Pec major repair

Rehabilitation programme following pectoralis major repair, with the arm protected in adduction and internal rotation early.

Typical timeframe: Return to sport from ~6 months (9 months for throwing)

Take it with you

Download the practice's own guide for pec major repair to print, save to your phone or share with your physiotherapist.

Word document, 344 KB

Phase 01 · Weeks 0 – 6

0 – 6 weeks after surgery

Wear sling when walking or travelling.
Otherwise remove sling with arm supported on a chair, table or pillow; the hand can be used for eating, computer and paperwork etc.
Begin passive motion 0 – 90° forward flexion supine, but the arm must be kept adducted and internally rotated during these exercises.
Don't move the shoulder too much.
At least 3 times a day, wrist and hand exercises with a squeeze ball.
Physiotherapy to teach isometric muscle contraction of deltoid and scapular stabilizers, elbow and hand movement.
Review with surgeon at the 2-week and 6-week mark.

Phase 02 · Weeks 6 – 12

6 – 12 weeks after surgery

No more sling, except if in a rowdy crowd situation.
Increase forward elevation 0 – 180°, and begin external rotation from against the tummy to 0°.
No abduction for 4 months until all other movements are full.

Phase 03 · Weeks 12 – 16

Continue stretching of the shoulder, including to full external rotation by 16 weeks — gently to protect the pec repair.
Begin formal strengthening of internal and external rotation; retraining of scapulo-thoracic rhythm and proprioception.
Patient may walk / jog and swim (breaststroke only).

Phase 04 · Weeks 16 – 24

Obtain full range of motion slowly over 24 weeks.
Sports specific strength and endurance training (tennis overhead serve, freestyle swimming, surfing) when fully rehabilitated with respect to motion, strength and proprioception. This usually does not occur until 6 months — 9 months for throwing.
Patient may feel more comfortable with shoulder taped or strapped for sports.

Last reviewed: 2025-10-15.