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Your recovery in hospital after cardiac surgery: activity and exercise

A smiling nurse aiding an elderly patient in a hospital ward

It is important for you to get up and move around as soon as you can. Lying in bed leads to muscle weakness and can cause blood clots and lung infections.

Title card of cardiac surgery guide video - exercises

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The benefits of activity when recovering from cardiac surgery

Activity has many benefits, including:  

  • Increasing strength.
  • Preventing complications.
  • Helping to get your bowels moving.

Remember to do your leg exercises (as explained in the "leg exercises" section on this page) while you are in bed.

On the day of your surgery, your nurse will get you up into a chair next to your bed or will help you to dangle your legs at the edge of your bed. When you start eating, try to sit up in the chair for all your meals.  

As you improve each day, you will be able to do more for yourself. Keep your activities short and do them often rather than trying to do everything at once. We do not want you to get too tired.  

We will encourage you to get up and walk around the unit as soon as you can. Most people are up and walking one to two days after surgery. In the beginning, it will be with assistance from the health-care team until you regain your independence.

Deep breathing and coughing exercise/ICOUGH protocol

After surgery, your lungs make extra mucus. Deep breathing and coughing exercises help clear this mucus from your lungs and prevent lung infections. Deep breathing opens up your lungs and helps loosen the mucus. Coughing helps remove the mucus from your lungs. Your health-care team may ask you to refer to your ICOUGH education booklet as well for additional strategies to prevent a lung infection.  

Before beginning, ensure your pain score is at a level that allows you to do these exercises. Ask for pain medication at least 30 minutes before doing these exercises, if needed.

Deep breathing exercise

Do EVERY HOUR while you are awake.  

  • Start by placing your hands on your ribs.  
  • Take a deep breath slowly in through your nose, expanding your lower chest until you feel your ribs push against your hands.  
  • Hold your breath for a count of three.  
  • Breathe out slowly through your mouth.  
  • Repeat this five more times.

 

* The nursing staff may provide you with an incentive spirometer to help you with your deep breathing exercises.  

Coughing exercise

Do EVERY TWO HOURS while you are awake and after your deep breathing exercise.  

  • Place a small pillow or blanket over your surgery area to protect or splint your incision. This helps decrease pain with coughing and allows a stronger cough.  
  • Do your deep breathing exercises.  
  • Cough several times.

Moving around in bed

Change position in bed at least EVERY TWO HOURS. This helps keep you from getting stiff and gets blood flowing to your arms, legs, and skin. This also helps to prevent bed sores. You may find moving difficult because of incision pain. Initially, you will require assistance repositioning in bed after surgery, but this will become easier over time. 

To move your body sideways

  • Lie on your back.
  • Bend your knees.
  • Lift your hips and shift them sideways.
  • Then follow with your shoulders.

To roll onto your side

  • Bend your knees.
  • Support your incision with a pillow and one hand (the hand on the side you are rolling onto. For example, if you’re rolling onto your left side, use your left hand to support your incision with the pillow). 
  • With the other hand, reach across your body and grab the bed-side rail.
  • Pull yourself onto your side, rolling like a log.

To sit up on the side of the bed

  • Lie on your back.  
  • Bend the knee furthest away from the side you are rolling to.
  • Use that bent knee to help you log roll onto your side. Roll your whole body as one, as much as possible. 
  • Drop your legs over the edge of the bed.
  • Push yourself up the rest of the way using minimal assistance with your uppermost arm. 

To stand from sitting at the side of the bed or chair

  • Slide to the edge of the bed/chair. Avoid pushing with your hands. 
  • Ensure both feet are flat on the floor.
  • Lean forward to position your shoulders over your knees, “nose over toes.” 
  • Place your hands on your knees. Use your legs to stand up.

Leg Exercises

These leg exercises help keep the blood flowing through your legs, keep your muscles strong, and prevent stiff joints. These leg exercises reduce the chances of you getting a blood clot.

Hospital patients are at risk of having a blood clot form in the leg veins. This is called a deep venous thrombosis (DVT). Sometimes, the clot can break off and “travel” to the lungs, causing a pulmonary embolism (PE), making breathing difficult. Although it is rare, PE can be fatal.

You can reduce your risk of DVT/PE in the hospital by doing the following exercises. You will also receive an injectable blood thinner while you are in the hospital.

Do all these exercises EVERY HOUR while awake until you can get up and walk around the nursing unit.

Ankle pumps

  • Bend your foot up towards your head.
  • Bend your foot down towards the foot of the bed.
  • Repeat five times.

Ankle circles

  • Move your feet around slowly in large circles.
  • Repeat five times in each direction.

Hip flexion

  • Bend your knee by sliding your heel up toward your body.
  • Slide your heel back down. 
  • Repeat five times.

Thigh Muscle Contraction

  • With your leg straight, tighten the muscles on the top of your thigh. 
  • Press the back of your knee down.
  • Hold for five seconds. Relax.
  • Repeat five times, then repeat this exercise with the other leg.

Protecting your sternum

Depending on the type of surgery you have, most people will have a sternotomy - a cut along the chest and through the sternum (breastbone). The sternum is then held together with stainless steel wires that stay in place long-term. After a sternotomy, the breastbone will take two to three months to heal. During this time, you must follow sternal precautions which include:  

  • No lifting anything weighing more than five to 10 pounds. 
  • Avoiding pushing or pulling with your arms. 
  • Hugging your chest when coughing.

Your surgical journey

Your recovery in hospital after cardiac surgery

Your recovery in hospital after cardiac surgery: what to expect each day

Going home from the hospital after cardiac surgery

Your recovery at home after cardiac surgery

Your recovery at home after cardiac surgery: activity and exercise

Adjusting to life after cardiac surgery

Waiting for your cardiac surgery

Preparing for your cardiac surgery and recovery

The day before your cardiac surgery

The day of your cardiac surgery

Your heart and how it works

Learn more about your heart surgery