The Best Exercises for Pectus Excavatum

Black-and-white photo of Steve Reeves posing confidently at the beach, demonstrating the potential benefits of exercises for pectus excavatum in improving chest shape and posture

Apart from the Vacuum Bell, physical exercise is one of the best methods to treat Pectus Excavatum without surgery.

In this article, I will cover a complete guide to the best exercises for Pectus Excavatum and how to do them to start improving your appearance. It's important to note that exercise alone doesn't usually fix Pectus Excavatum, but can help with the appearance of the indent, as well as treating secondary issues associated with Pectus Excavatum.

How does exercise treat Pectus Excavatum?

A typical Pectus Excavatum patient often has multiple physical problems related to Pectus such as forward posture, rounded shoulders, flared ribs, anterior pelvic tilt, and ‘pot belly’. These all contribute negatively to the overall appearance of the chest and physique. If you address these issues, the overall look of the body can be greatly improved.

Check out the photo of Steve Reeves above. His Pectus doesn't really impact the overall look of his physique because of his well-developed chest, good posture, and strong core.

I have included in this guide the most effective exercises to target each of the secondary issues associated with Pectus Excavatum. Implementing these will improve your overall appearance and help make your sunken chest less noticeable. We will start by addressing probably the worst problem related to Pectus Excavatum: Pot Belly.

Pot-Belly Exercises

Pectus Excavatum pot belly

One of the most common issues associated with Pectus Excavatum is a 'pot belly'. The process occurs as follows: The lower back hyper-extends to compensate for rounded upper body posture to keep the person upright. The abdominal muscles then stretch and weaken. The pelvis rotates forward, and the hip flexors take over stability of the core and get tight. The stomach region now distends outward, giving the appearance of a 'pot belly'. To effectively address the problem, we need to target each issue separately.

  1. The core muscles need to be strengthened.
  2. The hip flexor muscles need to be stretched.
  3. Forward posture restored to normal.

We will start firstly with the core muscles.

99% of people get this step wrong when trying to fix a pot belly

Most people who recommend core exercises for pectus excavatum recommend sit-ups, crunches and movements that involve lifting the legs, such as leg raises. The problem with these is that they all strongly activate the hip flexors, making them even tighter. This is exactly the opposite of what we want to do, and will make your pot belly and anterior pelvic tilt worse.

I recommend weighted planks because they are one of the only ab exercises that isolate the entire core without activating the hip flexors.

Abdominal exercises

When doing abdominal planks, focus on pulling the belly button in whilst squeezing your glutes and holding still. Beginners should start with body weight only and then add weight plates on their back after achieving 30 seconds with bodyweight. The added weight is more effective at building stronger, thicker abs than doing high reps with bodyweight. Most gyms have big rubber Olympic plates that fit well on your back, and I recommend using these.

Stretching the Hip Flexors

To get the pelvis back into a neutral position, we need to stretch the tight hip flexors. An effective way to do this is with a standing hip flexor stretch. I have personally found this stretch to be the best out of all the variations for stretching the hip flexors.

Begin by standing near a wall to support yourself. Flex your glutes and abs while rotating your pelvis into a posterior pelvis tilt. You should already start to feel a stretch in the hip flexors from this position. Now extend one foot in front of the other and slowly push your pelvis forward whilst holding the posterior pelvic tilt. Focus on flexing your abs while holding your pelvis locked into posterior tilt.

Exercises for slouched posture

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Most people with Pectus Excavatum usually present with weak upper back muscles that cause forward posture and rounded shoulders. A hunched posture makes someone look less attractive overall and also contributes to the 'pot-belly' effect. In addition, it negatively affects shoulder joint mobility and strength, priming you for injuries in the gym.

The Vacuum Bell is one the best tools to fix slouched posture in pectus, as the sunken sternum pulls the spine forward. Using the Vacuum Bell to elevate the sternum and then combining it with stretching and strengthening exercises is super effective at fixing hunched posture with pectus.

You might notice that after using the Vacuum Bell your upper back cracks and straightens up quite a lot. This can be further enhanced by adding some foam-rolling or upper-back stretches to help straighten up the spine.

The best exercises for this are those that target the muscles that pull the shoulders back. These include: the rear delts, rhomboids, lats, and rotator cuff muscles. For the back, the seated row and seated lat pull-down work well. I recommend using a neutral grip on all of these because it's easier on the shoulder joint and hits the rotator cuffs as well.

Along with the back, we also need to strengthen the weak and stretched rotator cuff muscles, which are responsible for pulling the shoulders back. Rotator cuff exercises are probably the best method to prevent injury to your shoulders, as well as improve posture, I recommend everyone to do them, regardless of if you have Pectus.

For rotator cuff exercises, I recommend face-pulls and YTWL's. When doing face pulls, you can attached two ropes to the machine to make one longer one. This lets your hands be wider apart, allowing a better range of motion at the rotator cuff. Also, try using a pronated grip (elbows down, thumbs facing you). This is more effective at targeting the rotator cuff, as you are doing the movement in an externally rotated position.

Chest exercises

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After you forward slouched posture and the other associated issues, you can start to work on building the chest. We can do this by implementing exercises that build big and thick pectoral muscles. Check out the example of Steve Reeves above; It's difficult to even notice his Pectus Excavatum. Some of the factors that contribute to this are:

1. Great posture (strong back muscles)

2. Thick abs that cover his flared ribs (weighted planks)

3. A well-developed chest that covers up the indent

When doing any form of chest training, it is important to remember to maintain good form. If you suffer from slouched posture, you are at a greater risk of injuring your shoulder joints when doing chest training. This is why a program of exercises for Pectus Excavatum should start with fixing rounded shoulders before any chest training.

Begin each exercise by pushing the chest up and arching your upper back, focus on pulling and holding the shoulder blades down (the opposite of a shrug). During the bench press, your elbows stay at about a 45-degree angle.

The final tip i have is to finish every chest workout with external rotator exercises. Chest workouts will tighten the internal rotator muscles that contribute to rounded shoulders. Doing external exercises after each chest workout helps to maintain the balance of external vs internal rotation.

Conclusion

I hope you have found this guide useful and now have a better understanding of the best exercises for Pectus Excavatum. If you have any questions, please feel free to contact me directly at info@pectus-solutions.com