How to exercise to correct pectus excavatum

Written by Zhang Zhi Gong
Cardiothoracic Surgery
Updated on September 03, 2024
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Pectus excavatum refers to the inward and backward indentation of the sternum, a deformity that can compress the patient's heart and lungs. To exercise for pectus excavatum, patients are advised to practice deep breathing exercises to enhance lung function, as well as engage in appropriate running and routine physical activities to strengthen heart function. However, in cases of severe pectus excavatum which severely compresses the heart, even pushing it entirely to the left side, patients may not be able to tolerate running and other intense activities. Therefore, it is quite difficult to completely correct pectus excavatum through exercise alone. Some parents might think that doing push-ups can correct pectus excavatum, but push-ups make the pectoral muscles on both sides stronger, and since these muscles pull outward, the force is not directed in the same way as the inward and backward indentation of pectus excavatum. Furthermore, continuously training the pectoral muscles causes them to develop, and the resultant thickening of the muscles on both sides can exacerbate the inward and backward indentation of the sternum in the middle. Thus, after appropriate cardiovascular and pulmonary exercises, those with severe pectus excavatum should still consult a doctor for active advice and consider surgical treatment options.

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Written by Zhang Zhi Gong
Cardiothoracic Surgery
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What should be noted for pectus excavatum in daily life?

The biggest difference between children with pectus excavatum and normal children lies in the middle chest bone structure sinking backwards and inward toward the spine, creating a deformity where the front chest and the back compress each other. Naturally, this completely compresses the normal position of the heart and lungs. Therefore, the heart of such children is compressed and deformed, pushing the entire heart to one side. We have encountered clinically cases where there are just a few millimeters of space between the sternum and the spine, leaving no room for the heart, thus completely compressing and pushing it to the left side. Imagine a heart, completely compressed and deformed, where the valves inside cannot function normally. Hence, some children may exhibit insufficiencies in their tricuspid and mitral valves. Therefore, in children with pectus excavatum, their heart is under pressure, their valves deformed, leading to poor cardiac function, and their lung function is also compromised. Since the lungs also need space to expand, lungs that are completely compressed cannot fully relax, resulting in such children having poor cardiac and lung functions, reduced exercise endurance, and since the lungs cannot fully expand, such children are prone to catching colds. Thus, for children with pectus excavatum, it is important to avoid catching colds. Moreover, treating the root cause of the condition, which is pectus excavatum itself, is crucial. Therefore, correcting pectus excavatum early on is essential.

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Written by Zhang Zhi Gong
Cardiothoracic Surgery
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Can people with funnel chest gain weight?

The majority of pectus excavatum cases encountered clinically are congenital thoracic deformities, which means the sternum in the middle of the chest is indented inward and backward. This inward and backward indentation can compress the lungs and the heart, especially in severe cases of pectus excavatum, causing significant compression to the lungs and heart. It prevents the heart from fully expanding, and might even push the entire heart into the left chest cavity, also preventing the lungs from effectively expanding. Therefore, children with this condition tend to have weaker constitutions, are prone to colds, and their ability to engage in physical activities like running is not as good as other children. Pectus excavatum generally affects the development of children, especially in severe cases. Mild pectus excavatum involves only a slight indentation and does not severely compress the heart, and children with such a condition can still gain weight if their nutrition is adequate. However, in severe cases of pectus excavatum, besides impacting the heart and lungs, it can also affect the patient's personality, self-confidence, and social interactions, potentially leading to insecurity, depression, and even suicidal tendencies.

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Written by Zhang Zhi Gong
Cardiothoracic Surgery
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Pectus excavatum causes

The etiology of pectus excavatum is not fully clear yet, but it has been found that the incidence of pectus excavatum greatly increases among patients with connective tissue diseases, possibly related to the disruption of the balance between growth genes and inhibitory genes affecting the cartilage on both sides of pectus excavatum. Moreover, it is also found that the complication of pectus excavatum significantly increases among patients with Marfan syndrome (also a type of connective tissue disease) and Noonan syndrome. In children with congenital airway stenosis and bronchopulmonary dysplasia, the incidence of pectus excavatum also significantly increases. This suggests that the causes of pectus excavatum are directly or indirectly related to genetics and heredity, and regardless, the causes of pectus excavatum, both acquired and congenital, are directly related to genes and heredity.

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Written by Zhang Zhi Gong
Cardiothoracic Surgery
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Can funnel chest heal itself?

Actually, a portion of children with pectus excavatum can heal on their own, especially those who are newly born and discovered to have pectus excavatum. This is because children are curled up while in the mother's womb. In some cases, their hands and feet might be placed in front of the sternum, pressing it backward and inward, causing a deformity. However, once the mother gives birth and the child's limbs unfold, the pressure on the sternum is relieved. As the chest grows, it gradually returns to its normal shape, and these children with pectus excavatum can be cured. On the other hand, another group of patients do not have pectus excavatum at birth, but develop a noticeable chest indentation as they grow older. These patients, when they are young, can also be treated with conservative methods, such as using a vacuum bell for pectus excavatum to gradually draw the indentation outward. With its stabilizing effect, as the child grows, the deformity can be slowly corrected. Of course, there are also children who might have a more rapid skeletal development, and essentially become "set" in their ways. At this stage, they may require surgical intervention to treat the condition. In summary, a portion of pectus excavatum patients can be healed, while another portion requires active intervention and treatment.

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Written by Zhang Zhi Gong
Cardiothoracic Surgery
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Can people with pectus excavatum join the military?

Theoretically, the current conscription system does not have strict restrictions on mild cases of pectus excavatum. However, obvious moderate or severe pectus excavatum, or sternums that are inwardly and backwardly concave, can significantly impact the function of both the heart and lungs by compressing them. This inward concavity can restrict the heart’s ability to fully expand, potentially causing complete deformation of the heart, or even prevent the heart’s valves from closing fully, leading to valve regurgitation. Such compromised cardiac and pulmonary functions are likely unable to withstand the physical demands experienced during military service. Therefore, for moderate and severe cases of pectus excavatum, we do not recommend enlisting in the military, although the current policy does not have clear restrictions on mild cases of pectus excavatum.