What are sternal precautions after heart surgery?

Reviewed by Erin Rose — healthcare price-transparency analyst. Last checked August 29, 2026. Part of the full heart-surgery recovery checklist. No affiliate links on this page — every link below goes to a primary source or another page on this site.

Sternal precautions are the movement rules that protect your breastbone while it heals from a sternotomy — the incision used for most open-heart and bypass surgery. In plain terms: don't lift, push, or pull more than about 10 pounds with both arms (5 with one arm), don't put your body weight through your arms, and don't reach behind your back or overhead. Bending at the waist, notably, is NOT restricted — a genuine difference from the no-bending rule this site's knee and hip hubs describe.

The rules, in the hospitals' own words

UW Medicine's occupational-therapy handout is the richest source found for this hub — a 6-page guide covering exact weight limits and the movement mechanics behind them. Four rules do almost all the work:

That third rule is why front-closure clothing matters so much on this hub's checklist — reaching behind your back for a bra clasp or a belt loop is precisely the motion it rules out. It's not a styling preference; it's the mechanism the hospital itself names.

The hug-a-pillow instruction

The single most concrete instruction across every source in this research pass: hug something to your chest, constantly, for weeks.

A hospital news article from Genesis HealthCare System explains why the pressure is worth bracing against at all:

Genesis also confirms the pillow is standard-issue, not something you're expected to buy in advance: the hospital distributes about 3,500 firm heart-shaped pillows a year to cardiac patients at discharge, at just that one system. Any pillow purchase on this site's checklist is framed as a hands-free-strap upgrade or a spare, not a first-time necessity — see the full checklist for that honest framing.

The phased weight-limit table

OSU Wexner Medical Center's own precautions sheet organizes recovery into a 5-category table by incision approach (sternotomy standard, sternotomy strict, thoracotomy standard, thoracotomy strict, transfemoral) rather than by which specific procedure — CABG, valve repair, or replacement — was performed through it. The table below is the sternotomy-standard category, the majority pattern this hub covers; stricter categories extend some of these windows further.

Honest scope note: this table covers the sternotomy-standard category only. OSU's own sheet lists four other categories (sternotomy strict, thoracotomy standard, thoracotomy strict, transfemoral) with shorter or differently phased timelines — driving, for example, ranges from "after 6 weeks as tolerated" (sternotomy standard) to "after 1 week as tolerated" (transfemoral procedures). Follow your own surgeon's specific category, not a general one, especially if your incision wasn't a standard sternotomy.

Bending is allowed — a genuine difference from knee and hip recovery

This is the finding this research pass flagged as most worth stating plainly, because it cuts against a reasonable assumption: sternal precautions do not restrict bending at the waist. UW Medicine's own guide says so directly:

That's a real, sourced difference from this site's knee-replacement and hip-replacement hubs, both of which describe genuine bending restrictions (a 90-degree hip precaution, a bent-knee limitation) for weeks after surgery. Here, a reacher or grabber's job is avoiding arm-strain and overreach under the weight limits above — not compensating for an inability to bend, which simply isn't the restriction this surgery imposes.

What does the hospital actually give you?

At minimum, the firm heart pillow at discharge, confirmed by two independent hospital/rehab sources (Genesis HealthCare System, OSU Wexner Medical Center). Beyond that, UW Medicine's occupational therapy team may conditionally suggest, depending on your situation:

• A higher bed, a pillow or foam cushion in your chair, or a raised toilet seat — "if it is hard for you to stand up from sitting."
• A long-handled reacher or a dressing stick — "if it is hard for you to put on your pants and underwear."
• A shower chair, a hand-held shower head, a non-skid mat, and a bendable long-handled sponge — "if showering is hard or tiring for you."
• A toilet aid — if reaching through your legs and wiping front to back (the method UW Medicine describes, to avoid reaching behind your back) is difficult.

Every one of these is stated conditionally in the source material ("may suggest," "if hard") — not as universal, standard-issue equipment. That's why this hub's own checklist places them in "Depends on your situation," not the core essentials.

Why isn't any of this Medicare DME?

Not a data gap — a scope difference, confirmed by reading all 68 codes in data/coverage_status.json directly. Every code in that set is lower-extremity or general-mobility DME: walkers, canes, commodes, hospital beds and rails, patient-lift slings, seat-lift mechanisms, manual wheelchairs. None of it maps to a heart pillow, a front-closure bra, compression stockings, or a pill organizer — this surgery's equipment needs sit entirely outside the categories this dataset tracks.

One honest exception is worth naming directly, because a reasonable reader might ask about it: Medicare-covered hospital beds with head elevation (HCPCS E0250–E0266) do exist in the tracked code set, and some patients genuinely struggle to sleep flat after this surgery. But no hospital source fetched for this research recommends renting one specifically for heart surgery — Cleveland Clinic's own sleep-after-heart-surgery guidance is thin ("arrange the pillows... to decrease muscle strain"), and no other source mentioned a hospital bed at all. The connection between "some patients can't sleep flat" and "a head-elevating hospital bed is Medicare-covered DME" is this research pass's own editorial bridge — offered here as a question worth raising with your doctor if a recliner or sleep wedge genuinely isn't working, not as a primary recommendation.