Physical Therapy Exercises for Pectus Excavatum

Pectus excavatum is a condition in which your sternum (breastbone) has sunk into your chest cavity. The condition is often not painful, but it occasionally can be. Most often, people with pectus excavatum only suffer from slight disfigurement of their chest cavity.

In severe cases, the caving in of the sternum may compress structures in your chest, causing heart problems or difficulties with lung function. In those cases, surgery may be recommended to correct the problem.

If you have pectus excavatum, you may benefit from the skilled services of a physical therapist. While the therapy you receive will not cure your condition, it can instruct you on what to do to maintain high levels of cardiac and pulmonary (heart and lung) function.

Performing the correct exercises for your condition under the guidance of a physical therapist may help you prevent loss of mobility and loss of cardiac or lung function, and it may prevent the need for surgical intervention.

Surgical Repair for Pectus Excavatum

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Exercises That Improve Pectus Excavatum Symptoms

During your physical therapy sessions, your therapist will likely prescribe exercises to help improve your strength, breathing, and mobility. Postural control exercises may also be done. The ultimate goal of the exercises is to maintain appropriate posture and strength and to decrease the likelihood of requiring surgery for your pectus excavatum.

Exercises for pectus excavatum should be done three to five times each week, and postural awareness (being conscious of your body posture) and correction should be done daily. Before starting any exercise program for pectus excavatum, discus this with your physician or physical therapist to ensure that exercise is safe for you.

Arm Sliders

To perform arm sliders, stand with your back against a wall, with your head and back of your hips touching the wall. Raise both arms overhead, and make sure your upper arms, elbows, and forearms are touching the wall.

Then, breathe in, and slowly breathe out as you slide your arms down the wall. Be sure your elbows and arms stay in contact with the wall. Reach up again, inhale, and repeat the exercise for 10–15 repetitions.

T-Stretch

The T-stretch opens up the chest wall and gives a good stretch to the pectoral muscles, which connect the front of your chest with your upper arm and shoulder. To perform the exercise, stand with an upright posture. Hold a light resistance band in both hands, placing the band behind your thighs. Bring your arms out to the side and open them up (your body should look like a letter "T"). Allow the resistance band to gently pull your arms apart and back. Hold the stretch for 15–30 seconds and repeat three times.

Push-Ups

Push-ups are a great upper-body exercise to improve the strength of the pectoral muscles. To perform the exercise, lie face down on the floor and place your palms flat on the floor next to your shoulders. Your toes should be on the floor, too.

Next, engage your abdominals and push your body up into a plank position, breathing out as you rise up. Hold this position for two seconds, and then lower slowly. Repeat 10–15 times.

Modification Tip

To make the push-up a little easier, you can start in a modified position, with your knees on the floor instead of your toes.

Chest Fly

To perform the chest fly, lie on your back. Hold two dumbbells in your hands (5 pounds is a good start). Hold the weights up in front of you, and then slowly allow your arms to spread out to the sides of your body, like a "T," with your palms (and the weights) facing the ceiling. Then breathe out as you slowly lift the weights back to the starting position. Repeat 15 times.

Dumbbell Row

The dumbbell row is a great exercise to strengthen your back muscles. To perform the exercise, hold two dumbbells in your hands. Bend forward slightly at your hips, keeping your back as straight as possible and your head up. Allow the weights to hang down in your arms towards the floor.

Breathe out as you slowly lift the dumbbells up into a rowing position. Squeeze your shoulder blades together. Hold this position for two seconds, and then slowly lower the weights back to the starting position. Repeat 15 times.

Dumbbell Rear Delt Fly

To perform the dumbbell rear delt fly, start by sitting in a chair or on a weight bench with your back straight. Hold two light dumbbells (1–3 pounds for starters), and place both arms out to the side, palms facing down. Bend forward slightly at the waist.

Breathe out as you lift both arms up and back. Hold the position for three seconds, and then return to the starting position. Repeat 15 times.

Superman

To perform the Superman exercise, lie on your stomach with a pillow underneath your pelvis. Reach both arms overhead. Then, lift up your arms and both legs, slightly arching your back, and breathe out. You should look like Superman flying through the air (without the cape). Hold this position for three seconds, and lower slowly. Repeat 10 times.

Seated Twist

The seated twist exercise helps to improve range of motion through your back and thoracic spine (the longest region of your spine). To perform the exercise, sit in a chair with upright posture. Make sure your feet are flat on the floor, and scoot up in the chair so your back is away from the backrest of the chair. Hold your arms out to the side and breathe out as you slowly turn your body to one side.

Hold this position for 15 seconds, and then return to the starting position. Repeat the exercise to the other side. Perform 10 repetitions of the seated twist to each side.

Bow Pose

The bow pose stretches the muscles in the front of your thighs and thorax, opening up your chest wall. To perform the exercise, lie on the floor on your stomach and bend both knees up. Reach back and grab your ankles with your hands, and gently pull until a stretch is felt in the front of your thighs and abdomen. Your body should be bowed up in this position.

Hold the stretch for 15–30 seconds, and then return to the starting position. Repeat three times.

Camel Pose

To perform this stretch that helps the front of your abdomen and chest, kneel on the floor with your shins and the front of your ankles flat. Place both hands on the back of your hips (or the tops of your ankles, if that is more comfortable). Keep your thighs perpendicular to the floor and slowly bend backward, tilting your head back as you bend. Breathe out as you stretch, and hold the position for 15 seconds. Repeat three times.

Summary

Pectus excavatum is a condition in which your sternum has sunk into your chest cavity. In addition to physical disfigurement, this condition can sometimes cause heart problems and difficulties with lung function. A physical therapist can provide exercises that can help maintain cardiac and pulmonary function. These include exercises to improve strength, breathing, mobility, and—in some cases—postural control.

A Word From Verywell

If you have pectus excavatum, you should understand that the condition may cause some cardiac and pulmonary problems if left untreated. If these problems occur, then you may require surgery.

Working with a physical therapist is a good idea to increase your heart and lung function. Your therapist can assess your condition and prescribe the correct exercises for you. That way, you can be sure to maintain function and decrease the need for surgery for pectus excavatum.

Frequently Asked Questions

  • Can exercise fix pectus excavatum?

    Physical therapy exercises for pectus excavatum will likely not cure the condition, but they can help decrease the likelihood of experiencing cardiac and pulmonary problems. They may also help to decrease the need for surgical intervention for pectus excavatum.

  • Will pectus excavatum ever go away?

    Pectus excavatum will likely not go away. However, you can perform exercises to minimize its effects on your day-to-day life.

  • How do you treat pectus excavatum without surgery?

    The best way to treat pectus excavatum without surgery is to work on improving the mobility of your thorax, stretching and strengthening the muscles in your chest and back, and maintaining appropriate posture.

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  1. Abid I, Ewais MAM, Marranca J, Jaroszewski DE. Pectus excavatum: A review of diagnosis and current treatment optionsJ Am Osteopath Assoc. 2017 Feb 1;117(2):106-113. doi:10.7556/jaoa.2017.021

  2. Amăricăi E, Suciu O, Onofrei RR, et al. Assessment of children with pectus excavatum without surgical correction. Wien Klin Wochenschr. 2019;131(5-6):126-131. doi: 10.1007/s00508-018-1406-0