First a little about what it is. Pectus carinatum (Lat.), also called pigeon chest is a malformation of the chest characterized by a protrusion of the sternum and ribs.
Pectus carinatum is a chest deformation when the breastbone and several ribs protrude outward abnormally. It’s also called atypical chest wall and characterized by abnormal growth of the costal cartilage between the ribs and sternum.
As result the chest looks similar pigeon chest. That type of deformity usually becomes noticiable only during the adolescent growth ( at 11-15 years old). Statistics shows that the deformity occurs in rougthly 1 out of 1500 people. Males susceptible to this disease nine times more than females.
There is a scale to determine the severity of pectus carinatum from 0 to 8. The eighth degree is the heaviest. The deformity easily diagnosed by visual inspection with or without X-ray examination.
It might be non-syndromic abnormality and patients don’t have any pressure on the heart and lungs. However the deformity maybe present with strong association with chronic syndromes: Marfan syndrome, Morquio syndrome and others.
According to the degree of deformity and its form (symmetrical or asymmetrical), further treatment prescribed to patients is determined.
What is the treatment for pectus carinatum?
Until recently, there were only two treatments for pectus carinatum: wearing orthotic braces and surgery.
Wearing special designed bracing that exerts constant pressure on the chest and ribs thereby reducing their protrusion.
Surgery: these are the modified Ravitch procedure (reconstruction) minimally invasive sternal depression or the Ravitch operation or the Nuss procedure. The Ravitch operation is considered quite traumatic, as it was developed back in the 1950s.
During the modified Ravitch procedure a thoracic surgeon opens the chest wall and get access to the ribs. Then the deformed cartilage removed from each side of the chest. Some patients need an osteotomy or placing inside a special bar to fix the ribs correction results. But more than 90% of the Ravitch surgeries normally go without inserting bars.
It sounds as if the problem is solved easily, but not everything is so simple. Wearing braces shows satisfactory results only for patients under 17 years of age when the cartilage is still elastic and it works similar to the way braces work on teeth. The brace is worn around the chest and provides pressure from both the front and back to move the breastbone back to its usual position.
So if you are under 17 consult your physician about the use of braces. It costs appr. $1500 (depends on the model and manufacturer).
If I wear braces, will my problem be solved?
Well. It might be but it might be not. It all depends on patients’ health status, severity of the deformation, duration and intensity of wearing. Be prepared that you have to wear bracing up to 4 years every day for up to 17 hours per day. What? Really? Yes, for the best result you even have to sleep in it. And more over – wearing braces not even painless. They can leave deep abrasions on your body because of the constant pressure to hurt you during wearing. And the end result may not be satisfying in terms of aesthetics.
But anyway if you are under 17 it better way than surgery. Why? What’s wrong with surgery? The first thing you will have to face if you still prefer surgery is the fundamental reluctance of surgeons to do anything at all.They say:“It’s a cosmetic defect; one the tall man the other short – so what; it doesn’t put pressure on your heart and lungs and no long term adverse health effects”. The fact that it looks ugly and spoils the whole life they don’t care at all. Just cosmetic! But why all these refusals, maybe they are hiding something?
First things first, let’s start with the statistics of complications during and after surgery. Here’s a list of possible complications:
Keloid scar (40%)
Extra bleeding (30%)
Seroma (30%)
Infections (25%)
Granulation tissue (20%)
Pleural effusion (8%)
Pneumothorax (8%)
Wound (8%)
and seemingly unthinkable – broken inserting bars take 8%. Don’t forget also about common mortality risk (now it’s at minimal levels but still exists). Maybe that’s why surgeons are so reluctant to take on surgery, knowing for sure about all these complications.
The second important aspect is, of course, the cost of surgery. Since pectus carinatum does not threaten life and vital organs, the cost of surgery usually is not covered by health insurance. Unlike pectus excavator deformity, more severe, when there is pressure on the heart, but mostly lungs and the patient is having trouble breathing.
So how much does pectus carinatum surgery cost?
The cost starts from $20,000 up to $100,000 (avr. $60,000).
And that’s without the cost of postoperative treatment. Don’t forget about the cost of possible second surgery (after one or two years) if removing the bar needed.
Is the Ravitch surgery painfull?
Well. They have to remove some of the cartilage which means cutting it off with а medical saw. With a saw! Certanly the operation is performed under anastesia and during it the patient doesn’t feel anything. But after it comes constant pain in the ribs. And the pain can remain up to 3 months despite all the pain medication.
Some more words about recovery. Despite the fact that practishioners say that it only takes some months, however, the full recovery can takes more than a year (together with all the necessary restorative therapy of course).
After all, there is a possibility of recurrence, when the condition may become even worse than before surgery.
And one more: very few thoracic surgeons are available – practishioners in the chest surgery. A few dozen, probably for a country like the US. Therefore, the wait for surgery can last for months or even years.
Summing up: we have expensive surgery (which you have to wait for many months) with high risk of complications after surgery and long recovery period and fear of a recurrence. And widely recommended bracing are only effective for patients under the age of 17 ( but there are a lot of unsatisfactory results among them).
Can pectus carinatum be fixed with exercises?
Well, it strongly depends on what you call fixing. Most people naively believe that it means to cover the deformation with muscles or (which is rarer ) fat layer. In other words you try to build new body when muscles hide the deformation. The main objection to this is when you quit bodybuilding (sooner or later), you will quite soon see your problem again.
So does this mean there are no exercises to fix pectus carinatum?
They say no. Actually, that was my case. At the age of fourteen I was diagnosed pectus carinatum. I got depressed when I heard this. All hopes for the future were shattered.
My practishioner, professor of Genetics, said there was no other way to fix it other than surgery ( there were no braces at that time yet) and gave a referral for surgery.
There was a long waiting list for surgery (they said minimum 4 months up to 18 ones) because it was a shortage of thoracic surgeons (there were 4 or 5 of them in my big city). So I waited for my turn but one day I found out that my surgeon canceled all operations and mine among them due to the death of a patient during the operation (thirty-eight year old man with Marfan syndrome). The surgent was very shocked and it was the first letal case in his career.
Other surgeons did not perform the operation for free and the queues for them were also long.Time was running out and at age of 18 they say there is nothing special in pigeon chest and now you have to live with it.
All my questions what are other methods of treatment pectus carinatum exist remained unanswered.
So I was left alone with my problem. But I didn’t give up because it was impossible to live with it normally (neither present nor future ).
I decided to start doing something. The first thing I started with was swimming. Of course, I was very shy about going to the public pool, so I swam in the lake — a huge lake nearby with almost sea waves. Three years of swimming there made me a first-class swimmer but didn’t get closer my goal at all. But I was so hoping for swimming!
Then I decided to try to fix it with exercises. Even though they said there were no exercises ( “well, you can’t stretch the bones, right?»). I went through several primary appointments with nearly all practishioners but the answer was the same everywhere: “ nothing will help you – sorry, boy, there are no any exercises for pectus carinatum”.
Despite this, I started doing my own sets of exercises. I started experimenting with approaches and loads. And pretty soon I was convinced that it wasn’t a load, but a combination of different exercises. Daily exercises and measurements of efficiency if you can call changes in a couple millimeters per week effiencity. Although I knew that this problem didn’t have a quick solution and continued to experiment.
Weeks turned into months and I had so many variations of exercises and data that I had to use tables Excel. There was still no quick solution, but the efficiency gradually began to increase. It was necessary to correlate loads with various types of exercises and their combinations.
Obviously, something began to work out: the security guards in the shops stopped watching me closely and the elderly ladies on the streets stopped staring at me. And the girls began to look at me differently, somehow interested, I would say.
And after many long months of training, that wonderful day finally came. It was a really great day when I put on a shirt and nothing protruded from under it. No one was staring at me because now I was just like everyone else. Actually, it’s worth a lot. And I understood what it means to be happy, to be happy every day. This is a story with a happy ending.
But wait a minute, this is not the end yet. One day, walking down the street, I saw a guy with such a familiar but already somewhat forgotten problem. He looked miserable. Another second and we would have parted but I stopped him. — You have pectus carinatum, right? — As you can see (he immediately understood what I was talking about). — Would you like to fix it? — You still ask, I want this more than life, it’s a pity that it’s impossible. — A familiar song.You know what, here’s the address of the gym, if you want to come tomorrow and I’ll show you some exercises that will help you fix it. I had it. — ??
The next day he came and we started training. I tried to choose exercises based on my experience, specifically for his case.After a couple of weeks of training, I gave him a piece of paper with instructions on what to do next on his own. A few months later, we met again to check the interim results and make the necessary adjustments. He was very interested and trained hard. His progress was evident, and the end result exceeded his wildest expectations. He thanked me so warmly that I thought I wanted to feel it again. So I started helping others with pectus carinatum. Now you can join too!
Ok, how does it work, are these exercises or something different?
These are specially selected exercises as well as accompanying activities for each specific case (various types of deformations). Their selection takes approximately two to three weeks (up to two hours in a gym dayly). After that, you will perform the proposed exercises on your own. Ongoing support provided.
How long do I need to do those exercises on my own to get the best result?
This is probably the most interesting question and it directly depends on your age and health status:
You are under 18 — from 7 months to 15 months
You are 18-26 — from 9 months to 18 months
You are 30+ — from 12 months to 24 months
You are 40+ — from 14 months to 28 months
Note! The time is until the full fix. Significant improvements will be almost immediately after the start of training. In fact, the total duration of training may not be much longer than the recovery period after surgery ( these are completely non-traumatic exercises). The end outcome is really worth it!
These exercises are primarily intended for those who cannot be operated due to medical restrictions or can’t afford surgery.
Any questions please email: 4verbitskiy@gmail.com
Please only persons those in need (with pectus carinatum).
Believe we will fix it!
How to fix Pectus Carinatum with exercises 