Pectus Carinatum and Excavatum

The over growth either causes the sternum to move inwards causing the sunken in appearance of Pectus Excavatum (PE), or the sternum is raised upward producing the chest protuberance seen with Pectus Carinatum (PC).

Pectus Excavatum
Conservative management for PE involves muscle work specifically utilizing the pectoralis muscles to make use of their sternal and anterior chest wall attachment sites to draw the hollowed regions forward. Postural strengthening to prevent forward slumped postures is also required to minimize caving in forces at the front of the chest. Breathing techniques (such as those utilized in the BSPTS Schroth-based method) that increase the front to back diameter of the ribcage are useful also in supporting the aim of filling out the chest hallow.

Pectus Carinatum
Often the ribcage of PC is very stiff and displays altered breathing mechanics. Exercise programs need to focus on improving thoracic cage mobility and rib movement. Often the outward rib excursion of normal inhalation is restricted therefore breathing techniques to increase the transverse diameter of the ribcage are useful. The schroth method targets the ribcage very specifically and can be tailored to emphasise lateral rib expansion.

Some forms of bracing have been found to be effective in reducing the size of the Pectus Carinatum, especially in the growing adolescent. At this stage we do not provide the bracing for this condition.