Ordinary Shoes the Main Cause of Pectus Excavatum

How can a small change under the feet cause pe?

I think we have to start from the beginning and ask a very basic question. What are the bones and the muscles in the body for? If the bones were removed the body would fall to the ground obviously. What would happen if the muscles were removed? The same thing. The conclusion of this is that the muscles and the bones are dependent of each other to keep up the human body. I think it’s important to keep that in mind.

Now to the question what will happen when you lift up the feet with “ordinary shoes”? My definition of ordinary shoes is that there is a difference between the front and the back of them causing the human heel to lift up a little. If not all, almost all shoes are constructed this way, why? I think it is mostly because of three reasons: Cultural, economy and design. Is it for some medical reason? No, except from one purpose. What? Running. The human body is optimized for walking. When doing this the muscles and the bones work together perfectly and hold it in an ergonomically perfect position (without shoes with heels). This is not the fact when running. So here shoes with heels will help. The only reason to use shoes with heels from a medical perspective is to use them when running.

Now I will explain how ordinary shoes can cause a trauma in the human body. First of all it’s not possible to do that if there is not a genetically factor involved and that factor is a high mobility and a composition of the body that is not made for alternation. Almost all bodies look a little different and also work a little different. So I think it is possible to have high mobility in the body without having pe. It depends a lot on how the construction is built up not only from a mobility perspective.

The lift of the heel
Let’s take an example. A human is standing on a flat surface, let’s say a floor in a house without shoes at all. Let’s say that the weight of the human is 60 kg. Each foot have to keep up a weight around 30 kg. Now let’s have a look at one of the feet. The human does not move. Where is the weight concentrated? On the heels or on the front of the foot while standing still? I don’t think this needs an explanation. Almost all of the weight is concentrated on the heels. Now let’s put on an ordinary shoe that lifts up let’s say 2 cm under the heel. We do it on booth feet. Where will the weight be concentrated now? I think the best way to understand what I mean here is to do this experiment by yourself. What you will find is that there will be a higher pressure on the front of the feet after the shoes have been put on. To compensate for the higher pressure on the front of the feet the body reacts by lean a little bit backwards to release the weight at the front. You can have a look at my webbsite (or blog) and compare the two figures to know what I mean. This is the devastating reaction that may led to pectus excavatum and I will now explain what may happen if there is a genetic predisposition for it.

In the example above a lot more things will also happen in the body. First of all when lifting up the heel the distance between the heel and the knee will be shorter. This leads to that the muscles in the whole lower part of the body (the legs) will start to work in a different way than it is supposed to do. This in turn will tilt the pelvis a little forward. This in turn will change how the muscles will work in the whole upper body. Together with the compensation from release of weight from the front of the feet (as I earlier mentioned) the upper part of the back will be put under pressure because the muscles and bones are no longer able to hold it up in a perfect way. How can this be so devastating? When the upper part of the body starts to compress, the blood flow will be reduced and the muscles in the back starts to malfunction leading to what I will call a free fall of the ribcage. This you can also see be illustrated in the two pictures on my website. This will lead to a permanent shortening of the back and cause the spine to take an unnatural curve called, kyphotic spine. By doing this constantly day out and day in, year out and year in the thorax will be more and more rotated as the years goes by. One thing that also happens is that when the thorax rotates the diaphragm can no longer work properly and keep the pressure from inside of the body causing the sternum to sink in even more (not only because the ribs pulls it in). The diaphragm is a very important muscle that is supposed to keep pressure under the sternum, it will not work properly when the thorax is rotated.

Why is the abdomen affected in most people with pe? The rotated pelvis and the flared ribs will keep it in wrong position cause even more malfunction in the back.

Why do the ribs flare out? This is caused by the rotation of the thorax but it will become even worse because the pressure from the diaphragm that is supposed to expand the lungs in the upper part of the body can’t do it properly. To compensate for the impossibility to expand the lungs under the sternum the pressure from the inside will be concentrated to the lower part of the thorax. So by constantly breathe with the lower part of the lungs it will cause the ribs to flare out even more (not only caused by the rotation). Advanced Version Here