Pectus excavatum refers to a chest wall deformity that leads to a sunken breastbone (sternum) appearance. It is sometimes called “funnel chest” and usually involves the lower half of the sternum. It most common appears in the middle of the chest, but may move to one side, usually the right. Till this day, there are no established effective nonoperative management strategies that can correct pectus excavatum. A number of exercise programs have been suggested. However, no substantial scientific evidence has determined that they are effective in achieving anatomical correction.

The cause of pectus excavatum is poorly understood, although most people with the condition have had it since birth or early infancy. It may occur due to uncoordinated growth between the ribs and the chest. If the ribs grow at a faster rate than the expansion of the heart and lungs (which push the sternum outward), then the sternum will be pushed inward. Once this has taken place, the deformity either persists or gets worse.

Regarding the use of external braces as a nonoperative management of pectus excavatum, the experience with this approach in the treatment of chest wall deformities in the United States is very limited and no results have been reported in the medical literature. 

Since most patients with the deformity are asymptomatic, treatment may not be required, or will be dependent upon the development of symptoms.

Physical therapy in young patients (below the age of 18, due to most pectus deformities remaining the same after this age) may contribute to slowing the development of the chest wall deformity and may possibly reverse some of the chest wall deformity. In adults, however, the correction is indicated for cosmetic reasons as decided by the patient him or herself.