Chest/sternal pain

[ETC908]

I am just about 10 weeks out from OHS. I received mixed instructions on restrictions after surgery. In the post-operative book that I was sent home with, they said not to lift more than 10 pounds for the first 8 weeks, and then no more than 20 lbs for weeks 8-12. When I met with the PA three weeks after surgery, she told me to avoid any lifting more than 10 lbs until I was 12 weeks out, and to avoid any activities, like skiing for example, where the sternum could be jeopardized. However, in the paperwork she later filled out for me for work, their instructions were no lifting for 8 weeks post-surgery. Either way, I remained very diligent for the first 8 weeks. I really didn't lift anything. I've dealt with the evolution of various chest wall musculoskeletal pains as time has gone on, but nothing seemingly out of the ordinary.

I've been doing cardiac rehab since early December, walking, using the stationary bike (trying not to put to much stress on my arms/chest), and doing some core. Since passing the 8-week mark I will admit that I've gotten a little impatient and have pushed it a bit more. I've done some planks, and have put a bit more stress on my arms while on the bike as I push the effort a little bit. In addition, there are things in every day life, especially after returning to work, that are unavoidable. A heavy door that I need to open, for example. I turned awkwardly in bed last week and put increased stress on my chest, and felt pain in the sternum. Last weekend I had no choice, and had to quickly lift my 3 year old, who weighs about 30 pounds. Other than that, and the planks, I have not knowingly lifted any more than 10-20 pounds over the past 2 weeks or so (and did zero lifting before that). I've added some lower body strengthening, and continue to do some core work as tolerated.

Over the past few days I've noticed some increased pain in the sternum. It's not excruciating, and there is no clicking or anything like that. Certain positions or movements seem to cause it.

I guess I'm wondering what others' experiences were as they tried to increase their physical activity...did you have persistent pain, did you work through it, scale back, etc? After clearing the 12 week mark I'd like to eventually return to pushups, chest presses, a bit heavier weight etc...but I'm not sure how much residual pain is normal/expected, vs a sign that I should scale back. I'm trying to balance an increase in my activity vs doing any damage to the surgical site. I appreciate any input and experiences you've had.

 

[carolinemc]

I am just about 10 weeks out from OHS. I received mixed instructions on restrictions after surgery. In the post-operative book that I was sent home with, they said not to lift more than 10 pounds for the first 8 weeks, and then no more than 20 lbs for weeks 8-12. When I met with the PA three weeks after surgery, she told me to avoid any lifting more than 10 lbs until I was 12 weeks out, and to avoid any activities, like skiing for example, where the sternum could be jeopardized. However, in the paperwork she later filled out for me for work, their instructions were no lifting for 8 weeks post-surgery. Either way, I remained very diligent for the first 8 weeks. I really didn't lift anything. I've dealt with the evolution of various chest wall musculoskeletal pains as time has gone on, but nothing seemingly out of the ordinary.

I've been doing cardiac rehab since early December, walking, using the stationary bike (trying not to put to much stress on my arms/chest), and doing some core. Since passing the 8-week mark I will admit that I've gotten a little impatient and have pushed it a bit more. I've done some planks, and have put a bit more stress on my arms while on the bike as I push the effort a little bit. In addition, there are things in every day life, especially after returning to work, that are unavoidable. A heavy door that I need to open, for example. I turned awkwardly in bed last week and put increased stress on my chest, and felt pain in the sternum. Last weekend I had no choice, and had to quickly lift my 3 year old, who weighs about 30 pounds. Other than that, and the planks, I have not knowingly lifted any more than 10-20 pounds over the past 2 weeks or so (and did zero lifting before that). I've added some lower body strengthening, and continue to do some core work as tolerated.

Over the past few days I've noticed some increased pain in the sternum. It's not excruciating, and there is no clicking or anything like that. Certain positions or movements seem to cause it.

I guess I'm wondering what others' experiences were as they tried to increase their physical activity...did you have persistent pain, did you work through it, scale back, etc? After clearing the 12 week mark I'd like to eventually return to pushups, chest presses, a bit heavier weight etc...but I'm not sure how much residual pain is normal/expected, vs a sign that I should scale back. I'm trying to balance an increase in my activity vs doing any damage to the surgical site. I appreciate any input and experiences you've had.

It takes a year for the muscles in the sternum to heal from the trauma of surgery. That is why Cardio tells you to ease back into routine and that it would take a year for the sternum to heal from the trauma of Open Heart Surgery. Just slow down and take it easy. Go slow and work it up. Take time. I know for someone like you it is not easy. But slow down a bit and go slow. You will heal better at a slower pace. You cannot heal super quickly. But you will be fine, build it slowly and watch the weights. You are not to lift no more than 5 pounds in the beginning of the healing process. Go slowly.

 

[Amy]

I’m 10 months post op and have been doing lots of prescribed stretches with exercise bands, some planks etc for some (unrelated-to-the-surgery) neck and back pain i was having.. and I think it’s setting off more of the chest / sternal pain like I had up until about 5-6 months post op. So even at this late stage, I feel my sternum is still not at 100%... though I wasn’t super athletic and didn’t work out before the surgery other than yoga and walking 3-5 miles a day.

I actually logged in today to see what early symptoms mightve been for those who had a late infection, this sort of low-level burning ache worries me so... but I hope it’s just the normal ‘pushed it a bit too hard’ one.

I second taking it easy... though it’s hard to see yourself losing muscle and strength.

 

[pellicle]

Hi

I actually logged in today to see what early symptoms mightve been for those who had a late infection, this sort of low-level burning ache worries me so...

I had no obvious symptoms until it erupted

http://cjeastwd.blogspot.com/2012/11/another-surgery.html
I had a little niggle at the start, but then it was entirely "unnoticed" until enough pus broke through from under the sternum.

I went to the doctors a week prior with a slight swelling of the manubrium, then within a few days this was getting worrying.

three days later it was this:

but here I am ... over 10 years later.

Stay vigilant, don't catastrophize and be prepared to move fast when / if you need to

Best Wishes

 

[carolinemc]

I’m 10 months post op and have been doing lots of prescribed stretches with exercise bands, some planks etc for some (unrelated-to-the-surgery) neck and back pain i was having.. and I think it’s setting off more of the chest / sternal pain like I had up until about 5-6 months post op. So even at this late stage, I feel my sternum is still not at 100%... though I wasn’t super athletic and didn’t work out before the surgery other than yoga and walking 3-5 miles a day.

I actually logged in today to see what early symptoms mightve been for those who had a late infection, this sort of low-level burning ache worries me so... but I hope it’s just the normal ‘pushed it a bit too hard’ one.

I second taking it easy... though it’s hard to see yourself losing muscle and strength.

Have you mentioned this to your GP? You may want to asap. And it takes the srenum a year to completely heal. But infection needs attention now.

 

[Brinntache]

I’m 10 months post op and have been doing lots of prescribed stretches with exercise bands, some planks etc for some (unrelated-to-the-surgery) neck and back pain i was having.. and I think it’s setting off more of the chest / sternal pain like I had up until about 5-6 months post op. So even at this late stage, I feel my sternum is still not at 100%... though I wasn’t super athletic and didn’t work out before the surgery other than yoga and walking 3-5 miles a day.

I actually logged in today to see what early symptoms might've been for those who had a late infection, this sort of low-level burning ache worries me so... but I hope it’s just the normal ‘pushed it a bit too hard’ one.

Hi, I'm 10 months post-op too and I have nothing like that. I had one rib pop a little out of place from a hard cough that needed some physio/massage to work back. The pain from that was very specific to the joint. I exercise every day (thanks to my wife/training partner) and the sternum feels pretty good. So yes, let your GP know.
And maybe a physiotherapist as well. It could also be jumped up in intensity too fast and those little muscles are not happy. I found an osteopath therapist who knew how to work on intercostal muscles. Oh the joy of pulling a muscle you didn't know you had. But again, the pain from that was very specific. I knew exactly where that muscle was and where it attached. A general ache is different.
General rule: Specialist are very good at seeing things within their specialty, not so good at things outside it. I had to argue with my GP to prescribe massage instead of drugs for muscle issues. Good luck.

 

[d333gs]

It takes a year for the muscles in the sternum to heal from the trauma of surgery. That is why Cardio tells you to ease back into routine and that it would take a year for the sternum to heal from the trauma of Open Heart Surgery. Just slow down and take it easy. Go slow and work it up. Take time. I know for someone like you it is not easy. But slow down a bit and go slow. You will heal better at a slower pace. You cannot heal super quickly. But you will be fine, build it slowly and watch the weights. You are not to lift no more than 5 pounds in the beginning of the healing process. Go slowly.

It is difficult to know what to listen to: check out “sternum healing & sternal infection rates after heart surgery “ on YouTube ….doctor says a month

 

[Brinntache]

It is difficult to know what to listen to: check out “sternum healing & sternal infection rates after heart surgery “ on YouTube ….doctor says a month

There are different levels/definitions of healed. After a month your sternum is on its way to knitting back together, meaning you are no longer the surgeons problem. God help you if you take a blow to the chest 4 weeks after OHS.

 

[Chuck C]

It is difficult to know what to listen to: check out “sternum healing & sternal infection rates after heart surgery “ on YouTube ….doctor says a month

Your surgeon's office should have given you a an exercise guide, in terms of what activities you can do when, as well as some gentle exercises that they will want you to do daily right away. And, of course walking right away is ok.

But 30 days for full sternal healing? I watched the video that you mentioned. I understand that the person being interviewed in that video is a surgeon and some people believe that they are never wrong, but I would not resume full physical activities after 30 days.

I used the guide from my surgeon to ease back into exercise, increasing the briskness and duration of my walking accordingly. I gradually increased my level of activity, but did not go near 100% until I got the clearance from my cardiologist at my follow up, 4 months after my surgery. I asked him if I could resume all my activities 100% and he said that yes, as I was past the 12 week point I was cleared to go 100%.

So, despite that video, I would not attemp the Sandwich Bed of Nails World Record after just 30 days. Might wait at least 12 weeks for that one:

 

[d333gs]

There are different levels/definitions of healed. After a month your sternum is on its way to knitting back together, meaning you are no longer the surgeons problem. God help you if you take a blow to the chest 4 weeks after OHS.

The way I feel at two weeks I very much agree with you !!! Did you watch the video?

Your surgeon's office should have given you a an exercise guide, in terms of what activities you can do when, as well as some gentle exercises that they will want you to do daily right away. And, of course walking right away is ok.

But 30 days for full sternal healing? I watched the video that you mentioned. I understand that the person being interviewed in that video is a surgeon and some people believe that they are never wrong, but I would not resume full physical activities after 30 days.

I used the guide from my surgeon to ease back into exercise, increasing the briskness and duration of my walking accordingly. I gradually increased my level of activity, but did not go near 100% until I got the clearance from my cardiologist at my follow up, 4 months after my surgery. I asked him if I could resume all my activities 100% and he said that yes, as I was past the 12 week point I was cleared to go 100%.

So, despite that video, I would not attemp the Sandwich Bed of Nails World Record after just 30 days. Might wait at least 12 weeks for that one:

thanks Chuck,
I did not mean to suggest any one follow this video, I was surprised at the range of time for healing that has been thrown into the arena . I am in a rehab place now working on reanimation as they call it here. One of the exercises we had to day was putting a soft gym ball between our hands and pressing them together: I certainly felt the feebleness of the joint and breast muscles doing that! On the other hand a year sounds like a long time for muscle to rebound to the chest bone material. I have had two other surgeries for severed “long tendons” in both armes about a year apart . These required repositioning the tendons by drilling holes in the arm bones , inserting the tendons and then wedging it in tightly with a wedge that dissolves over time. This took a good three to four months for comfortable function to return. Pain wise they were worse than the sternum. In all these cases, arms and sternum ,my doctors have under estimated pain , and with the arms, recovery time. In this reanimation place they are saying three months before the sternum can tolerate the shock of riding a road bike on a bumpy road .

 

[Chuck C]

In this reanimation place they are saying three months before the sternum can tolerate the shock of riding a road bike on a bumpy road

That sounds about right to me. Maybe a bit conservative, but you want to be conservative in letting things heal, rather than push too early and get a severe injury.

 

[paulk]

My chest pain was to the point where it only hurt when coughing, or twisting, about two weeks post-op. Took a small dog for a walk, bring careful to lock my hands together and on the leash, so chest muscles & sternum wouldn’t be strained If/when she pulled. Now it hurts a bit - whoops! No more dog walks for me…

 

[d333gs]

I am back home after one week in IC and 3 weeks in rehab. I just set up my stationary bike and I will continue the bike /walk/movement exercises for the next couple of months .
Re Walking my dog ............Not yet ; I still can get some serious pain in the sternum after too hard a walk and left side pecs to under my arm when just reaching in the wrong direction, it always surprises me when it happens.I still have one spot that needs another week to heal , I think it was a tube hole . Rehab was good. There were three of us who had surgery and we were moved around in a group: ICU to rehab, same exercise schedules and walks to a "goodbye and good luck" yesterday as our 3 weeks ended and we had to be out by 10am.

 

[Superman]

Careful on that stationary bike posture. Too much weight on the arms may not feel like much during a ride, but even a 20 minute easy ride, I suspect you feel that in the chest. Set it up beach cruiser style (upright) vs time trial style.

 

[Chuck C]

Glad that you are home and keeping up the rehab!

Re Walking my dog ............Not yet

That's probably a good idea. I have a high energey German Shepherd and talking him on walks was something that I waited about 6 weeks to do. It might be a good idea to give it even longer. The last thing I needed was him ripping open my sternum as he took off after a squirrel, as I held on to the leash.

Like this:

https://www.youtube.com/shorts/4CdBwrLRtp8

 

[pellicle]

triggered a funny memory

That's probably a good idea. I have a high energey German Shepherd and talking him on walks was something that I waited about 6 weeks to do.

a well dressed "hot chick" (visually probably about 23) walking her dog (St Bernard) in the snow (Finland, -10C) and talking on the phone when the dog saw another dog (turned out to be a ***** on heat) and just launched in bounds through the snow towards it ... meanwhile "hot chick" is in tow like a bouncing sled with snow ploughing up either side like one of those road clearing machines ... she was squeaking squealing at the Bernie in a high pitch but he was on a mission.

That was so funny

 

[d333gs]

Glad that you are home and keeping up the rehab!



That's probably a good idea. I have a high energey German Shepherd and talking him on walks was something that I waited about 6 weeks to do. It might be a good idea to give it even longer. The last thing I needed was him ripping open my sternum as he took off after a squirrel, as I held on to the leash.

Like this:

https://www.youtube.com/shorts/4CdBwrLRtp8

That would have been very destructive

 

[carolinemc]

I am back home after one week in IC and 3 weeks in rehab. I just set up my stationary bike and I will continue the bike /walk/movement exercises for the next couple of months .
Re Walking my dog ............Not yet ; I still can get some serious pain in the sternum after too hard a walk and left side pecs to under my arm when just reaching in the wrong direction, it always surprises me when it happens.I still have one spot that needs another week to heal , I think it was a tube hole . Rehab was good. There were three of us who had surgery and we were moved around in a group: ICU to rehab, same exercise schedules and walks to a "goodbye and good luck" yesterday as our 3 weeks ended and we had to be out by 10am.

ON the bike, when you ride, you are leaning and when you get off, you can have a time straightening out. Should not be biking yet, for the sternum needs more time to heal. Walking by yourself would be better cause the dog can pull you into a direction change. Wait a few extra weeks before walking the dog and biking.

 

[d333gs]

ON the bike, when you ride, you are leaning and when you get off, you can have a time straightening out. Should not be biking yet, for the sternum needs more time to heal. Walking by yourself would be better cause the dog can pull you into a direction change. Wait a few extra weeks before walking the dog and biking.

 

[d333gs]

Thanks for the concern, I am actually following the the same exercise program we had in rehab. They put us on bikes day one!?