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Pectus Excavatum Repair Part 2 - Exercise Routine to Improve Chest Appearance

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This is Part 2 a continuation from Pectus Excavatum Repair part 1 and this hub will discuss specific exercises you can try to help your pectus excavatum condition.The main question in managing pectus excavatum is how to pull forward the sunken sternum and bring the chest wall outwards and forward.  

Steps to improve your Pectus Excavatum  

When improving your pectus excavatum through exercises the following steps should be followed in sequence in their daily exercise program.  

These are  

1. To increase the mobility and flexibility of the spine and chest wall. 

2. To lengthen any tightened and shortened structures. 

3. To strengthen muscles in elevating and expanding the depressed chest wall. 

4. To restore normal posture.   

The first two steps are to mobilize the articulating joints and to lengthen any tight soft tissue around the chest wall so that less impedance will be encountered during the elevation of depressed chest.   


The Daily Routine

 1. Forward arm stretching in pone kneeling

The patient is positioned in an inclined prone kneeling position with hands stretching forward and  supported by wall bar (about 2 to 3 feet high from ground) Slowly lower his upper body and press his scapula (are around underarms) towards the floor. Experience the stretch feeling around the underarm and shoulder. Hold 8 seconds (may get a deep breathe and hold to increasingly stretch the chest wall) and release. Repeat for 20 times and 4 sessions per day.  

Purpose: Stretch all anterior chest wall muscles especially pectoralis major (main pec muscles) and extend the upper back. 


2. Upper trunk rotation in standing The patient is to stand side on to a wall. The hand closest to the wall is put on the wall a bit higher than the shoulder level. The patient’s pelvis turns to the opposite side while still leaving the hand fixed on the wall. A stretch is felt at the anterior shoulder and upper chest wall.

Hold 8 second, then release and return to the original position. Take a rest and repeat on the other side. Repeat for 20 cycles and 4 sessions per day.

 Purpose: Rotation gives the greatest range of movement for thoracic vertebrae (fancy word for spine) allowing stretch to ligaments, muscles and joints around the chest wall in a different direction.


 3. Upper trunk side flexion in sitting 

The patient is seated on a chair. Side bend to one side with the opposite hand crossing over the head to another side. A stretching feeling is felt on the other side of trunk. Hold 8 seconds (may get a deep breathe and hold to increasingly stretch the chest wall) and then return to the original position. Take a rest and repeat on the other side. Repeat for 20 times and 4 sessions per day. 

Scroll to Continue

Purpose: Similar to the 2nd exercise 


Strengthening Exercise

1. Weightlifting in stretch supine lying

The patient is positioned in supine with the upper trunk on a small foam roll around 2 to 3 inches in diameter (if patient can’t tolerate, just lie flat). The arms are put in an upward stretched position. The hands should hold on a fixed wall bar or hardly movable weight about 10 inches from the surface of the bed (pillows may be used to support the weight) . Deeply inspire and exert maximal force in lifting the wall bar or weight. Hold 8 seconds and relax. Repeat 10 times as 1 lot. Take rest then and repeat another 2 lots performing a total of 30 repetitions and 4 sessions per day. 

Purpose: By the technique of “reverse origin and insertion”, the arms are being fixed and the anterior chest wall is lifted up mainly by the pectoralis major and minor. Maximal force exertion allows recruitment of surrounding respiratory muscles for training. The foam roll under the upper to middle part of the trunk exerts postero-anterior force to the thoracic spine helping in extension, which mobilizes and corrects any unnatural bends in the back (poor posture related usually). The depressed chest will also be “opened” up facilitating the elevation of the chest wall. Arms, being in a mid-length muscle range, are capable to exert the greatest force to elevate the depressed chest. Tone of pectorlis major is built up for better posture and outlook. 


2. Upper trunk extension in prone lying

The patient is positioned in prone lying with one or two pillows under the tummy (avoiding the lower anterior chest pressing on the pillow, area where lungs and heart are keep pillow lower down) . The hands are placed behind the head. The feet may be fixed on wall bar. Deeply inspire and extend the upper trunk with arms arching back. Stay and hold 8 seconds and then relax. Repeat 10 times as 1 lot. Take rest then and repeat another 2 lots. Perform a total of 30 repetitions and 4 sessions per day.  

Purpose: The strengthened upper back muscles help to balance the improved muscle force of the anterior chest wall muscle. This prevents the development of Poor back posture due to strong anterior muscle pull and keeps a good posture.  


3. Push up

The patient is positioned in prone lying and both hands are used to push up his body. The level of difficulty depends on the actual ability of the patients (1st level – upper trunk pushed up, 2nd level – whole body pushed up in one piece, 3rd level – push and clap both hands in mid air). Start with the 1st level and when the patient is able to finish the level easily, he may proceed to next level). Repeat 10 times as 1 lot. Take rest and then repeat another 2 lots performing a total of 30 repetitions and 4 sessions per day.   

Purpose: The exercise aims at general strengthening of the chest wall. Moreover, the high intensity but low frequency impacting force may be advantageous to stimulate remodeling and shaping of the chest wall deformity. Bone mineralization may also be enhanced.  


4. Hands up and down movement behind and by the sides of body (with theraband or stretchy rope/velcro)

The patient is positioned in sitting or standing with both arms in a stretched position. Each hand holds one end of a theraband or a spring (resistance should be set at 10 repetitive maximum, RM, i.e. theresistance that one can perform 10 repetitions but no more). Then stretch the theraband and maintain the elbows straight . Slowly put the hands behind and pass by the sides of body and then down below buttock. After 3 seconds rest, the hands slowly go up and along the same track to the starting position. Repeat 10 times as 1 lot. Take rest and then repeat another 2 lots performing a total 30 repetitions and 4 sessions per day.  

Purpose: The exercise is used to strengthen the neck, shoulder, upper back and anterior upper chest muscles. It can be treated as a kind of stabilization exercise to the upper thorax.  

Pectus Exercise Products

Posture & Pectus Excavatum

The most important aspect of improving pectus excavatum appearance is your posture and working on general posture correcting exercises will help bring your sunken sternum back to a normal chest position, good luck and remember to consult your doctor before commencing any sort of physical or exercise program and most of all take it easy. I also recommend a yoga mat for some of these exercises definitely beats breaking your ribs on a hard floor. Any questions, leave them in comment area   

Other Pectus Excavatum Hubs/Articles

  • Pectus Excavatum Repair Part 1
    This hub is about pectus excavatum repair and I will share some exercises and things you can do to improve the appearance of your chest wall without going for the surgery option. As the surgery can take a...
  • Pectus Excavatum Insurance & Surgery Tips
    I’m currently running a website on Pectus Excavatum and also have the Pectus Excavatum chest deformity and a lot of people ask me for tips on getting insurance cover as well as how to approach the whole...
  • Pectus Excavatum Surgery Introduction
    Pectus excavatum is a chest disorder that effects approximately one in every 1000 people. The deformity is easily recognized by the concave , funnel shaped chest. The sunken sternum can apply pressure on...
  • Pectus Excavatum Surgery Procedure
    This hub will a continuation from my last hub which was an introduction into pectus excavatum surgery this hub will go into the detail of the actual surgery procedure including graphic images. 1. The first...
  • Pectus Excavatum Surgery
    Pectus Excavatum Surgery covers the nuss procedure, plastic surgery options, and helps you choose the right surgeon and get insurance cover for your PE surgery
  • Pectus Excavatum PostOperative Care
    This hub will go through the details of post operative care. The things you should do after having the surgery to speed up recovery and to get the full benefit of the pectus excavatum surgery. Patients...
  • What is Pectus Excavatum
    I have pectus excavatum and I'm writing this hub to help people understand what pectus excavatum is, what it involves and my general experience with the chest deformity and its overall effect on daily...


will morgan98 on January 03, 2014:

Hi. Im 15 and have moderate pe. Im about 5ft 4" and I've been to a gp and a paediatrician and all they have said is that i need to wait and see what happens when im older. They said they would only consider doing anything when im 18. I dont really know what to do. Ive had mild pains in the sternum area for a while but the doctor said it was nothing. Is there anyway to have the surgery without the nhs (im from the uk) or do i have to try and correct it like u have. I also have mild hypermobility in case that affects anything

Titus on November 21, 2013:


I'm doing these exercises for a couple of weeks.

The first exercise ("Forward arm stretching in pone kneeling") would be the same as the Rader Chest Pull?

Daphne Young on June 24, 2013:

Has everyone on this post officially been diagnosed with PE? I ask this because, as you might haven noticed, many writers have stated that they are more than six feet tall and have some other health issues too. Please be sure to be properly diagnosed because other disorders, such as Marfans Syndrome, (which is dangerous and can be deadly), are sometimes misdiagnosed as PE.

My son has PE and is 6'3" and 115 pounds now at 19 years old. When he was born, he was diagnosed as having an under-developed esophagus, which caused him to spit up his baby formula. I guess this was actually part of the PE.

Be well everyone.

expectus (author) from Land Downunder on May 21, 2013:


the braces will most likely correct flared ribs but not have a huge effect on the sternum, but it may move a little bit outwards.

what sort of exercises are you doing at the gym? the usual things like dumbbell pullovers and fly's for your chest? you might want to try some breathing exercises but I have found dumbbell pullovers quite effective as long as i take deep breaths into my chest when I do it

Istvan on May 21, 2013:

Hello, I'm 21 and I have a moderate form of PE. 7/10.

I'm 6'0" and weight 175. I have been lifting and staying in shape

since middle school.

My PE has not improved from exercise and I Doubt any exercises

will improve it.

I have heard however that at a younger age the PE deformity can be repaired by simply wearing a rib brace.

Adrian on May 19, 2013:

thank you very much expectus

expectus (author) from Land Downunder on May 19, 2013:

Adrian - 4 sessions would be a bit too much to start off with you can always start with 1-2 sessions , I believe 4 sessions was recommended but I've found even 1 session is enough to feel a stretch and push on the sternum

usually I will rotate exercises so I am not doing the same ones everyday and just listen to your body so if your doing strength type exercises make sure your muscles have time to rest if they are sore

expectus (author) from Land Downunder on May 19, 2013:

Sergio - Yep a small pillow underneath your back directly behind your sternum can help get a better stretch when doing breathing exercises , for flared ribs you can do abdominal exercises , some people have also had success with posture braces.

Adrian on May 19, 2013:

Hey I'm 20, My PE is mild but still very noticeable so I'd love to improve it, reading these exercises got me kind of confused they are all 4 sessions per day and 8 exercises in total so if I'm correct this is like a 3 hours workout every day?

Sergio on May 19, 2013:

Hey am 17 yrs old, can a pillow under back help me and doing the breathing excercise at the same time? Also i have mu left rib sticking out doing abb excersice can help me get it to look normal?

rollyrollypolly on April 26, 2013:

Thank you for your help expectus. Will hopefully be coming back to this page with good feedback then!

expectus (author) from Land Downunder on April 25, 2013:

Hey J aka Rollypolly ,

it really changes from person to person , it is usually a lot quicker for younger people because there bones are more malleable but the fastest time i have heard of is about 3 months

yea they usually tell you to wear them all day and night and only take them off to wash

Rollyrollypolly on April 25, 2013:

Thank you for your quick reply expectus. I will definitely look into trying out a posture brace then. How long does it take to notice improvement? I guess I should wear it pretty much non stop too...apart from in showers and stuff hehe

EDIT: I'm 'J' by the way! Just signed up on hub now

expectus (author) from Land Downunder on April 25, 2013:

Hello J,

generally posture vests are very helpful for flared ribs as the act of fixing posture it sometimes enough to bring back your ribs into their neutral position.

I can't recall the exact website but there was one company specializing in pectus excavatum braces and had before and after pictures and they looked very promising for fixing flared ribs, hopefully you can google it

I'm not sure that it would make you appear narrower , it won't bring in your ribcage anymore than normal. hope that helps a bit , good luck

J on April 25, 2013:

This is a great page!

I have PE as well, plus my lower left rib flares out. I was thinking of taking your advice and buying a posture vest to fix the rib flare...but do you think it will straighten the sides of of my rib cage as well? At the moment there is a sort of indent there, but when I push my rib flare in that side sort of fills out and looks more straight.

I was apprehensive about wearing a posture vest as I don't want it to make the sides of my rib cage look any narrower, but I think because of its affect on the rib flare it might actually help fill out and realign it.

What do you think? :) I hope I haven't confused you!

expectus (author) from Land Downunder on April 23, 2013:

Hello Brandonsnowpe, pushups may help a bit especially if you are just starting out and have overstretched back muscles. I know that push ups don't directly work the back but it will work it to some extent and help.

If you hold a plank type hold, a partial push up this may help even further. Hope that helps

Brandonsnowpe on April 21, 2013:

Hi I have a pectus excavatum and it is about 1-2 inches deep if I did about 30-40 push ups a day would this help me at all ?

expectus (author) from Land Downunder on April 10, 2013:

Hello Anne, if you are going to get the surgery in the near future the best things you can do are maintain good posture and practice deep breathing exercises as long as they don't cause pain

anne on March 25, 2013:

Hi! I'm 22 years old and I have PE. I plan to have the surgery next year, Ravitch technique, because I have some money troubles. My chest is uneven, is quite severe. I want to know if there are some exercises I can do, I don't want my chest diformity to evolve until the surgery. Please help me! Thank you!

Nathaniel wulforst on March 21, 2013:

Thank you so much. From now one ill do these exercises every day and I'm 15 and this I think will be a huge confidence booster because I don't swim or do anything that requires no shirt in front of people because of it

Patrick on September 25, 2012:

Hey. Im 14 and i have pe. Ive been looking at your site the past couple of weeks and have been trying my hardest to work on the exercises provided. I haven't seen a ton of improvement but i wanted to know if its just too soon to start seeing results. (I can be very impatient). My chest sinks abiut 3 cm. It doesn't bother my breathing, however, its hard not to get picked on going to the pool or any time having my shirt off. I just would like to know which exercises would be more affective and take the least amount of time.

PS- I also apreciate your help for everybody here. This is what we need now-a-days! Thanks!:)

sk on August 10, 2012:


In my opinion your age is BEST for any solution - exercises or surgery (or both). At your age ribcage is still developing. I think you could expect substantial improvement, if you do the right things and regularly for months, and probably years.

From surgery and exercises I prefer exercises. Especially Rader chest pull (search for it in the comments above). Try it for at least 3-4 months, 2 times a day, every day. If you do notice improvement, then continue. If not, try other exercise - the time is on you side now.

I'm 39 yo now and do this exercise for almost 2 years now. Despite my age I find improvement, especially in upper part of ribcage.


I wish you and your child a good health!

Kristin on August 02, 2012:

Guess what? There's a new procedure being tested in California. I just heard it on NPR the one day. The procedure is they are putting a high powered magnet under the chest wall and this works by the patient wears the other part of the magnet in a chest belt overnight and millimeter by millimeter the chest wall grows outward. Apparently average time of treatment is 2 years. The pain factor is little to nothing post op, which is an issue even for the Nuss procedure. Many people end up on pain meds for months post op with Nuss, but with the new procedure they don't. This procedure works best on kids who are still growing and may not be able to be used on adults. But that's great because kids on pain meds is no bueno. My 5 year old daughter has moderate PE. I was excited to hear this.

igbaria on August 01, 2012:

hey,, i just saw this, 2 years late :)

anyways, i'm 25 years old, and i wounder is it too late for me to do these exercises? are they going to do some changes considering my age ?!

thank you !

Yeser on July 28, 2012:

I have P.E and I'm 15 years old. I have a perfect posture. Do these exercises work for a 15 years old youth? And do you have any other advices for me? The problem is that I have moderate P.E and fast metabolism!

Please answer these questions:

1- Is doing these exercises in my age more effective than doing them when I'm older?

2- How can I make sure that my chest pulls out and my ribs come back in? What if only parts of my chest pulled out, and the ribs changed in an ugly way?

3- I'm in Syria. There are no P.E surgeons or tools. All I can do is excersise. So, I really need a long routine and advice from you for my age. My life depends on it!

Thank you for these articles! Please give me long descriptions :)

Yeser on July 28, 2012:

I have P.E and I'm 15 years old. Do these exercises work for a 15 years old youth? And do you have any other advices for me? The problem is that I have moderate P.E and fast metabolism!

Josh on June 28, 2012:

This has been a major help. Thank you.

matt on June 26, 2012:

I had p.e on both sides of my chest but now only have it on my left side, my right side has corrected itself some how, why is this?

Kyle on May 31, 2012:

I had the metal rod done in 1999 when I was 11 years old. I had it taken out in 2002. I recently started doing some exercises that Bruce Lee did and have noticed a big difference in the past month.

Nathan on May 29, 2012:

I had surgery for mine without the medal bar at christ hospital and it didn't fully fix mine... So I've been lifting weights in hope of at least masking it . Am I gonna risk injury if I lift to heavy or will it be beneficial to my chest?

Catherine on April 24, 2012:

Hi all, I'm a mother of a 13 year old boy in Australia. I noticed the indent in his chest and flared ribs becoming more prominent in the last year (he has grown heaps in last 6 months or so). Finding help for this condition has been a bit of an ordeal really because local doctors seem to have little knowledge of such things. Thank god for the internet though eh? ... Anyhow, I surfed upon a medical facility in Brazil that uses custom-made braces for flared ribs. They have the before and after shots to show the very impressive improvement in flattening ribs (as well as other pectus problems). I think it's called Centrico Clinico Orthopectus. I thought there must be someone in Australia who can make these things...had to hunt around and found that Royal Melbourne Children's Hospital makes braces for flared ribs at the Orthotics Dept. You have to get referral to their relevant orthopaedic guy (who was Alex Auldist as ExPectus said a while back, but it is now a guy called Joe Camiri or Cameri (something like that). Brace is about $550 (AU). As we live near Sydney, I then thought surely Westmead Children's Hospital should have something similar. Saw Orthopaedic guy Michael Bellemore and then Sean Hogan in the orthotics dept. at the hospital. Sean has custom-made a brace for my son's flared ribs (after making a plaster cast of his chest). The brace cost $390 (AU) and although my son has only had it for a week, there is already a very noticeable improvement. He has to wear it fulltime (except for shower and swimming or contact sport) for 9 months to 2 years depending on the progress. Hope this helps someone out there...(try the orthotics Department of any large children's hospital)... It can be a lonely and tough journey to have a problem that few people understand or can help you with. SO...on that note..I want to say thank you to ExPectus for all his wonderful advice and great patience (especially as he often has to repeat himself). Good on you ExPectus and all the best to you and your readers.

Morina on March 12, 2012:

Is there any proof that a posture brace will fix a flared rib cage?

Morina on March 12, 2012:

Do you have any proof that a posture brace can correct flared ribs?

I have a flared rib cage and seeking to correct this. I have terrible posture so I do believe the posture brace will be a good thing to start doing regardless, but I am curious if anyone has had success in fixing their flared ribs by using a posture brace.

Gavin on March 08, 2012:

Awesome article, I will start trying all these workouts asap. I'm curious, say you were to get you're posture corrected and your PE completely unnoticeable, would you have to continue these workouts to maintain the correction?

Colyn on March 06, 2012:

Hey, thanks for posting this article it's a good feeling knowing I'm not the only one with P.E. I'm 16 yrs old and 5ft 6 and 110 lb's, I was wondering because I've been working out for a while now hoping to add some muscle mass and to get get overall, bigger. I wanted to know if by weight training would my P.E. worsen?

DJ on March 05, 2012:

Great article mate thanks, have just started weighr training to help improve appearance as mine is more cosmetic than anything, but will now try your stretching exercises aswell, great advice, cheers..

nige on February 21, 2012:

i've read that you say a posture vest can help you? how exactly would this improve my PE? thank you

ALEX on February 20, 2012:

by the way. where did you get these exercises from? Is there any data which proves that it works?

thanks again

ALEX on February 12, 2012:

hey expectus, baically my PE is 2cm deep. i'm 17 and going on holiday with my friends this year in 6 months time and want to take off my top without being afraid. i'm intending to do 28 breathing exercises, 40 chest stretches and 30weighted exercises two times a week. i will also do another 28 breathing and 40 chest stretches two times a week.(4 sessions per week in total)

do you think i will have good appearance of chest in 6 months time?

lewis on December 21, 2011:

hey mate thanks for the advice!

I've just turned 16 I'm 5"11 and I have what I would say is mild P.E. I also have stretch marks on my back and flared ribs these are my main concern as they make me very self concious. You said in the article about swimming and I would love to but the fact that it feels like everyone is watching me when I swim really dints my confidence.

I was wondering if there is any other sports that really help. Without having to take off my shirt. Thanks a lot I start tomorrow! :D

restrelax from Los angeles CA on December 19, 2011:

Awesome information on hub. Thanks for sharing

Nicholas on December 18, 2011:

Hello, im Nicholas im 14 years old and i have P.E and i live in lebanon and people are very judgemental at the beach

Im 5 11 and i weigh like 112 but i eat like a pig. Every half hour i eat something but still no weight gain

And on top of all that at my school the students enjoy fights, i do too but i never win so i take up fighting lessons to use my opponents weight against them

I wear a back brace and do the breathing exercises and a few exercises a doctor game me to make my ribs pop back out because that's all i have time for because of homework

So Expectus, can you give me 2 or 3 exercises to do in the time that i have please?

artesa on December 16, 2011:

please can you tell me if these extercises will help me or should i do an operation im 17 and my PE isn't very big please give me answer

Tyler on December 14, 2011:

I hope these exercises help me, I probably have a mild to moderate rate of PE, but with these, breathing exercises, and how I keep doing exercising mon-fri I hope to increase it well, the only problem i have is flared ribs... I hope it gets fixed soon, thanks for the info!

artesa on December 12, 2011:

hi im 17 years old and im 1.66 taller and i have P.E FOR LIKE 2 YEARS i haven't tryed any extercises my P.E isn't very big but i want to fixs it do you think this extercises will help me thank you

Mitch on December 06, 2011:


I am 22 and i had PE for a while now. I believe its 1inch deep or so.

I have been lifting weights and just now started do different push ups and various ab work outs.

Also have been doing broom twists & breathing routines.

Am I on a good track? Can I really improve my PE this way?

jono on November 30, 2011:

expectus - I am 15 years old, 5,10. i consider myself to have a mild degree of PE but im not 100% sure. can you please inform me on an efficient and easy way to find out the degrees or your chest and how deep it is and howw to be able to tell if you are mild, moderate, severe ect.

any advice will be with taken with gratitude.

alex on November 26, 2011:

hey expectus, if i do the broomtwist exercise and bring in my flaired ribs will my pot belly look go down?

inam on November 24, 2011:

i think it will be good for me.perhaps it will work out. thanks for guiding.

Elizabeth V. on November 24, 2011:

Hi I'm Elizabeth and I'm 17 5'0 and I have PE it's pretty deep and it makes my ribs stick out alot. I have trouble sleeping because The only way i can sleep is facing down and it feels like my ribs are being crushed at times. I have considered surgery but it's just too expensive. I was wondering if these exercizes will really help and if I should get a back brave because I have scoliosis as well but it's only 5%

Thak you so much

sk on November 21, 2011:

@Filip, try Rader Chest pull (I've mention it above) - 20 reps in the morning and 20 reps in the evening. As deep as you can. I'll see improvement in less than a year.


I think if you do deep breaths (in Rader Chest pull mode) regularly pops and cracks will be decreased. In the beginning don't try so hard (first week).

Later you can try vacuum bell - it helps more in worst PE conditions.

Jeremy on November 14, 2011:


I am 21 years old 6'5" tall and have a pretty bad PE, i think the cat scan said 5cm between the deepest point and my spine. anyways, i looked into surgery when i was younger but decided against it. One thing i have noticed lately is that i can take a really deep breath and tighten my abs and my chest will actually pop like cracking a knuckle or something. This makes me thing there is significant this a good thing or is this dangerous? i asked my chiropractor and he was not sure. thoughts?

Patel on November 13, 2011:


i am 16 years old and 6'3 tall.i tried many exersises

but not it safe to get a surgery or nuss bar procedure?is it safe to put bar under chest?what about infection under chest.

Filip on November 11, 2011:


I am 29 yrs old and have this PE thing. It's not that it's too bad, and it certainly doesn't give me any problems, but I wish I could correct that somehow. I am so against the surgery, since it is not too deep (2 cm maybe) and it is not giving me breathing problems, but it does look funny. So - I am going to the gym, I do exercise, but I do not see any progress. Can you tell me, from your experience, is it possible to correct this in my age? And if it is, can you tell me what exercise, how many reps, and how often should I do? And what is the best way (except surgery) to flatten my ribs? THanks a lot in advance.

Charlie on November 05, 2011:

is the same guy from the above comment, please give me your GMAIL , i need to talk to you (srs)

Charlie on November 05, 2011:

please, tell me... do i have to do ALL the exercises??

or just 1 or 2??

expectus (author) from Land Downunder on November 01, 2011:

lol piyush joshi - that's very interesting about the 5 cm expansion, what about people who breath into their abdomen instead of up into their chests :P

good luck and I'm happy to help , as I too have PE

hello - to me it sounds like you have made improvement and your ribs are coming down and then coming in slowly, its normal for it to go chest/ribs/stomach. I know that it looks a bit strange but the next step will just be to work on your abdominal to try and bring in those ribs

and regarding age, it is true that the older you get the less malleable your bones get but i've heard of guys over 40 correcting their pe so I wouldn't be too worried about it, all the best

expectus (author) from Land Downunder on November 01, 2011:

daniel - yes posture correction will definitely help pe

andy - i have some links to posture vests on this page, mostly on amazon but you can usually buy them from your local pharmacy/chemist

David - sorry I haven't replied to your email, that address is flooded so much with spam since i gave it out its impossible to separate the genuine stuff.

you say you still have a pot belly, unfortunately pe does give you that pot belly look and if you have any weight around your midsection it will show. You can always try some abdominal work, and try doing some stomach vacuum exercises. 2cm deep is quite moderate if you tense your abs are you able to bring your abs in?

hello on October 29, 2011:

great article!

I have PE , I'm 17 and I'm trying to resolve this estetical problem. The thing is, after a while of doing this kind of exercises , my 'pectum' sure got wider, but my lower chest/ribs went a bit further than the pecs' level, so now when I put a shirt on it looks like I have some strange bump between my stomach and pecs. I tried to resolve this by sitting face-down on my stomach, extending my back, so I level up my ribs or something.

Any suggestions on how to put the pecs more in front and the lower ribs to remain in position or something?

Also, I'm wondering, is PE ALWAYS a repairable thing? at any age? cause i'm very concerned that after I pass like 20+ years my ribcage will be more stiff and won't allow much mobility or something.

Please respond, I wanna talk to someone like you.


lol piyush joshi on October 15, 2011:


i want 2 join army and my PE is 1.7 cms, iam 21 yrs old height is 5'8" .B.M.I check up criteria is:-

The body is check for its appropriate weight, height and chest sizes. The chest should expand minimum 5 cms while inhalation.

Would i get through it.

P.S. U r doing a great job...helping people with their deformity is such a selfless deed..keep it up.

David on October 07, 2011:

Hi Expectus! You're still alive!

I've posted some comments now and then since 8 months ago (I also sent you an e-mail once, which you haven't replied yet). That's when I started to do your exercises (in the beginning more frequent than nowadays). I still have my problems: the worst is my pot belly due to my flared ribs. Furthermore, I've got a dent, like 2 cm deep. I think your exercises haven't really worked for me yet... :(

Any suggestions?

andy on October 05, 2011:

hey expectus, thanks so much for your hub, its really helped. Can u maybe link me to a website to buy a posture brace that will help me with flared ribs? also will improving the flared ribs help the pectus as well? im 14 and was wondering if that's a good thing or a bad thing that im younger. also is there any other weighted exercises i could do that would help. Thanks!

expectus (author) from Land Downunder on October 05, 2011:

apologies for not replying to questions, have been a bit flooded lately , will try and answer them over the next few days if i can

Will - for me doing weights and exercise did not make one side of my chest higher, its true you may have one pec muscle which is slightly smaller depending on the location of your sunken sternum (more left or right) , me personally do 1 session a day for anything strength related but i do breathing and stretching twice a day.

alex- have never heard that before alex, you may have to consult your doctor if your worried about high blood pressure, but breathing in deeply should help oxygenate your blood.

Will on September 26, 2011:

Hi, I am 187 cm (about 6.1 I think) and I weigh 64kg. I have pectus excavatum and I have started noticing it from when I was 13-14. Now I am 15 and I want to fix my minor pectus excavatum. I read here that doing these exercises could make it worse and cause one side of your chest be higher. Mine look pretty even, so should I do some of these exercises? So do you do 30 repititions a day during 4 sessions or 30 repititions in 1 session and 4 sessions a day? Thanks.

alex on September 18, 2011:

is it true that these beathing exercises can give you high blood pressure?

Julius on August 31, 2011:

This forum is making me really frustrated to read. I feel really sorry for all you guys with PE. The straight truth is that EXERCISES WILL NOT CURE PE. The only cure for PE is surgery. Any type of chest exercises that build muscle will make it appear WORSE because increasing the size of the pec muscles will make the dent appear deeper and larger. Additionally most PE is assymetrical and this will also add to the worsened appearance. Braces will only give a TEMPORARY cure at best on young kids with flexible bones. On adults they are a total waste of time. Nuss is the way to go, yes its expenive (approx price of a new car) but it works. I am 38 years old and had this 3 years ago with excellent results. On younger people/kids its much easier. To that guy who doesn't want his 14yo son to have the OP - WHY?? Its madness not to. 14 is the perfect age. Then afterwards you can start to exercise and look like a cover model!!!

Josh d on August 21, 2011:

How long would it take to improve my PE if I do this exercises once every day?

steven on August 20, 2011:

Sorry my little brother wrote that!

I just wanted to see if anyone could suggest which brace is best.

KM on August 09, 2011:

For those in Sydney, Australia, there is a Dr Richard Chard at Westmead Hospital who treats PE (either Ravitch or Nuss) and if you have private health insurance, it becomes fairly affordable. I initially thought I had to pay tens of thousands of dollars for an operation, but my insurance brought it down to $5000 - of which a further $3500 would be covered by a different clause in my policy, meaning all I had to pay was $1500.

Kid 8 on July 26, 2011:

hey so the 3 exercises under the daily routine category will really improve the PE to return to a normal chest? How long will the process take? And will working out your chest like at the gym on the machines affect the PE to become worse?

Asker on July 06, 2011:

hi I also have pectus and I am going to start to do those exercises. But how long do you thing it will take?? Do you thing it will be normal till next summer(1 year later) ?? Thanks

ordinaryguy on June 17, 2011:


I have same problem, flared ribs. I hope someone will answer us what exercises to do to fix flared ribs.

Random23 on June 13, 2011:

I have flared ribs. It makes me look like I have a pot belly. I feel really uncomfortable in bathing suits. I'm embarrass to talk to my parents. Will I grow out of them or will I have to do lots of exercises to get them away?

Dnilra on June 08, 2011:

HI , I`m 17 and have slightly PE. What kind of exercises should I do to get my chest look normal as I have to go in october in a trip with my class to the sea and don`t want to look like I do now. (sorry for my english)

daniel? on May 28, 2011:

I was told reposturing techniques help, do you know if that is true

daniel? on May 28, 2011:

I was told reposturing techniques help, do you know if that is true

Matt on May 25, 2011:

Hey I'm 19 with about 3cm deep PE and slightly flared ribs. Would wearing a brace defeat the purpose of doing the rader pulls if it only constricts the lateral sides of your ribs and not the sternum?

David on May 22, 2011:

Hi silverkeen,

Do you think dumbbell pullovers will also help pushing the sternum forward?

And by the way, why are there so few people commenting here? Are they discussing somewhere else? Do you know?

silverkeen on May 21, 2011:

Hi James, (and thank you, David, you are riht)

I wish I'd heard of such short time exercise. But I didn't.

I use to apply vacuum bell (kind of device for nonsurgical treatment of pectus excavatum) last year for 11 months and it really accomplish short time outcomes that lasts for minutes after first applications and for days after several months of regular application. But despite I find it very helpful for decreasing indentation it didn't expand at all my ribcage. What is more, vacuum bell somehow totally eliminates the effect of Rader chest pull. Can't explain why but after lots of trial and error now I've stopped using vacuum bell at all and use only Rader chest pull exercise for rib cage expanding and for indent correction. I find it much more helpful than vacuum bell.

So, if you have enough rib cage volume and your only problem is small indent of sternum, you can try vacuum bell. You can read here a medical survey for this device:

David on May 19, 2011:

Hi James,

I know I'm not silverkeen but I'd like to talk with others about pectus. Perhaps we could exchange some ideas.

I think he would recommend the rader chest pull to expand the ribcage and push the sternum a bit forward. Search these comments (or those in part 1 or in 'What is pectus excavatum') for information about the rader chest pull.

Furthermore, you can do the stretching exercises from this topic to loosen your muscles. You have to do these exercises frequently, like two times a day. It doesn't take much time.

A good posture is important! Shoulder shrugs can also help you to achieve a good posture.

Lastly, you could do the breathing exercises Expectus explained in one of his topics and you can do something like jogging or swimming.

Good luck!

James on May 18, 2011:

Hi, Silverkeen

I have about a 3cm deep pectus chest, was wondering what's the best exercise to do to see the most significant improvement in 2months + i know in 2months nothing much will probably happen but im going away then and would like to know what i can start doing now im very tall and slim

David on May 14, 2011:

Hi silverkeen,

Wow, thanks! I already thought it were my intercostal muscles which hurt and the cartilages which crack. And I'm also glad it's normal. Well, thanks for your help and I'll keep doing those exercises!

silverkeen on May 14, 2011:

Hi David,

Breathing with chest is only for correction purpose during this exercise, it is not a breathing instruction for daily life. Actually men breathes with belly, while women breathes mostly with chest. But this is not important for pectus condition since in one normal breath you take about 500 ml of air, while in Rader chest pull breathing you have to inhale several liters of air (as much as possible, and... even more next time).

For observable effect you have to do breathing exercises regularly for at least 3-4 months, probably more, and for relatively constant results probably years.

As for the pain in the sternum - I consider this is normal, it is the tendon and muscles (intercostal ones) that hurts there. Often it is a muscle fever. I experience pain also but it not bothers me.

But don't try to push your sternum using lungs, it could be harmful. Use for this Rader chest pull.

Cracks "in sternum" are actually in ribs joints and cartilages.

David on May 11, 2011:


Thanks for your extensive reply! So only during the rader chest pull I have to do the breathing with my chest? Because my doctor told me to always breathe with my belly. Breathing mainly with your chest causes bad breathing.

Well, I'll try the rader chest pull again from now. Can't you post something on YouTube or something (just asking)?

The problem is, I've been doing the breathing exercise sometimes since December 2010 and since then I've been experiencing pain in my (upper) chest, in the sternum. Everytime I'm pushing out my sternum along with deep breathing (the breathing exercise)I'm experiencing pain and sometimes it's cracking a bit.

Even if I'm not doing the exercises anymore, sometimes my sternum gets 'stiff' and then I'm feeling pressure on my sternum. So I push it out and then it cracks a bit...

DePuy Pinnacle Lawsuit on May 09, 2011:

Exercise can help our body maintain a normal posture. Chest exercises also help strengthen chest muscles which are important for those with Pectus excavatum. Back and hip exercises can also be performed for optimal support on the upper torso and extremeties.

I don't have Pectus Excavatum, but I personally have had a DePuy Pinnacle hip implant a few months ago. What's bothering me now are the lawsuits and complaints filed by those harmed with the Pinnacle device. I'm still learning and reading more about its updates on the site.

What are your impressions on the complaints filed by those harmed from the Pinnacle device?

silverkeen on May 08, 2011:


It took me about two months to learn how to perform Rader chest pull :)

It is not easy to explain. Probably you have to learn some yoga breathing to understand it. Probably not. But it is fundamental to inhale mostly with your upper part of the ribcage. This way to avoid as much as possible diaphragmal breathing which cause the paradoxal breathing (increasing sunken chest during inspiration) in pectus condition. The muscles that do the job are external intercostal ones, and using hands and external support mainly gives a direction of the inspiration. I.e. to move the upper part of the chest wall onward and slightly upward during the inspiration. During the exhalation you have to loose your hands - this is all passive movement.

This way your lower ribs (and flared ones) almost don't take part in this movement. Also, try to read explanations from links, that I've provided in one of the comments above.

This exercise (Rader chest pull) is for expanding the upper part of the ribcage mainly. But there are pectus excavatum conditions with only a small concavity of the sternum. For this type of the deformity probably the exercise wouldn't be so effective. Don't know.

David on May 06, 2011:

Hi silverkeen,

Thanks for your reply. I hate my pot belly due to my flared ribs. I hate it that I look fat even though I've almost got no fat.

As for the breathing exercises, am I not pushing my flared ribs out as well?

Allright, I'll try the cobra exercises and I'll work out my abs. Could you please explain some good exercises to expand the ribcage? For example, I don't really understand the rader chest pull and on the internet there isn't much information about it.

silverkeen on May 03, 2011:


I don't consider myself "expert". Just lots of search, ask and try.

As for the flared ribs - since I almost don't have flared ribs, I didn't pay so much attention. Yet every morning I do some kind of "cobra" exercise, mostly for stretching purpose combined with very deep breath. Probably it will help but I wouldn't give guarantee. Also you can train the abdominal muscles. In my opinion for bone shape to change there must be a prolonged, if not constant, influence. I don't know such exercise. In my case expanding the upper part of the rib cage masks flared ribs to some degree.

But if you are so worried about your flared ribs probably you don't have to avoid braces.

David on May 02, 2011:

Hi silverkeen,

I guess you're the expert now, since Expectus isn't reacting anymore. My dent is like 1,5 to 2 cm deep and I also have flared ribs. I know the exercises for the dent now, but what do I have to do to repair my flared ribs? I don't want to wear a brace or corset or something. Do you know any good exercises?

silverkeen on May 01, 2011:

hi rex,

two months is too short time for noticeable improvement, no mater how many times you did the exercise during the day.

I'm doing Rader chest pull once in the morning and once in the evening in 20-25 repeats (inhales/exhales - for 5-8 minutes total per series, depending on how long I hold my breath). For more series during the day I have no strength. I've tried but I'm losing my inhale power.

rex on April 27, 2011:

hey silverkeen,

im 16 and im going on holiday in about 2 months and want my chest to look good. how many times a day should i do the rader chest pull to see an improvement? my dip is only about 2 cm and 1.5 cm when i pull my shoulders back.


Michael on April 21, 2011:

I was wondering if i have pectus. My left side is about half an inch deeper than my right. My back is also uneven my right is bigger same goes with every other part of my body my right is bigger

silverkeen on April 17, 2011:

Dave, weight lifting wouldn't help much against pectus condition. Except those exercises that include very deep breathing.

Besides, there are no muscles above the sternum to increase their volume.

Yet there are two weight lifting exercises that are very useful - breathing squats and pullover, but if performing them with deepest possible breathing.

But as I take it - don't waste your time with heavy weights. Since the time is most valuable thing at your age, and if you miss this moment later it will become harder for any change. So - do breathing exercises, especially Rader chest pull (I've mention this exercise in comments above). It takes months to gain improvement, but it really works.

Mitch on April 08, 2011:

Im 16 im on the track team and about to do cross country but this problem with p.e. seems like its trying to stop me from reaching high expectations.When I was little ill ammit I never paid attention to my posture so I know the problem.The fact is it seems like im trying harder and harder breathing wise. And had no clue why.. But I heard this is the problem. But what im trying to get at is: -will i get any better at running(and breathing wise.) -And how long will it take?

Dave on March 28, 2011:

By the way im 17 years old, 6'3" 150lbs and my PE is around 2 inches

Dave on March 28, 2011:

I have PE and through weight training i have started to grow some of the muscle down into the deformed sternum. I just wanted to know if there is a weight lifting exercise that will work on the central muscles so that i can grow those more and try to make them grow towards the center of my sternum

Will on March 12, 2011:

I have pe and i am thinking about getting a brace. If i do, should i still do the exercises?

ddddd on March 07, 2011:

hey, i have a mild case... about 1 cm... i have started to do the exercises but i was wondering... first off, once i fix it to where i want it, are the results permanent or should i keep doing the stretches? second, with such a mild case, can a brace work? if so, again, are the results permanent? and where can i find the best quality brace and at what time of day should i wear it? any help would be appreciated greatly... thanks!!

Laura on March 01, 2011:

Hello. im 19 and have really bad upper back pain which the doctor says is caused by my PE which is pushing my ribcage back and causing my spine to curve. Will these exercises also help my back pain? would be great to speak to anyone else with this problem that has found anythink to help!?

richard on February 19, 2011:

What are shrugs ?

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