Physical Therapy for Pectus Excavatum: Pathways to Improved Posture and Function

Physical Therapy for Pectus Excavatum: Pathways to Improved Posture and Function

Pectus excavatum, commonly known as “sunken chest,” is a congenital deformity that can affect an individual’s physical appearance and overall self-confidence. Beyond the noticeable indentation in the chest, it can also impact one’s posture, respiratory efficiency, and musculoskeletal health. While surgical interventions are sometimes recommended, many individuals are discovering the transformative power of physical therapy in managing this condition. In this blog post, we’ll delve deep into the role of physical therapy for pectus excavatum, offering insights into how targeted exercises and techniques can lead to improved posture, function, and self-confidence.

Can You Fix The Pectus Excavatum Without Surgery?

Can You Fix The Pectus Excavatum Without Surgery?Pectus excavatum is a congenital deformity where the sternum and rib cage grow abnormally, creating a noticeable indentation in the middle of the chest. The decision to treat pectus excavatum often depends on its severity and the presence of associated symptoms. While severe cases, especially those impacting cardiac and respiratory function, might require surgical intervention. Still, the milder forms can be managed without surgery.

Non-surgical approaches primarily focus on improving posture, strengthening chest and core muscles, and enhancing respiratory function. Physical therapy, posture-correcting exercises, and specialized braces are among the techniques employed to address the condition. It’s essential to note that while these methods can help alleviate some symptoms and improve chest appearance to an extent, they might not completely “fix” the deformity. Consultation with a medical professional is crucial to determine the best course of action.

How Does Pectus Excavatum Physical Therapy Work?

Pectus excavatum physical therapy focuses on addressing the musculoskeletal abnormalities and functional challenges associated with the “sunken chest” deformity. Here’s a breakdown of how pectus excavatum physical therapy typically works:

Postural Training

Pectus excavatum often leads to an altered posture, characterized by a forward rounding of the shoulders and an accentuated curvature of the upper spine. This not only accentuates the sunken appearance of the chest but can also lead to other musculoskeletal issues over time. Physical therapists prioritize postural retraining as a cornerstone of their intervention. Through exercises and consistent reminders, they help patients develop the muscular strength and awareness needed to maintain an upright posture. Over time, this can significantly mitigate the visual impact of the deformity and also alleviate associated discomforts like back pain.

Strengthening Exercises

Strengthening the musculature surrounding the chest and upper back is pivotal. Weak muscles can exacerbate the appearance of pectus excavatum and can contribute to other associated issues like back pain. By introducing targeted exercises, therapists aim to bolster the muscles around the rib cage, offering better support to the sternum and potentially reducing the indentation. Moreover, a strong core helps in maintaining optimal posture and provides stability to the entire torso.


While physical exercises are crucial, some patients might also benefit from external interventions like orthotic bracing. This isn’t a standalone solution but is often used in conjunction with physical therapy. The brace, when worn, applies gentle but consistent pressure to the sternum, aiming to gradually remodel the chest wall. Physical therapists can provide guidance on how to effectively use these braces, ensuring that they complement the ongoing therapeutic exercises.

Patient Education

Awareness and understanding play a significant role in managing any condition. Physical therapists take the time to educate patients about pectus excavatum, helping them understand the mechanics behind their deformity and its implications. By doing so, they empower patients to make informed decisions about their daily activities, adopt ergonomic practices, and embed beneficial lifestyle habits that support and extend the benefits of the therapy.

Routine Monitoring

Routine MonitoringHealing and improvement are processes that require time and consistent effort. Regular sessions with the therapist allow for continuous monitoring of progress. Based on the individual’s response to the exercises and any feedback received, the therapist can adjust the regimen, ensuring that it remains effective and aligned with the patient’s goals.

Overall, physical therapy for pectus excavatum isn’t just about a set of exercises. It’s a holistic approach that aims to address the physical and functional challenges associated with the condition, while also empowering patients with knowledge and tools to better manage their health.

What Are Some Key Exercises for Pectus Excavatum?

Certainly, here are some key exercises often recommended for individuals with pectus excavatum. These exercises focus on improving chest wall flexibility, strengthening the surrounding musculature, and enhancing respiratory function:

Chest Wall Stretches

  • Wall Angels: Stand with your back against a wall. Place your arms in a ‘W’ shape with elbows and wrists touching the wall. Slide your arms up to form a ‘Y’ shape and then bring them back down to the ‘W’ position. This stretches and strengthens the chest and shoulder muscles.
  • Doorway Stretch: Stand in a doorway with your arms bent at a 90-degree angle. Place your forearms against the doorframe. Step forward with one foot and feel a stretch in the front of your chest. Hold for 15-30 seconds.

Strengthening Exercises

  • Push-ups: Push-ups, whether traditional or modified (on the knees), strengthen the chest, shoulders, and core.
  • Dumbbell Pullovers: Lying on a bench with a dumbbell held with both hands above your chest, slowly lower the weight back and behind your head, then pull it back up to the starting position. This works the chest and the serratus anterior, a muscle that wraps around your rib cage.
  • Scapular Squeezes: With your arms relaxed by your sides, squeeze your shoulder blades together. This helps strengthen the upper back muscles and counteract forward shoulder posture.

Posture-Correcting Exercises

  • Thoracic Extension: Sit or stand up straight. Gently arch your upper back (thoracic spine) while keeping your neck neutral. This encourages an upright posture.
  • Chin Tucks: While sitting or standing, keep your spine straight and tuck your chin slightly towards your chest. This exercise strengthens neck muscles and ensures your head is aligned with your spine.

Breathing Exercises

  • Diaphragmatic Breathing: Lie on your back with your knees bent. Place one hand on your chest and the other on your abdomen. Breathe in deeply through your nose, directing the air into your diaphragm (the lower hand should rise more than the upper hand). Exhale slowly through your mouth.
  • Pursed Lip Breathing: Inhale deeply through your nose and then exhale through pursed lips, making the exhale twice as long as the inhale. This exercise helps increase oxygen exchange in the lungs.

Core Strengthening

  • Planks: Holding a plank position, either on your hands or forearms, strengthens the entire core.
  • Bridges: Lying on your back with knees bent, lift your hips off the ground until your body forms a straight line from shoulders to knees.

Before starting any exercise regimen, it’s crucial to consult with a physical therapist or medical professional who can provide guidance tailored to individual needs and ensure exercises are done correctly and safely. They can also adapt the exercises to match the individual’s current fitness level and specific requirements related to their pectus excavatum severity.

What Are The Benefits Of Choosing Physical Therapy?

What Are The Benefits Of Choosing Physical Therapy?If you’re undergoing physical therapy for pectus excavatum or are engaging in exercises tailored to address this condition, here are the potential benefits you can expect:

Improved Posture

One of the primary benefits of targeted exercises is the correction of postural abnormalities often seen with pectus excavatum. Strengthening the muscles in the chest, back, and core helps to pull the shoulders back and promote an upright posture. This not only enhances appearance but also facilitates better musculoskeletal function.

Reduced Physical Discomfort

Strengthening and flexibility exercises can alleviate some of the discomforts or pains associated with pectus excavatum. For instance, a stronger upper back can offset the strain caused by a forward-leaning posture.

Enhanced Respiratory Function

The sunken chest can sometimes impede optimal respiratory function. Breathing exercises can help increase lung capacity, allowing for more efficient oxygen exchange potentially improving stamina and reducing breathlessness during physical activities.

Better Aesthetic Appearance

While exercises might not drastically change the structural deformity of pectus excavatum, the combined effect of improved posture, muscle toning, and chest flexibility can make the indentation appear less pronounced.

Increased Self-confidence

With an improved physical appearance and posture, along with reduced symptoms, many individuals experience a boost in self-esteem and confidence. This can positively impact social interactions, physical activities, and overall mental well-being.

Enhanced Core Strength

Many of the exercises recommended for pectus excavatum, like planks and bridges, also target the core. A strong core is fundamental for overall body strength, stability, and function.

Prevention of Related Issues

Regular exercises can help in preventing or mitigating related musculoskeletal issues like scoliosis or kyphosis, which might develop due to imbalanced postures associated with pectus excavatum.

Empowerment and Knowledge

Engaging in a physical therapy or exercise regimen often educates individuals about their bodies and their condition. This knowledge empowers them to take proactive steps in other areas of their lives, fostering a sense of control over their health.

Holistic Health Improvement

Regular exercise promotes cardiovascular health, boosts the immune system, and releases endorphins. These are natural mood elevators. Thus, beyond the direct benefits related to pectus excavatum, there are overarching positive effects on general health.

It’s important to note that while these benefits are possible, individual experiences can vary based on the severity of pectus excavatum, the consistency of the exercise regimen, and other individual factors. As always, it’s essential to consult with healthcare professionals to tailor the approach best suited to individual needs.


In conclusion, pectus excavatum, while primarily a structural chest deformity, has implications that stretch beyond mere appearance. Through targeted physical therapy and exercises, individuals can mitigate many of the condition’s associated challenges, from postural abnormalities to respiratory constraints. The journey is not just about rectifying a physical indentation, but also about empowering oneself with knowledge, improving overall health, and reclaiming confidence.

With dedication and guided intervention, those with pectus excavatum can lead fulfilling lives, making the most of their physical potential and embracing their unique journey toward well-being. Physical Therapy helps patients recover from pain. If you’re experiencing Back, Shoulder, Knee, Neck, Elbow, Hip, or Arthritis pain, a physical therapist at PhysioMantra can help: Book an online physical therapy session.