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Why is My Chest Sinking Inwards?

Pectus deformities are the most common malformation of the chest wall. There are two types: pectus carinatum and pectus excavatum (PE). PE is a condition where the breast bone of the individual is sunken resulting from abnormal growth of cartilage that connects the ribs to the sternum. It is more common in male adolescents than females with a prevalence of one in 300-400 youths. PE is a congenital deformity that becomes more apparent as the child goes through a growth spurt and begins puberty. Once the child reaches skeletal maturity, the PE should not get any better or worse. 

Mild cases may not be noticeable or are only cosmetic in nature. Severe PE can cause the breastbone to compress on the lungs and heart leading to: 

  • Problems tolerating exercise and limitations with physical activities 
  • Tiredness, fatigue and dizziness 
  • Chest pain, coughing or wheezing 
  • Reduced capacity for lung expansion 
  • Inefficient heart function due to restricted space 
  • Rapid heartbeat or heart palpitations 
  • Frequent respiratory infection 


Diagnosis & Treatment 

PE is initially diagnosed through physical examination and confirmed with CT scan or chest MRI. Depending on the severity of the deformity and the effects on cardio and pulmonary function, your physician may suggest surgical intervention or orthotic management. Individuals who are not bothered by the physical appearance and who have a mild case of PE typically don’t need treatment. Mild to moderate cases can be managed conservatively using an orthotic device that slowly raises the chest wall and complemented with physical therapy to strengthen the chest muscles and improve posture. More severe or rigid deformities can be corrected surgically via the Nuss procedure and the Ravitch technique. LHSC has a fabulous paediatric thoracic surgery department that sees PE deformities on a regular basis and performs both procedures when necessary. 

Custom Orthotics of London works directly with the LHSC thoracic team to provide a patient focused team approach to treating chest wall deformities. If you have any questions about PE, chest wall deformities, orthotic intervention or would like a complimentary consultation with our clinicians, please do not hesitate to reach out to our office.


The Custom Orthotics Team (519) 850-4721 | office@customorthoticsoflondon.com | @cool_bracing


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