Pectus excavatum, sometimes called funnel chest, is an abnormal development of the rib cage where the breastbone grows inward. The causes of pectus excavatum aren’t completely clear. It’s not preventable but it can be treated. One of the ways to treat it is through exercise.

However, exercise might not exactly sound easy since pectus excavatum can cause:

  • trouble breathing
  • chest pain
  • decreased exercise tolerance

According to Anton H. Schwabegger, author of “Congenital Thoracic Wall Deformities: Diagnosis, Therapy and Current Developments,” pectus exercises include deep breathing and breath-holding exercises, as well as strength training for the back and chest muscles.

If you do these exercises slowly and focus on breathing as deeply as possible, you’ll get more out of them. Your form will be better, you’ll deliver much-needed oxygen to your muscles, your body will relax, and you’ll avoid holding your breath, which is easy to do if something is uncomfortable.

Keep in mind that you should inhale on the easier phase of the movement and exhale on the exertion phase of each exercise. Specific benefits and directions are included in each exercise below.

The moves listed below are strengthening and stretching exercises targeting the pectoral and serratus muscles, the back muscles, and the core muscles to improve overall posture. Strengthening these muscles will help with rib flare caused by pectus excavatum and the side effects of it, both physical and cosmetic.

Pushups

This one may seem basic, but there’s no denying that pushups are one of the best ways to strengthen the pectoral muscles. These can be done on the knees or toes. If you’re not ready for full pushups, start with your hands resting on a solid surface higher than your feet — like a very sturdy coffee table or the edge of a couch, cushions removed, that’s pressed up against a wall — and start on the toes.

Having your hands higher than your feet and your body at an angle can be a good way to start a pushup regimen. As you get stronger, you can begin to lower the angle of your body. This will help you transition to full pushups more easily than going from knees to toes. A full plank engages the muscles differently, even at an angle.

When doing pushups, aim for 2 sets of 10 reps per day.

  1. Start in plank position with your hands under your shoulders and your core engaged.
  2. As you lower, inhale.
  3. As you engage your muscles to push yourself up, exhale. Keep your elbows hugging in close to your body. Keep your focus on slowly breathing as you do these, and on engaging the pectorals while keeping the core tight.

Don’t just crank these out to get them done — this can compromise your form and do more harm than good. If the movement is really tough, break the sets into three or five to start, or find a higher point to begin after a week of exercise. If necessary, you can even stand and do pushups pushing against a wall.

Chest fly

For this exercise, you’ll need a bench or exercise ball as well as some dumbbells. If you don’t have weights, you can always use the old standby: a soup can in each hand. Just keep in mind that dumbbells are easier to hold and you can get more out of using them, as even 5-pound weights are heavier than your heaviest canned goods.

  1. Lie with your upper and middle back on a bench or ball, with your legs at a 90-degree angle. Hold a weight in each hand and extend your arms to the sky, elbows slightly bent.
  2. As you inhale, lower your arms out wide, until your elbows are at shoulder height.
  3. As you exhale, raise your hands until they meet above your chest again.
  4. Do 2 sets of 10.

If that feels pretty easy, up it to 2 sets of 15 or increase the weight you’re using.

Dumbbell row

Strengthening your back muscles is an important component of treating pectus excavatum. The dumbbell row targets your lat muscles. The way it’s described below also strengthens your core, another important component of treating the condition. You’ll need some dumbbells to complete this move — err on the lighter side if you’ve never done a row before.

  1. Hold one dumbbell in each hand with your arms extended. Hinge at the hips until your upper body reaches a 45-degree angle.
  2. Keeping your neck in line with your spine and your gaze straight down, pull your elbows straight back and squeeze between your shoulder blades.
  3. Extend your arms back to the starting position. Complete 2 sets of 10.

Dumbbell rear delt fly

Another move to strengthen your back, a dumbbell rear delt fly also focuses on the lats, as well as the rhomboids and the traps. Choose a light pair of dumbbells to complete this move and ensure that you’re pinching your shoulder blades together at the top to get the most out of it.

  1. Hold one dumbbell in each hand with your arms extended. Hinge at the hips until your upper body reaches a 45-degree angle and bring the dumbbells together.
  2. Keeping your spine and neck neutral, inhale and push the dumbbells out and up to the side until your arms are parallel to the floor.
  3. Exhale and return to the start in a slow and controlled motion. Complete 2 sets of 10.

Superman

Bad posture can contribute to the severity and appearance of pectus excavatum. Strengthening your postural muscles can help. Because we often work on our front body — especially when strengthening our chest to help with pectus excavatum — this exercise will help balance your body by strengthening your posterior chain — those muscles on the back of the body.

  1. Lie on your stomach on a mat with your arms extended in front of you and your forehead resting on the ground.
  2. As you inhale, lift your head, legs, and arms.
  3. Hold for a count of 5 and gently release back to the ground.
  4. Complete 2 sets of 10.

Seated twist

The great thing about this exercise is that it can be done at work — in a regular chair with no weights. Or it can be made more difficult by sitting on an exercise ball and using weights. You’ll feel this in your upper back and obliques. It’ll also work your core and your pecs, especially if you use weights.

  1. Sit up straight and engage your core. Extend your arms out in front of you. If you’re using a weight, hold it with both hands, either wrapping 1 hand over the other or stacking them on the weight.
  2. Inhale and as you exhale, twist to the right.
  3. Count slowly to 5, and then move with your breath. You’ll twist when you exhale and sit up taller or untwist when you inhale.

Bow Pose

Stretching is also a vital component to treating pectus excavatum. Yoga chest openers will help to expand the chest while also promoting deep breathing. Try Bow Pose to start.

  1. Lie on your stomach on a mat with your arms at your sides, palms facing up.
  2. Bend your knees and bring your feet to your backside, grabbing your ankles with your hands.
  3. Inhale and lift your thighs away from the floor, pressing your shoulder blades back to open your chest. Your gaze should be forward.
  4. Maintain the pose for at least 15 seconds, ensuring that you continue to breath. Complete 2 rounds.

Camel Pose

Another chest-opening yoga pose, Camel gives you a deep stretch through the entire upper body. This will be difficult for beginners — if you can’t achieve the full pose, lean back with your hands on the back of your pelvis, feeling the stretch there.

  1. Kneel on the floor with your shins and the tops of your feet pressed into the ground. Place your hands on the back of your pelvis.
  2. Keeping your thighs perpendicular to the ground and pushing against your tail bone, lean back, aiming to drop your hands to your heels. Drop your head back.
  3. Maintain the pose for at least 15 seconds. Complete 2 rounds.

The takeaway

Exercise is a key component to treating pectus excavatum. By strengthening your chest, back, and core muscles and stretching your chest cavity, you can combat the condition’s effects. Aim to complete these exercises several times a week to maximize results.