Breathing exercises for pectus excavatum: what they can and can't do
By Javier Santana, founder of Pectus Academy · Updated October 2026
Short answer: we have not found studies showing that breathing exercises change the shape of the breastbone, but physical therapy may increase how far the chest expands. It makes sense to work on them together with posture. If you get short of breath during exercise, the first step is a medical assessment, not a routine.
Does pectus affect breathing?
It depends on severity. Many people have no symptoms at all. In more pronounced cases, lung function tests show mild to moderate drops in vital capacity and in the volume of air breathed out, and the heart may pump less blood with each beat, which lowers exercise tolerance.
What can breathing exercises add?
- Mayo Clinic notes that some physical therapy exercises may increase how far the chest can expand.
- In the only randomized trial we have found, the physical therapy program added to the vacuum bell improved the depth of the dip and posture more than the bell alone.
- We have not found studies measuring the effect of breathing exercises on their own.
Which exercises are used?
| Exercise | What it involves |
|---|---|
| Diaphragmatic breathing | Breathing in toward the belly without lifting the shoulders |
| Rib breathing | Breathing in while opening the ribs sideways and backward |
| Deep breath with a pause | Filling the chest slowly, holding for a couple of seconds and letting go |
| Breathing with mobility | Combining the in-breath with extension of the upper back |
These are standard breathing physical therapy techniques. They have no studies of their own in people with pectus. If you feel dizzy, stop: the point is not to hold your breath as long as you can.
When is it not a matter of exercises?
If you get short of breath with light effort, or have chest pain, palpitations or fainting, see a doctor. The usual tests are lung function, an echocardiogram and an exercise test, which can reveal limitations that do not show at rest.
What we know and what we don't
What we know
- In pronounced cases, pectus can reduce lung function and exercise tolerance.
- Physical therapy may improve chest expansion.
What we don't know
- How much breathing exercises add on their own.
- Which technique and dose work best.
Where to start
The 16-week program organizes breathing together with mobility and posture. You can also read posture and rib flare and which exercises help and which don't.
This content is educational and does not replace the advice of a healthcare professional. We do not promise a specific result.
Sources
- Sharma G, Carter YM. Pectus Excavatum. StatPearls, updated February 15, 2026. ncbi.nlm.nih.gov/books/NBK430918
- Mayo Clinic. Pectus excavatum: diagnosis and treatment. mayoclinic.org
- Alaca N, Alaca I, Yuksel M. Physiotherapy in addition to vacuum bell therapy in patients with pectus excavatum. Interactive Cardiovascular and Thoracic Surgery, 2020;31(5):661-668. doi.org/10.1093/icvts/ivaa161
Prefer a structured plan? See the 16-week program.