Pectoralis Major Repair Rehabilitation Protocols

12 Pectoralis Major Repair rehabilitation protocols from 12 institutions, published 2023–2025. Weight-bearing progressions vary by institution — compare them in the table below before selecting a protocol.

Compare by institution

Institution	Weight-Bearing	Key Restrictions
Dr. Michael C. Fu MD (Hospital for Special Surgery)…	N/A	Immobilizer day and night for 6 weeks; PROM limits: 30 ER, 90 FF supine, no extension, no abduction, arm must…
iOrtho	Sling in neutral/IR; sleep in sling; bone-tendon wean at wk 4…	Very limited PROM initially (ER at 0 deg ADD, flex 45 deg, ABD 30 deg); no shoulder AROM until wks 6-8; no…
Massachusetts General Hospital	Sling neutral or IR Phase I-II; WB through surgical side permitted Phase III (wks 6-8)	No IR isometrics Phase I-II; no pec major loading until Phase IV (9-14 wks); ER limited early (neutral…
NYU Langone Health — Pectoralis Major Tendon Repair…	N/A	Passive shoulder rest 2 wks; sling 6 wks total; no pec major isometrics until wk 3 (shortened position only…
Orthopaedic Associates of Maine	FWB; immobilizer day and night wks 0-2; immobilizer daytime only wks 2-6; no immobilizer…	No PROM wks 0-3; PROM limits wks 3-6: 90° flex, 45° ER, 20° ext, 45° abd; no resisted IR/adduction until…
Orthopedic & Sports Medicine Specialists (OSMS)	Sling for soft-tissue healing x6-8 wks total (limited removal in safe environments at 4…	Avoid active shoulder movement all planes Phase I; avoid shoulder ER beyond 40 deg and horizontal abduction…
Sanford Health — Pectoralis Major Repair	N/A – upper extremity	No stretching (horizontal ABD, extension, ER) or squeezing (horizontal ADD) immediately; sling 3 wks…
Sutter Health / Palo Alto Medical Foundation — Pectoralis…	N/A (upper extremity)	Sling with abduction pillow at all times wks 1-6 (remove for exercises/showering); D/C sling at wks 6-8…
UCLA Department of Orthopaedic Surgery - Sports Medicine	N/A (upper extremity)	Sling at all times including sleep x 8 wks (may remove for grooming/exercise; remove for desktop work after…
University of New Mexico (UNM) Sports Medicine — Pectoralis…	N/A (upper extremity)	Sling x 4 weeks (remove 3x/day for exercises); no passive ER or abduction x 6 weeks; ER limited to 0 degrees…
University of Virginia Orthopaedic Surgery — Pectoralis Major…	NWB surgical UE	Sling at all times (except HEP and PT) for 6 weeks; sleep in sling; no lifting with operative shoulder…
UW Health Sports Medicine — Pectoralis Major (Pec) Muscle…	N/A (shoulder surgery)	Sling continuously Phase I; sling whenever not doing rehab Phase II; PROM only: ABD starts 30° (+5°/wk)…