Improving Pectus Excavatum, Flared Ribs and Posture Through Chest Expansion Using Breathing Exercises

I’ve written before about how posture affects your chest, and how it compresses it to the point it deforms here.

This time, I want to focus on a few key breathing techniques that will help you expand your chest and decompress it.

This article will be part 1 of 3 on this topic, so let’s get started.

So what is chest compression? In short, your back lower ribs get pushed in by the spine through improper posture and breathing patterns. This pushes your lower ribs forward, which leads to rib flaring, as well as improper expansion of the rib cage, which may also contribute towards worsening of Pectus Excavatum.

For now, we’ll focus only on 3 main breathing exercises. These should be performed 3-4 times per week, 3 sets each, 10 deep breaths per set. I’ll usually do them before my workouts, which takes me about 20 minutes in total with all the other warm up and breathing exercises.

Firstly, we’ll start with the pelvis. Although the focus of these exercises is to expand the chest wall, we cannot neglect the pelvis’ role in the postural chain. The pelvis dictates your spinal position. If the pelvis in anterior orientation (the famous “duck butt”), then this will over-curve the spine and lead to lower chest compression.

So to decompress the chest, we must first decompress the hips. Here’s how you do it. Find something you can hold, either gymnastic rings, a bar, a door frame, a table, or anything else, that allows you to lean back as you go into a deep squat, and stand shoulder width apart, with your feet perfectly straight – toes have to point forward. The leaning back is important. As you lean back, you want your lower back to be neutral. Keep close attention to that. Again, there should be no bending of the lower spine in any direction. You then go down into a squat and stay there while you breathe deeply into your lower abdomen. Here, make sure you’re pushing your knees as far forward as you can while still maintaining contact with your heels, and your lower back neutral. You should also relax your shoulder and let them go forward into a protracted position.

If you feel tightness in your hips, then you know you’re on the right track. If you feel a dull pain on the back of your pelvis, near your tail bone, then don’t be alarmed, that’s your SI joint finally opening up and regaining lost mobility.

To make the exercise easier, you should lean back as much as you can by moving your feet forward. If you come to a point where your butt touches the ground, then simply move your feet back a bit, which will reduce the lean and move you up.

If you still find this exercise too difficult due to limited mobility, then it can also be performed on the floor next to a wall. Simply lay on your back, move yourself into position so that your butt is very close to the wall and put your feet on the wall, so that it looks like you’re pushing off the wall in a squatting position. Then, just lightly push off the wall with your legs (essentially, you are doing a lying squat) and breathe deeply. You can spend more time in this position than the above one, but I would not recommend more than 5 minutes.

The second exercise targets the expansion of the rib cage at the back, near the spine. To perform it is relatively easy. Simply find an elevated platform like a bench, chair, bar, or something similar and go into a push-up position with your feet together. From there, push your shoulders down (scapular depression) and forward (scapular protraction) and maintain it with each inhale and each exhale. At the same time, make sure your core remains tight throughout the whole time. Brace your front lower rib cage and under no circumstances allow for “belly breathing” (diaphragm expanding downward).

It’s very important that your hip position stays neutral here. Don’t let them rotate in either direction by keeping your glutes squeezed.

This way, you will only be breathing into the back of your rib cage. You should feel some tension and potentially pain in your ribs near the spine. That’s perfectly normal, and is an indicator of chest expansion.

The third exercise is performed in exactly the same way as the second one, but the arm orientation and body position changes. This time we want the elbows to be about head height and our body to be fairly upright. This can be done from a wall, a pillar, door frame, or a ladder as is shown on the image.

The important part here is that you are pushing your elbows forward as much as possible, with each inhale and each exhale. With this, we are targeting the upper chest, which is more rigid as the ribs here have less cartilage than the bottom ones. You will probably feel some pain and tightness around your shoulder blades. This is a good indicator that the exercise is being done correctly.

As said before, each exercise should be performed 3 times, with each set for 10 deep breaths, 3-4 times per week. Doing these too much and too often can lead to rapid changes, to which your body will not be able to adapt fast enough. Be aware that as you decompress your hips, chest and spine, you actually lose some stability, as your body has gotten used to relying on said compression for it. It’s like taking away crutches from someone who’s been walking with them for years. It takes time to adapt to new posture. Remember, this isn’t a sprint, it’s a marathon. Postural changes should come gradually, and naturally, from decompression.

In part 2 I will go into how to perform the breathing exercises if you have asymmetrical rib flaring and/or Pectus Excavatum.