Psychological Support in Pectus Deformities (Excavatum & Carinatum)Pectus deformities, particularly pectus excavatum and pectus carinatum, often carry a significant psychosocial burden, especially in adolescents and young adults. While many patients have no physical symptoms, they may suffer from poor body image, low self-esteem, anxiety, or even depression.🌪️ Common Psychological ChallengesArea ExamplesBody Image Embarrassment, avoiding tight clothing or swimmingSocial Anxiety Avoidance of school, sports, or changing in locker roomsSelf-Esteem Feelings of inferiority or “being different”Depression & Anxiety Especially during puberty/adolescenceBullying or Teasing Often reported in school-age childrenSurgical Anxiety Fear of pain, outcome, or visible scarring🩺 When Psychological Support Is EssentialPatient refuses physical activities due to embarrassmentHigh body image dissatisfactionPreoperative distress or hesitation about surgical decisionsConcerns persist after physical correctionParental anxiety or overprotectionNon-compliance with braces or therapy due to emotional issues🧰 Psychological Support Approaches1. Clinical Psychology or PsychiatryFormal assessment of anxiety, depression, and self-imageSupport during decision-making about surgery or bracingCognitive Behavioral Therapy (CBT) for distorted body image or anxiety2. Counseling & PsychotherapySafe space for teens to explore self-worth and emotionsCan involve individual, family, or group therapy3. Preoperative CounselingEducation about surgical outcomes and pain managementRealistic expectations (especially for cosmetic results)Post-op body image adaptation support4. Peer Support & Patient GroupsSharing experiences with others who have undergone bracing or surgeryRole models or peer mentorsOnline forums or local support networks5. Multidisciplinary Team InvolvementPsychologists, pediatricians, physiotherapists, and surgeons working togetherHelps personalize care and improve overall outcomes

Physical Therapy for Pectus DeformitiesPhysical therapy plays a supportive role in the management of pectus excavatum and pectus carinatum, either as a primary intervention in mild cases or as an adjunct to surgical or bracing treatment.While physical therapy cannot fully correct the structural deformity, it can significantly improve:PostureChest expansionRespiratory functionMuscle balanceBody image and confidence🎯 Goals of Physical TherapyImprove postural alignment (especially kyphosis and rounded shoulders)Strengthen thoracic and scapular stabilizersEnhance pulmonary function through breathing exercisesStretch tight anterior chest structuresImprove exercise tolerance and enduranceReduce chest wall stiffness pre- and post-surgery🔧 Core Components of a Pectus Physical Therapy Program1. Postural CorrectionFocus: counteract kyphotic posture often seen in pectus patientsExercises:Wall angelsShoulder blade squeezesChin tucksFoam roller thoracic extensions2. Strengthening ExercisesTarget: upper back, scapular muscles, coreExercises:Rows (resistance bands or cable)Prone Y/T/WsPlanks and side planksDead bug variations3. Stretching Tight StructuresPectoralis major and minorAnterior shoulders and upper abdominalsHip flexors (due to postural compensation)Methods:Doorway stretchesChest openers on foam roller4. Breathing ExercisesEncourage diaphragmatic breathing and chest expansionTechniques:Pursed-lip breathingIncentive spirometrySegmental chest expansion exercisesYoga-based breathing (e.g., pranayama)5. Aerobic ConditioningImproves cardiovascular fitness and lung capacityExamples:Walking, swimming, cyclingGradually increased intensity

Bracing Therapy for Pectus CarinatumBracing is the first-line, non-surgical treatment for pectus carinatum (protruding chest), especially in children and adolescents with a flexible chest wall. It uses external pressure to gradually reshape the sternum and costal cartilages.🎯 IndicationsMild to moderate pectus carinatumFlexible deformity (corrects with manual pressure)Growing children/adolescents (most effective during growth spurts)Patient is motivated and compliant with daily use🧰 Types of BracesDynamic Compression Braces (most common)Adjustable external pressure systemApplies inward force over the protrusionTypically worn under clothesCustom-Fitted BracesMade based on the individual's chest shape using scanning or moldingBetter fit and comfortPrefabricated BracesLess expensive but may not fit all chest types well