Does Pectus Carinatum Affect Muscle Growth?

by Dakota Brace

Will pectus carinatum affect your child’s physical development and muscle growth? With various research available, it can sometimes be confusing to sort through the various information and sort correlation from causation. This article will get you up to speed with the latest research on how pectus carinatum affects muscle growth.

What Is Pectus Carinatum?

Pectus carinatum is a chest wall deformity present from birth, although it usually becomes more prominent during early puberty. In this condition, the sternum (breastbone) protrudes outward, causing the chest to appear pushed forward. This condition is caused by an overgrowth of cartilage that connects the ribs to the sternum, causing the sternum to stick out.

It affects around one in 1000 teenagers [1] and is more common in males than females. There are two broad categories of pectus carinatum based on their cause. Isolated pectus carinatum is where the pectus carinatum (chest protrusion) is the main condition, and it occurs in isolation. In these cases, the cause of pectus carinatum appears to be a combination of genetic inheritance, environmental influences, and random chance. 

On the other hand, pectus carinatum may be present as a secondary consequence resulting from another underlying condition such as:

  • Marfan syndrome
  • Ehlers-Danlos syndrome
  • Morquio syndrome
  • Noonan syndrome
  • Osteogenesis imperfecta
  • Trisomy 18, or
  • Down Syndrome (Trisomy 21)

The most common side effects or symptoms of pectus carinatum are well documented. In addition to the most obvious physical protrusion of the chest, other symptoms include fatigue, shortness of breath or difficulty breathing, flaring of the ribs, rounding of the shoulders, hunching of the back or poor posture, increased heart rate (tachycardia) and chest pain.

Does Pigeon Chest Affect Muscle Growth?

With all of these potential side effects arising from pectus carinatum, you’re probably wondering if it also influences muscle growth or development. When answering this question, it is important to distinguish between causation and correlation. The current state of research does not indicate any direct impacts of pectus carinatum on muscle development.

However, one of the most common symptoms of pectus carinatum is shortness of breath or asthma-like symptoms, which leads to reduced exercise tolerance.[3] As pectus carinatum becomes more prominent during early adolescence, it will likely affect children’s participation in group and individual sports and fitness activities. In turn, this would lead to reduced fitness and potentially poorer muscle development. In addition, poorer posture associated with pectus carinatum can cause muscle tightness, back pain, and poor core strength, which can also influence participation in physical activities.

Does Pectus Carinatum Affect Muscle Growth? — Dakota Brace

Potential confusion between causation and correlation may arise in cases of non-isolated pectus carinatum. As mentioned in the introduction, pectus carinatum commonly occurs in people who suffer from a variety of other conditions or syndromes, such as Marfan syndrome or Ehlers-Danlos syndrome. Many of these are connective tissue disorders, which can, in turn, negatively influence muscle development.[4,5] Consequently, pectus carinatum sufferers as a population tend to have poorer muscle development — even though pectus carinatum per se does not influence muscle growth.

Does Pectus Carinatum Affect Strength?

As is the case for muscle growth, the association between a number of connective tissue disorders (amongst others) and pectus carinatum means that, as a population, pectus carinatum sufferers tend to have reduced strength. This can arise due to a combination of muscle fiber damage and reduced ligament strength.

One study in children with pectus carinatum, but no other chronic systemic disorders or musculoskeletal diseases, reported significantly reduced grip strength, body and back muscle strength, and trunk muscle endurance compared to a healthy control group.[6] This may be related to reduced exercise tolerance arising from their lower lung capacity, as well as other factors.

Can You Play Sports With Pectus Carinatum?

Although it may be slightly more difficult, it is certainly possible for children with pectus carinatum to also play and enjoy sports activities. Even though pectus carinatum sufferers tend to have much lower activity levels compared to the general population, up to 10% of them maintain a high level of physical activity.[6] However, due to their reduced lung capacity, particular caution should be exercised to ensure that your child does not overexert themselves.

Another factor to consider is that many children suffering from pectus carinatum are particularly self-conscious of their appearance. They are likely to avoid situations where their chest may be exposed, such as swimming or gym class. In these instances, corrective treatment of the chest protrusion will increase their level of participation.

Help Your Child With a Custom Dakota Brace

The good news is that pectus carinatum should not significantly impact your child’s physical development or general health. However, the best way to minimize the impacts of pectus carinatum on your child’s development (both physically and emotionally) is through effective treatment of the underlying condition. It is now easier than ever to treat pectus carinatum using orthotic bracing. This is a non-surgical treatment method that involves wearing a custom-made chest brace to reshape the chest wall gradually. The brace applies pressure to the protruding area of the chest, which helps to push the sternum back into a more normal position gradually. The treatment is most effective in children and adolescents, as their bones are still developing and the cartilage forming the sternum is still malleable.

Orthotic braces for pectus carinatum are made of lightweight materials to ensure that they do not interfere with daily activities, as far as possible. For most people, the brace will need to be worn for up to 20–22 hours per day for the initial correction period, which is typically 6–12 months long. After this, the bracing requirements can be reduced for the maintenance bracing period, which is usually a further 1–2 years. 

Custom Pectus Carinatum Brace by Dakota Brace

At Dakota Brace, we offer a Custom Pectus Brace, which is 3D-printed to suit the shape of your child’s chest perfectly. This ensures maximum comfort for your child during the treatment process. For patients with concomitant rib flare, we also have a Custom Pectus & Rib Flare Brace


Does your child suffer from pectus carinatum? Here at Dakota Brace, we aim to provide the best possible treatment for pectus carinatum, at an affordable cost. Arrange a free consultation with one of our health professionals and $75 off your first order!


  1. McHam, B., & Winkler, L. (2019). Pectus carinatum. StatPearls. 
  2. Shamberger, R. C. (1996). Congenital chest wall deformities. Current Problems in Surgery, 33(6), 469-542.
  3. Williams, A. M., & Crabbe, D. C. G. (2003). Pectus deformities of the anterior chest wall. Paediatric Respiratory Reviews, 4(3), 237-242.
  4. Haine, E., Salles, J. P., Khau Van Kien, P., Conte‐Auriol, F., Gennero, I., Plancke, A., ... & Edouard, T. (2015). Muscle and bone impairment in children with Marfan syndrome: correlation with age and FBN1 genotype. Journal of Bone and Mineral Research, 30(8), 1369-1376.
  5. Malfait, F., Wenstrup, R. J., & De Paepe, A. (2010). Clinical and genetic aspects of Ehlers-Danlos syndrome, classic type. Genetics in Medicine, 12(10), 597-605.
  6. Alaca, N., & Yüksel, M. (2021). Comparison of physical functions and psychosocial conditions between adolescents with pectus excavatum, pectus carinatum and healthy controls. Pediatric Surgery International, 37, 765-775.