Swimming Times60 April 2017 April 2017 Swimming Times 61

Pectus condition

Around one in 300 people have some form of pectus condition – a chest deformity that can, at the very least, make you feel self-conscious about undressing

for the pool and at worst can seriously affect your quality of life. Since Olympic swimming medallist Cody Miller spoke out about his own experience with the condition, more and more people are becoming aware that you don’t have to live with pectus if it’s making you unhappy. The good news is that pectus anomalies can be treated successfully – often without surgery – but there is a variety of treatments available and it can be confusing trying to understand what’s best.

What is pectus?Pectus conditions fall into two main categories. Pectus excavatum (PE) is also known as ‘sunken chest’ and affects roughly one in 300 people with a 3:1 male to female ratio. Pectus carinatum (PC) or ‘pigeon chest’ is where the breast-bone abnormally protrudes and affects about one in 1,000

people. Both conditions are present at birth but become more noticeable during adolescence.

The exact causes aren’t known – although pectus excavatum is thought to be caused by excessive growth of the rib cartilage in the chest. While roughly 40 per cent of pectus patients have family members with a pectus deformity, a direct genetic link is yet to be identified.

What are the symptoms of pectus?Pectus conditions are characterised by the chest or sternum appearing to be pushed out (carinatum) or collapsed inward (excavatum) – but these conditions can vary hugely in degrees of severity. Though not fully recognised, other symptoms can include decreased lung capacity, respiratory problems,

chest pain and sometimes compromised ability to exercise.

No matter what the level of severity, there are often psychological issues associated with pectus. It often causes embarrassment, social anxiety and low self-esteem, especially during those self-conscious adolescent years.

It’s great that high-profile Olympic swimmers like Cody Miller and Kevin Cordes are setting an example by being so open about the condition and proving that it doesn’t have to destroy your confidence or prevent you from getting in the pool.

How is pectus treated?Diagnosis is confirmed with physical examination. In mild cases, treatment may not be needed at all and some pectus patients decide that they are happy with their chest

COPING WITH PECTUS

Sam Walmsley, pectus specialist at the London Orthotic Consultancy, explains the facts on pectus, its treatment and how swimming is a fantastic sport for addressing the condition

‘Olympic swimmers are setting an example by being open about it’

A brace is fitted on a young patient; opposite: Cody Miller (left) celebrates Olympic medley relay gold in Rio with team-mates Michael Phelps and Ryan Murphy

Swimming Times62 April 2017 April 2017 Swimming Times 63

Pectus condition

the brace is supposed to be worn for 23 hours a day, with 30-40 minutes of exercise in between, in conjunction with breathing techniques. Deep breathing exercises at certain points during exercise will help to improve your chest’s flexibility to achieve maximum correction to its shape. That makes

swimming extremely beneficial for people with pectus conditions. In fact, the focused breathing that swimming demands works in a very similar way to the breathing exercises we prescribe for our patients.

If you’re using a dynamic chest compressor, you need to remove it for activities like

swimming or contact sports, but wearing a brace shouldn’t stop you doing anything you want to. You should simply try to minimise the time when you’re not wearing the compressor. The ideal scenario is that you remove the brace at the poolside, jump in, and then put it back on when you’re out of the pool or in the shower.

The only swim stroke you should avoid is butterfly, because the process of propelling yourself with both arms simultaneously can compound the problem by collapsing the chest inward. Frontcrawl is different, because you’re keeping your shoulders open while alternating arms. Breaststroke and backstroke are fine too.

Who can I contact for more support?Your first port of call should be your GP, especially if you are worried that you may be experiencing other health problems because of a pectus condition. Often, GPs will reassure you that pectus does not have any long-term associated health risks but they can still refer you to a specialist who should be able to help. However, even if your concern is simply cosmetic, you can also approach an orthotist directly without needing a referral from your GP.

• For more information and advice, visit www.londonorthotics.co.uk/pectus-deformities

shape as it is. For those who aren’t, there is a wide range of pectus treatment options available. Surgery is well established and may improve the patient’s confidence. However, it brings with it associated risks and a chance of scarring. Non-surgical solutions are also available, including treatment pioneered by the late Dr Haje, who showed that chest wall deformity could be improved with a combination of bracing and exercise treatment.

Vacuum bell treatment, for example, uses a silicone cup and a vacuum pump to create an area of low pressure over the ‘sunken’ sternum area.

Another treatment is the dynamic chest compressor – a custom-made orthosis which applies pressure over areas of the skeleton to remodel the chest and rib bones.

Can I swim with a pectus deformity?Having a pectus deformity shouldn’t prevent you from exercising, unless you are in pain or suffer from shortness of breath, in which case you should always seek medical advice. With treatments like the dynamic chest compressor,

A patient with uncorrected pectus;

above: the brace in place

Swimming’s focused breathing is similar to the breathing exercises prescribed for pectus patients

Mount Kelly Swim Centre . Parkwood Road . Tavistock . Devon . PL19 0HZ01822 813170 swim@mountkelly.com www.mountkellyswimcentre.com

50 metre Pool (8 lanes) and a 25 metre Pool (4 lanes)On-Site Accommodation . Catering - Breakfast, Lunch, Tea or Packed Lunches

Swimming Gym . Video Analysis . Activity Hall . Classrooms Extensive Grounds . Sports Pitches . Easy access to Dartmoor

Residential Swim Camp Training Venue

Book Now