push‐Ups

• Return 
to 
athletics 
at
 6
 months 
post ­op