Pectus excavatum and sports: can I exercise normally?
By Javier Santana, founder of Pectus Academy · Updated October 2026
Short answer: for many people, yes. Many children with pectus have a normal, active childhood, and the sources recommend staying active. In teenagers with pectus studied in hospitals, the heart pumped less blood during exertion, even though there were no differences at rest. Being active is linked to better fitness with pectus too. If you have symptoms, get evaluated first.
Does pectus limit performance?
| Study | Who | What it found |
|---|---|---|
| Lesbo et al., 2011 | 49 teenagers with pectus and 26 without | No differences at rest. During submaximal exercise the patients' hearts pumped less: cardiac index of 6.6 vs 8.0 L/min/m² |
| Casatori et al., 2022 | 15 teenagers with pectus and 15 without | Maximum oxygen uptake of 37.2 vs 45.4 mL/kg/min |
| StatPearls (review) | Several studies | Mild to moderate decreases in lung function tests |
These are patients studied in hospitals, so their pectus was probably more marked than average. Many people with pectus have no symptoms at all.
Does training help?
There are signs that it does. In the Casatori study, a pilot with 15 patients, teenagers with pectus who were more physically active had a higher maximum oxygen uptake. What did not change with activity was the oxygen pulse, an indirect measure of the blood the heart moves with each beat. The authors recommend promoting physical activity and note that a marked reduction in that measure may point toward surgery.
In the Basel vacuum bell series, all patients are advised to keep up their sports.
Which sport is best?
We have not found studies comparing sports in people with pectus. You often hear that swimming is best, but we have not found data putting it ahead of others. A practical rule: pick one you will stick with and add upper back and mobility work, as we explain in pectus excavatum and the gym.
Mayo Clinic notes that many people with pectus avoid activities like swimming so as not to show their chest. If that is what holds you back, it is not a fitness problem: we cover it in body image and confidence.
When should you get checked before exercising?
- If you get short of breath or tire much sooner than other people at a similar effort.
- If you notice chest pain, palpitations or wheezing during exercise.
- If you have felt dizzy or fainted while playing sports.
An exercise test can reveal limitations that do not show at rest. If you have any of those symptoms, stop and see a doctor before continuing.
What about after surgery?
The surgeon sets the restrictions. As a rough guide, one parents' guide mentions avoiding strenuous activity, including running, for the first six weeks, no sports with a risk of a blow to the chest until the surgeon gives the go-ahead, and six months or more to get back to all activities.
Does performance improve after surgery? The data disagree. A meta-analysis of 15 studies found no significant change in maximum oxygen uptake before and after surgery. On the other hand, in a study of 264 patients aged 8 to 21, the physical difficulties they themselves perceived went down a year after the operation.
My case
I was very into sports, and one of the reasons I did not have surgery was that I did not want to be sidelined for that long. That is my case, not a recommendation.
What we know and what we don't
What we know
- In teenagers with pectus studied in hospitals, the heart pumped less during exertion, even though the cardiac index at rest was normal.
- More physical activity is linked to better aerobic fitness with pectus too.
What we don't know
- How much a mild pectus limits you: the studies are done on hospital patients.
- Whether some sports are better than others.
- How much real-world performance improves after surgery.
Keep reading
- Pectus excavatum and the gym
- Breathing exercises for pectus excavatum
- Mild vs severe pectus excavatum: when to see a doctor
This content is educational and does not replace the advice of a healthcare professional. We do not promise a specific result.
Sources
- Lesbo M, Tang M, Nielsen HH, et al. Compromised cardiac function in exercising teenagers with pectus excavatum. Interactive Cardiovascular and Thoracic Surgery, 2011;13(4):377-380. doi.org/10.1510/icvts.2011.267054
- Casatori, Pellegrino, Messineo, et al. Differential Influence of Physical Activity on Cardiopulmonary Performance and Stroke Volume Assessed at Cardiopulmonary Exercise Test in Pectus Excavatum: A Pilot Study. Frontiers in Physiology, 2022;13:831504. doi.org/10.3389/fphys.2022.831504
- Sharma G, Carter YM. Pectus Excavatum. StatPearls, updated February 15, 2026. ncbi.nlm.nih.gov/books/NBK430918
- Mayo Clinic. Pectus excavatum: symptoms and causes, updated March 14, 2025. mayoclinic.org
- Mayo Clinic. Pectus excavatum: diagnosis and treatment, updated March 14, 2025. mayoclinic.org
- Seattle Children's Hospital. Pectus Excavatum. seattlechildrens.org
- Haecker FM, Sesia S. Vacuum bell therapy. Annals of Cardiothoracic Surgery, 2016. annalscts.com
- Nemours KidsHealth. The Nuss Procedure, reviewed May 2023. kidshealth.org
- Kelly RE Jr, Cash TF, Shamberger RC, et al. Surgical repair of pectus excavatum markedly improves body image and perceived ability for physical activity: multicenter study. Pediatrics, 2008;122(6):1218-1222. doi.org/10.1542/peds.2007-2723
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