Pectus excavatum exercise: the natural alternative to surgery for some patients

On this page you can find out more about pectus excavatum exercises including:

• Options of surgery for pectus excavatum
• Why is exercise effective for pectus excavatum?
• Can exercise fix pectus excavatum?
• Types of exercise for pectus excavatum
• Push-ups
• Dumbbell pullover
• Incline dumbbell press
• Flat bench press
• Pull-ups
• Vacuum bell therapy
• Frequently asked questions on pectus excavatum

Pectus excavatum can cause both physical and psychological issues. Often known as “funnel chest”, common physical symptoms include sunken ribs, rounded shoulders, a poor posture, flared ribs, a potbelly and a rounded spine.

When pectus excavatum is severe, the condition can cause symptoms such as chest pain, lung problems and difficulty breathing. Whether the condition is severe or not, many people who have pectus excavatum become self-conscious and unhappy with their appearance.

The clinical description of the severity of pectus excavatum is based on the depth that the sternum is pushed inwards. You can read more about pectus excavatum symptoms in our guide Causes, symptoms and surgery options for pectus excavatum.

Surgery options for pectus excavatum

Some individuals with severe pectus excavatum opt for surgery to treat the condition. It’s estimated that approximately 380 pectus surgery operations are performed in the UK alone each year (source).

Patients are offered surgery based on the severity of their condition. It’s rare that surgery for pectus excavatum is done on the NHS. In the vast majority of cases individuals need to fund the procedure themselves.

Surgery options are only recommended for people with severe symptoms.

The two main options for surgery are:

The Nuss Procedure: this involves slipping a concave metal bar through an incision in the side of the chest. The bar is then flipped to a convex position to push the sternum outward.

The Ravitch Procedure: this involves the surgeon opening your chest to access your ribs and sternum. The surgeon then removes small sections of chest cartilage, repositioning the ribs and sternum. Steel bars are then inserted to hold the ribs and sternum in place.

A third, and much less invasive, option for surgery is an implant . You can find out more about how implants can help correct the appearance of pectus excavatum with our guide Pectus excavatum implant surgery: explaining the procedure, results and cost.

If you have a mild case of pectus excavatum then you may be able to improve your symptoms with exercise, however, you should always speak to a medical professional if you are experiencing symptoms from pectus excavatum.

Why is exercise effective for pectus excavatum?

As exercise can be difficult for people with pectus excavatum, it might sound surprising to hear it can be used to improve the condition. However, strengthening and stretching the core muscles can help with rib flare caused by pectus excavatum in some individuals.

As an option for pectus excavatum treatment without surgery, exercise is a non-invasive, natural option for treating the condition. However, excersise cannot cure pectus excavatum.

Exercise can provide the following benefits for people with pectus excavatum:

• Developing the upper body area
• Expanding the lungs capacity
• Improving posture
• Adding muscle mass to the pectorals and spine muscles

Can exercise fix pectus excavatum?

Pectus excavatum can’t be cured fully through exercise. However, in some people with mild cases, practicing exercises can improve symptoms. Whilst the physical deformity of pectus excavatum can’t be fixed, exercise can improve posture and the degree to which the chest expands (source).

Types of exercises for pectus excavatum

When exercising, it’s important not to focus only on the pectoral muscles. Practising different types of body building exercises can ensure you exercise all the necessary muscles. These exercises are also useful as they can be done at home, meaning you don’t even need to visit a gym.

Here’s a guide to the different types of exercises and the muscles they strengthen:

1. Push-ups

Push-ups are effective in strengthening the upper pectoral muscles, as well as stretching the chest muscles properly. Push-ups are also useful for helping blood flow to the back muscles, improving symptoms in people with a round back or curved spine.

How to do push ups

1. Lie in a plank position, ensuring your hands are placed directly under your shoulders.
2. Lower your body, whilst taking a deep breath. Try and keep your elbows at a 45 degree angle.
3. Exhale as you begin to push yourself up again.
4. Twist your elbows inwards slightly to get better control of motion and further engage your chest.

How often should you do these?

For the best results, try and do two sets of ten push-ups per day. As you become more confident doing these, you can increase this to three to six sets of push-ups.

2. Dumbbell pullover

The dumbbell pullover is effective in strengthening the pectoral muscles and the latissimus dorsi, a flat muscle on the back. Practising this exercise helps expand the rib cage and push the sternum out.

What you need

A bench and dumbbells.

How to do a dumbbell pullover

1. Lie on a weight bench or on the floor.
2. Hold a dumbbell over your chest with a slight bend in your elbows.
3. Gradually lower the dumbbell until it’s behind you.
4. Take a large breath to expand your rib cage.
5. Finish the movement to your starting position while exhaling.

How often should you do these?

Try to do four sets of these exercises three times a week. Start by using fairly light weights until you feel strong enough to use heavy weights.

3. Incline dumbbell press

An incline dumbbell bench press allows you to work on the anterior deltoid, a muscle in the top of the shoulder. It also works the upper part of the pectoralis major, a muscle situated in the chest.

What you need

Bench and dumbbells

How to do an incline dumbbell press

1. Lying down on an incline bench, grasp a dumbbell in each hand on top of your thighs. Ensure the palms of your hands are facing each other.
2. Push the dumbbells up, using your thighs. Hold them shoulder width apart by lifting them one at a time.
3. Rotate your wrists so the palms of your hands are facing away from you
4. Push the dumbbells up using your chest.
5. Once you get to the top, lock your arms. Begin slowly lowering the weight.
6. When you have finished, place the dumbbells on your thighs to move the weights to the floor.

How often should you do these?

Do this exercise two times a week for four sets of 10, using moderate weights.

4. Flat bench press

A flat bench press is one of the most effective exercises for your upper body. It focuses on the triceps, shoulders and chest. It’s a fairly easy exercise for mass muscle building.

What you need

Bench and barbell.

How to do a flat bench press

1. Lie down on a bench. Use a wide grip on a barbell, ensuring the chest musculature will be more involved in the movement. Ensure the weights are in a straight line above your chest.
2. Lower the barbell slowly for two seconds, letting it touch your lower chest.
3. Exhale, pushing the barbell in the starting position.

How often should you do these?

Do this exercise two times a week for four sets of 10, using moderate weights.

Pull-ups

Pull-ups work the latissimus dorsi, biceps and pectoral muscles. They are particularly useful for improving upper back strength and posture. You do need a pull up bar to do these, however they are fairly easy to perform.

What you need

Pull bar.

How to do pull-ups

1. With your arms fully stretched, grab a pull-up bar with both hands.
2. Pull yourself up, whilst squeezing your shoulder blades when you reach the top.
3. Lower yourself back to the starting position in a straight, slow motion.

How often should you do these?

Start with practicing five pull-ups in the morning and night. Once you become confident doing them, try and perform five sets of as many pull-ups you can, four times a week.

Vacuum bell exercises

The vacuum bell is designed to attach to your chest and create a vacuum that pulls the chest forward. Over time, your chest wall should stay forward on its own.

What you need

A vacuum bell.

You can find out more about vacuum bell therapy in our guide What is vacuum bell therapy and does it cure pectus excavatum?

Here is a sample exercise plan that you can follow two days a week. We recommend using certified personal trainers when working on strength training programmes.

Exercise	Reps	Rest in seconds	Sets	Equipment Needed
Flat Bench Press	10	90	4 sets 2 times a week	Bench and Barbell
Incline Dumbbell Press	10	60	4 sets 2 times a week	Bench and Dumbbells
Pull-Ups		60	As many as you can do, 4 times a week	Pull Up Bar
Dumbbell Pullover	10	60	4 sets 3 times a week	Bench and Dumbbells
Push-Ups	10	60	2 sets per day

Pectus excavatum and exercise: frequently asked questions

Why is exercise capacity reduced in people with pectus excavatum?

Pectus excavatum can sometimes cause difficulty breathing and chest pain, meaning it can be easy to run out of breath quickly. This can make it hard to exercise for a long time.

Patients with pectus excavatum also often complain of fatigue, tachypnoea (abnormally rapid breathing), discomfort and dyspnoea (laboured breathing), meaning they often have compromised energy levels. If you experience any of these symptoms, it’s best to speak to your GP.

Should I do pectus excavatum exercises regularly?

Although it can be difficult, exercise can go a long way to improving your overall health and symptoms. As well as improving posture and the outside appearance of your pectus excavatum, exercise can also increase lung volumes (source).

Studies have shown that the more you keep up with the exercises, the easier you will find it to stay active. This can have a huge impact on your psychological health as well as your physical health.

What’s a common mistake made when doing pectus excavatum exercises?

A common mistake when exercising to improve pectus excavatum is only focussing on the pectoral muscles. If you only focus on the pectoral muscles, as the pectoral muscles get more mass, the hole in the chest will only become more contrasted and look bigger (source). Ensure you do a broad range of exercises, to strengthen all the necessary muscles.

How long does it take for exercises to work?

A patient who suffers from a mild case of pectus excavatum will start to see a slight improvement in a few months. It usually takes a minimum of around four weeks to see a small muscle building response in the muscles. To see a change in ligaments and cartilage, you’re looking at around 20 weeks (source). Often, the condition does not completely resolve. It is important to keep up with the exercises to ensure you get the best results.

Please note: there is no guarantee that exercise will improve the appearance of pectus excavatum. Always speak to your GP or health professional before starting a new exercise regime.

For information on how Stephen McCulley can help you, contact the clinic on 0115 962 4535 or email enquiries@stephenmcculley.co.uk , or visit the pectus excavatum section of our website here.