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Pectus Excavatum & Exercise

Jul 19, 2011 | By Penny Kendall

Pectus excavatum, or PE, is a congenital deformity of the chest wall. Some children with PE do not exhibit health problems but may suffer psychologically because of the appearance of the deformity. Moderate to severe PE can cause significant physical symptoms such as shortness of breath on exercising or heart problems, conditions that may worsen as a child grows and the deformed sternum exerts more pressure on organs in the chest. In these cases, corrective surgery is often necessary. Certain exercises can help people with mild forms of PE look and feel better. Since PE can affect your heart and lung function, consult your physician before beginning any therapeutic or recreational exercise program.

Identification

Pectus excavatum is a congenital deformity of the front chest at the point where cartilage joins the ribs to the sternum, or breastbone. This abnormality causes a caved-in or dented appearance to the chest around the lower and middle parts of the sternum. In some instances, PE can cause the breastbone to roll to to one side, usually to the right. Mild PE may have no physical symptoms but may be of cosmetic concern to the individual.

Incidence and Impact in Adolescence

PE occurs in approximately one out of 1,000 births and is seen more frequently in males, although some females with scoliosis or other congenital musculoskeletal conditions also exhibit PE. Pectus excavatum may not cause ill health in early childhood, but physical problems can manifest and worsen rapidly with the adolescent growth spurt. This spurt can worsen the chest deformity and cause compression of the heart and lungs. At this point, the child may begin to experience exercise fatigue and shortness of breath at play and during school sports.

Exercise Treatment

Exercise treatment focuses on pulling the shoulders from a rounded position into an erect, squared posture. Consistent exercise therapy can increase lung volume and minimize the pot belly that results from the concave dent in the breastbone. An exercise program can prevent progression of the condition in mild cases, ease surgical repair and prevent recurrence after surgical appliances have been removed, according to the Children's Hospital of the King's Daughters Health System. MayoClinic.com recommends physical therapy in mildly symptomatic cases of PE to encourage better posture and increase lung capacity.

Symptomatic Moderate to Severe PE

In severe cases of pectus excavatum, the dent in the breastbone puts pressure on the lungs and restricts the ability of the lungs to expand fully. This causes shortness of breath and exercise intolerance, which often are the first health problems a PE patient may experience. In severe cases, PE can place pressure on the right side of the heart and displace the heart to the left, causing cardiac symptoms from the heart's inability to pump effectively. These symptoms include chest pain, fatigue, a heart murmur and palpitations. Surgery is the only way to correct pectus excavatum and involves bracing the breastbone with surgical appliances for a period of time. The ideal age for this surgery is between 12 to 18 years old, according to doctors at the University of Minnesota.

References

Article reviewed by SarahP Last updated on: Jul 19, 2011

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