What are the weight restrictions for a patient after coronary artery bypass grafting (CABG) surgery?

Weight Restrictions After CABG Surgery

Patients with recent coronary artery bypass surgery should avoid traditional upper-body resistance training exercises (lifting weights ≥50% of maximum voluntary contraction) for 8 to 12 weeks to allow for proper healing of the sternum. 1

Critical Healing Timeline

The sternum requires 6-8 weeks to heal adequately, which is the primary determinant for when patients can safely progress to more strenuous activities. 2 This healing period directly governs weight-bearing restrictions and return to physical activities.

Immediate Post-Discharge Period (First Week)

• Daily walking on flat surfaces and stair climbing can begin within a few days after uncomplicated CABG 2
• No specific weight restrictions are mentioned for basic activities of daily living during this period
• Patients should avoid straining and breath-holding during any physical activity 1

Early Recovery Phase (Weeks 1-8)

• Avoid lifting weights at 50% or greater of maximum voluntary contraction for upper body exercises 1
• Many men can safely perform static-dynamic activity equivalent to carrying up to 30 pounds by 3 weeks after acute myocardial infarction, but this timeline is explicitly different and more permissive than post-CABG patients 1
• Before attempting side-turning or more vigorous activities, patients must ensure the sternotomy is well-healed (typically 6-8 weeks) and have received clearance from their healthcare provider 2

Return to Resistance Training (After 8-12 Weeks)

Once the 8-12 week healing period has passed, patients can begin structured resistance training with specific parameters:

• Initial intensity: 30-40% of 1-repetition maximum (1-RM) for upper body exercises 1
• Initial intensity: 50-60% of 1-RM for hips and legs 1
• Single-set programs performed a minimum of 2 days per week are recommended initially 1
• A comprehensive program of 8-10 exercises can be accomplished in 15-20 minutes and should be performed after the aerobic component to ensure adequate warm-up 1

Monitoring During Resistance Exercise

• Rate-pressure product should be 20% less than that observed at the angina or ECG ischemic threshold during exercise testing 1
• Target perceived exertion during resistance training should approximate 11-14 on the Borg scale ("fairly light") 1
• Heart rate and blood pressure measurements are essential, as systolic blood pressure elevation contributes more than heart rate to myocardial stress during resistance exercise 1

Return to Work Considerations

• Sedentary work: 6-8 weeks once sternal healing is complete 2
• Physically demanding jobs: longer recovery periods are required, though specific timelines depend on job demands 2
• Return to work rates range from 63-94% depending on physical demands 2

Common Pitfalls

The most critical error is allowing patients to resume upper-body resistance training or heavy lifting before 8-12 weeks post-surgery, which risks sternal dehiscence and serious complications. The American Heart Association explicitly distinguishes post-CABG patients from post-MI patients, noting that CABG patients require a longer restriction period specifically due to sternal healing requirements. 1

Patients should reduce resistance levels and increase repetitions to achieve lower relative effort, reducing the likelihood of breath-holding and straining—both of which can compromise sternal healing and increase cardiovascular stress. 1