Pectus excavatum and the gym: which exercises make sense
By Javier Santana, founder of Pectus Academy · Updated October 2026
Short answer: building muscle in the chest and back changes how pectus looks and helps posture. We have not found studies measuring whether the gym alone corrects the dip, or comparing routines in people with pectus, so what follows is practical judgment: balance pushing and pulling, look after your posture and do not leave out the upper back.
Can I train with pectus?
In most cases, yes. For many people the only sign is a slight dip in the chest, with no symptoms. If you notice shortness of breath, chest pain, palpitations or dizziness during exercise, stop and see a doctor before carrying on: in some cases pectus reduces exercise tolerance, and that is assessed with an exercise test.
What should you prioritize?
| Group | Why | Examples |
|---|---|---|
| Upper back | Hold the shoulders back and open the chest | Rows, pulldowns, rear-delt flyes |
| Chest | Add volume around the dip | Incline press, flyes through a comfortable range |
| Serratus anterior | Rib cage stability | Push-up plus |
| Deep core | Control the lower ribs | Planks, floor-based control drills |
| Upper-back mobility | Counter a rounded back | Thoracic extension over a foam roller |
This is a training rule of thumb, not a protocol studied in pectus.
Does muscle hide the dip?
Only partly. The chest muscle grows on either side of the breastbone, not on top of it: there is no muscle over the center of the breastbone that can gain volume. A more developed chest changes the outline and makes the whole area look different, but the center of the dip does not fill in with muscle.
Common mistakes
- Training only chest and abs and leaving out the back.
- Lifting with a rounded back and forward shoulders.
- Expecting a fixed timeline: what changes, and how much, depends on the person.
What if I have had surgery?
If you have a bar in place or had surgery recently, your surgeon sets the restrictions. Do not follow a generic routine.
What we know and what we don't
What we know
- Physical therapy may improve posture and chest expansion.
- Muscle changes the outline of the chest; it does not fill in the center of the dip.
What we don't know
- Which routine works best in people with pectus.
- How much appearance changes with strength training.
Where to start
The 16-week program includes the targeted training together with mobility, breathing and posture. Before that, read which exercises help and which don't and posture and rib flare.
This content is educational and does not replace the advice of a healthcare professional. We do not promise a specific result.
Sources
- Mayo Clinic. Pectus excavatum: symptoms, causes, diagnosis and treatment. mayoclinic.org
- Sharma G, Carter YM. Pectus Excavatum. StatPearls, updated February 15, 2026. ncbi.nlm.nih.gov/books/NBK430918
Prefer a structured plan? See the 16-week program.