PE: Stone Age vs Today (Did it Exist?)

What do you think? Did pectus excavatum exist at Stone Age?

This is what I think!

Yes, maybe very mild cases (?) and the reason to why I believe that, is because I have tried to figure out how the ergonomic environment must have changed since then.

Yet another illustration which I have made in paint (windows 8.1) shows the difference in the ergonomic environment and what must be the difference from Stone Age and now. The illustration is color coded. The upper row is Stone Age and the lower one is today.

1.      Even the environment before birth have changed simply because babies are getting a lot bigger today which practically means that they are more heavily bent today compared to Stone Age.

2.      At Stone Age there were no pillows and soft beds which could bend the body into many unnatural positions. The average risk to get into such a negative situation was therefore very much lower than today.

3.      There were no chairs so they probably sat down in a very natural position most of the time especially good for the upper back and the lower ribs.

4.      They did not form their bodies into S-shapes by raising their heels.

To sum it up: There have never been any reason to develop extremely strong connections between the skeletal system and the muscular system until now (the environmental prerequisites have undergone a dramatic change).

"Some old good genes" find themselves to not fit in to this dramatic environmental change.

That is the reason (I believe) to why genes for such heavy deformations like pectus excavatum, could have passed through the evolution. 

Fix PE=Go Back to Stone Age

Sloped Shoulders Related to Kyphosis, PE and a Fix

Sloped shoulders is very common among people with PE and is both a direct consequence of the kyphosis and the sunken sternum. The idea to help the upper back towards a correct position by using a clavicle support is well known today and I have even seen suggestions from doctors on the internet, that this can help mild cases of PE. But that is without the zero drop/barefoot shoes included! The effective combination; zero drop+clavicle support is a must to even be worth trying. So here I will give my hottest tip for a long time which I have tested myself for some time and it really has a good effect.

   1.      Use zero drop shoes and no heavy clothes on the upper body.

   2.      At the same time as point one; use a clavicle support to help correct the spine.

   3.      Be physically active (stand up and walk) around two hours.

But as always: I don’t think that the more one uses it, the better it becomes. The body needs rest in between as with all form of physical training/stress. After all, you are going to physically correct your body quite dramatically so I use it just few hours a day (at least in the initial stage which I am into right now, zero drop I use constantly, the essential base of the whole thing).

What does the clavicle support directly do?

When the shoulders are held back in a natural position the muscles in the upper back will be activated so that they pushes the ribs in the direction of the sunken sternum, this will straighten the spine upwards and help further lift of the sternum.

I recommend to especially take a look on this post: “Nuss Procedure vs Do-it-Yourself-Procedure”. The clavicle support will help doing exactly what is described there.

Very Important Information: Your collarbones shall never go behind your ears. Don't put pressure on your shoulders. The clavicle support is just an advisor for your muscles so they gets activated correctly and reminds you to keep a good posture.    

Recovery Timeline and the Future

The time has come to make a short description of my recovery timeline as a whole. What to focus on in the beginning and so on. I think one can divide the recovery timeline into three parts from a moderate case perspective:

1.      Posture correction for a few months (it will lift the sternum quite rapidly according to my experience). I recommend to read “Short quick Start Guide”.

2.      Continue with the above (point 1) and do some exercises until the lowest part of the sternum is loosening up and a new way to breathe occurs (this may take several months or around a year).

3.      The beginning of the end of the recovery which includes a continuation of natural ergonomics, my latest sleeping strategy and sporadic exercises if necessary.

After all, the ultimate goal is to come to an end with the struggle against pectus excavatum. I have been thinking a lot lately, when I should not care about it anymore. I have started to be willing to accept a mild case. I must admit that my motivation have decreased dramatically mainly because of two reasons:

1.      I am sure about what causes PE and hope that it over time will lead to clinical studies based on my hard work so that people becomes aware about its causes and future development of PE among humanity will come to a minimum and of course a zero-vision is the ultimate thought.

2.      I have been fighting against difficulties with the breathing process as long as I can remember and when it finally come to an end it such a relief so a small dent don’t bother me in the same way it did before. The physical aspects with PE is what have bothered me most and a struggle against myths related to the condition. And not to mention the complete unwillingness to care about it from a Swedish-health-care-system-perspective. My struggle and my blog is the ultimate revenge and a proof that an impossible mission can be completed (from some aspects). That is how I view it.

Will I give up?

No. I will never give up. But the time has come to withdraw the declaration of war against PE. For me MY battle is over. If my PE will continue to improve, be so. But I am not willing to fight it the same way I did in the past.

Will I continue with my blog?

Yes. I have a lot more to tell especially about my experience in going to the gym. But also a lot of other things. After all, I will continue to develop new strategies and the site is under constant development.

Important to NOT Gain Weight

Or to be more precise: it is important to not put on weight on the stomach.

There are two reasons for that.

1.      My latest strategy “How to Lift Your Sternum During Sleep 4.0” will not work under such circumstances simply because the pressure from the brace will be focused on the belly instead of the ribs, with discomfort in the abdominal area as a result.

2.      The fat on the belly will cause a weight imbalance and make the thorax to lean backwards to compensate for the increased weight on the front of the body and will cause the muscles in the upper back to work in an unnatural way.

Overweight is usually not a problem for people with PE but as I earlier mentioned; I have made such great improvements to my condition so that the over activity in the breathing process is gone. I can barely feel that I breathe anymore, like it should be. The breathing process does not steal most of the calories anymore and as a result I have gained weight even though I don’t eat more calories. And the difference is dramatic. My recovery process have therefore been interrupted for a few weeks and I have made the decision to lose weight to see if the recovery process can continue. My condition is now classified as mild and the only thing I do at the moment (exept incline push-ups) is to focus on the latest sleeping strategy with the brace. Exercises works very well to a certain point but when the PE has become very mild it is better to almost completely focus on ergonomics and the latest sleeping strategy I think. That’s the only thing I do right now. With other words; exercises have a very limited effect on mild cases from my experience. What is mild PE? My definition of mild PE is that the flared ribs are almost gone and that it is possible to feel that the lowest part of the sternum is loosening up. At that point the sternum will probably be just a few millimeters indenting and the spine in the upper back has "disappeared" (the kyphosis is gone). The reason to continue with incline push-ups is that the pectoralis muscles in the upper chest is quite underdeveloped in people with PE and I will try to fix the muscular asymetry. It is also good for the posture and kyphosis.  

Overgrowth of Costal Cartilage the Cause of PE?

One of the biggest myths related to pectus excavatum is that overgrowth of costal cartilage is the cause of the condition. On some medical sites on the internet this is presented as a fact. But as usual when it comes to PE; no statistics and no clinical studies that can prove the claims. But there are actually some studies made. I first heard about “the rumor” about the cartilage around ten years ago, but as usual I never think that there is any reason to believe in “facts” which have not been proven. However the “fact” that PE is caused by overgrowth of cartilage, have been verified by a few people from the medical world and a study can now prove once and for all that:

Overgrowth of costal cartilage is not the etiology of pectus excavatum.

Link to the outcome of the study: http://www.ncbi.nlm.nih.gov/pubmed/20920721 

The purpose with this post is to contribute to that false information about pectus excavatum must be put to an end for the sake of those who suffer from this condition.

(The study was made a few years ago so some people whom read this probably know already).

Football/Soccer Player=Perfect Posture Why? Shoes?

When I say perfect I mean perfect, not just good.

This is the answer.

Have you ever seen a football/soccer player with bad posture? I have, but only goal keepers. I think that taking a look on football players is the closest to an evidence one can get for that zero drop/barefoot shoes, combined with physical activity,  makes it highly unlikely or maybe even impossible to develop bad posture. Goal keepers are not as physically active on the football field, so that is probably the reason why they in general have a little worse posture than players whom are more active. And I have an extraordinary experience to tell. When I grow up I saw a guy with pectus CARINATUM (not excavatum) completely grow out of it between he was 12 to 22. I don’t think that it is a coincidence that he was a very active football player (training 3-4 times a week). Although I have seen soccer players with pectus excvatum, the degree of them have always been very mild. If they started to develop it before or after they started to play football, is to me unknown. Even  possible improvements after they started to play is unknown to me as well. Almost all shoes used on a football field are zero drop or very mildly lifted. On the other hand the heels sinks down quite easy on the field so maybe a little elevation won’t hurt.

Whenever I try to falsify* my theories, they just get stronger!

*prove (a statement or theory) to be false

The Truth About Pectus Excavatum (Link to Wikipedia)

After a lot of talking on my site about “scandal” and “myth” (especially in Sweden where  I live) I just want to make a post that links to what I believe is the closest to the truth one can get which comes from another source than myself. I have read through this (wiki) a couple of times and agree with most of it and I think that it is something that Swedish doctors and probably doctors in other countries as well shall look on and ask the question to themselves; why does this not match what is written in the National Encyclopedia or my Medical Lexicon? Obviously, Wikipedia is more up to date to say it straight out. I recommend everyone whom gets in conflict with their doctors about thier health condition related to PE, to tell those doctors to look in Wikipedia so they hopefully will rethink what they are so sure about.

But there is one thing which is wrong in the text (the same as in all lexicons). PE can NOT be classified as a congenital disorder or disease. For me that is obvious. I wonder, is that hard to understand? You can’t call something congenital which can start to develop during puberty. Once again, is that hard to understand? I will put a link to the definition of “congenital” as well. I don’t think you must be Einstein to understand that this is obviously contradictive! The right thing to say should be: PE can sometimes be present at birth and is probably partly genetically predestinated together with other factors. And I am sure about, according to my theory, that environmental factors plays a key role even before birth. The environment before birth is definitely not perfect for the human body (ergonomically).

Link to Pectus Excavatum on Wikipedia: http://en.wikipedia.org/wiki/Pectus_excavatum

Link to Congenital Disorder or Disease on Wikipedia: http://en.wikipedia.org/wiki/Congenital_disorder

This is the last time I will bring up this subject (hopefully) but as I earlier mentioned; another source than myself can be good to have a look on. I will from now on focus on more serious things.

And as in my other posts concerning this question; some people working in health care systems around the world already know about this contradiction. I don’t want to offend anyone. I just want the truth to come out in the light.

How to Lift Your Sternum During Sleep 4.0

I think that I may have found the key to lift the sternum completely, or at least very effectively during sleep by put a brace on the lower ribs while lying on the back without lifting the head up with a pillow.

I have like many others tried to brace my lower ribs many times in an attempt to fix pectus excavatum but without any results at all. The key is according to my experience to use the brace only during sleep the initial 2 hours during the night, then remove it and not use it during the day. For example I have found during my testing that it even can make the sternum to sink in while sitting down. So once again; According to my experience it works only while lying down on the back without pillow on a quite hard surface.

The brace I use looks like this.

It should be put on like this, right below the pectoralis muscles.

 

 
This photo was taken after 2 hours on my back with the brace. I could see a difference immediately (once 50 now 4-5 mm).

If you can’t sleep with the brace on, I have a tip: Why not watch a movie during 2 hours? Just place the TV/monitor on the ceiling (it is important to look straight up or slightly downwards).

Try to breathe through the nose so that the intercostal muscles gets as deactivated as possible.

Basic extremely important rule: Try to put as mild pressure on the lower ribs as possible without losing the effect. If it is put on too tight, the pressure from the sides will be too great compared to the pressure from front view, and very likely, the effect will be lost.

I recommend to stand up a few minutes before the brace is put on and it should be put on while standing as well. The brace should almost fall off in a standing position and when you lie down, you will probably find that the pressure from it will increase.

Another important thing is that it will work optimal around 3 hours after the last meal. The diaphragm will have more space to operate in under such circumstances and therefore produce a stronger lift effect on the sternum from the inside.

High Precision Measurement of PE

As I have stated many times; I think it is important to measuring the depth of PE quite often. The reason is that it can be very difficult to see with the bare eyes if one lifts the sternum let’s say 2 mm in two weeks. 2 mm may not seem that much in a two weeks period but in one year, at that rate, it will be 5.2 cm which is not that difficult to calculate. It means that most moderate cases should be minimized in one year. I can say from my own experience that the improvement rate was extremely fast in the beginning and the only thing I did in the beginning was to quit lift the heel and also stopped lifting my head up while lying on the back. I remember that by only doing that I lifted my sternum from around 5 cm to 3.5 cm in 60 days. After that the progress rate slowed down. I also remember the excitement of measuring it almost daily and it got me motivated at a maximum level. If one can’t see any difference in the beginning (just with the eyes) it may lead to that the motivation drops sharply even though there is a slow improvement progress.

Here is a suggestion to; how to make high precision measurement of pectus excavatum:

Take a piece of wood stick (wood is not as cold as metal) and drill a hole on the middle; big enough to make it possible for a vernier caliper to fit in it. Also try to find a small coin or any very hard coin like object.

Make preparations for a correct calculation of the depth:

Measure the thickness of the stick and the coin.

It should look like this while the actual measurement takes place.

 

 

Try to do it as accurate as possible by lying down on a hard flat surface and look straight up “in the ceiling”. If you look down on the PE while measuring you will probably find that it will be deeper while you look down on it and this experience will also proof the fact that the sternum lifts out by NOT using a pillow while sleeping on the back.

Make a correct calculation of the actual depth:

I recommend to make a series of measurements to get used to it and to learn how to do it with high precision.

Let’s say you measure the depth to 35.0 mm. After that, remove the thickness of the stick. The thickness of the stick in the picture is 14.0 mm. This means 35.0-14.0=21.0. After that you must do the opposite with the coin. The coin in the picture is 1.2 mm. This means 21.0+1.2=22.2 mm or expressed in another way 2.22 cm. Now you have the actual depth.

(If you don’t know how to use a vernier caliper, it can be a little tricky if you are a beginner, just google it).

Kyphosis Fixer for PE 2.0

The aim with this exercise is to straighten the spine (which will make the sternum to lift out) and at the same time bend the flared ribs inwards from a front view perspective.

I have made some changes to the first one to make it more effective.

1.      Lie down on a flat horizontal surface on the stomach and hold a pair of light weighted dumbbells.

2.      Form your legs like a “V” and bend the knees 90 degrees (this is to get the pelvis into a beneficial position).

3.      Lift your arms in a “military posture style” so that they touch each other at the same time as you lift your upper body up a little so you can feel a distinct pressure on the flared ribs. Look forward.

4.      Repeat 10 times, 3 sets.

       
       5.    Try to take a short walk (barefoot style) right after this exercise. You should feel that your body
               straightens up while walking.

Short Quick Start Guide

For those who wants to try out what I have done; here is a short Quick Start Guide.

This is also a recommended start and if zero drop shoes are ignored, the rest of my blog is more or less meaningless.
   

It is very important to understand that exercises is just a complement to a complete change of ergonomics around the clock. The most problematic thing is that most people don’t use barefoot/zero drop shoes, and this is the most important thing to change (flip flops is a cheap alternative). Except the shoes, the best and fastest thing to start with is to remove the pillow during the first 2 hours during the night and sleep on the back. Then the rest of the night with a pillow on both the left and the right side. This will help to fix the kyphosis related to PE which is a prerequisite for the sternum to lift out.

Try to measure the depth daily so you can see the important small changes that makes you know you are on the right way.

The fastest way to go forward with exercises is “special pushups for pectus excavatum”. And another good way to start is to try out the breathing exercise where you holds the breath. Its purpose is to save energy which will help to build up the body.

Being physically active (stand up or walk) during the first hours in the morning have proven to me, to be very beneficial.

"Sitting Posture that Lifts Out the Sternum" is a very effective and easy thing to start with. Try to avoid a back leaning posture while sitting down in general.

A tip is to take a look at my post about "Nutrition and Pectus Excavatum".

Always warm up before doing exercises by taking a short or long walk (always around the clock zero drop).

This exercise is more or less a must to effectively reduce/fix PE: CLICK HERE

/I think this is a very good start for a beginner.

All information you need is here on this blog.

Sternum Lifter 2.0

I have now a second version of my completely own exercise ”Sternum Lifter”. I simply call it;

Sternum Lifter 2.0

I have implemented the same idea as I did with the exercise “Modified Dumbbell Pullovers 2.0” and the idea is to increase the amount of force in the abdominal area by lifting the legs in the form of a “V”. And the reason for the new one is to be able to use heavier weights which will produce more force on the sternum and make it to lift and stretch more effective.

1.       Lie down on the back on a flat absolutely horizontal surface and hold a pair of dumbbells.

2.       Lift your legs, arms and upper body at the same time. It is important to not lift the arms too highly. Not higher than the illustration shows.

       3.     Repeat 10 times, 3 sets.

Modified Dumbbell Pullovers for Pectus Excavatum 2.0

Warning! 

This exercise is the second modification of ordinary dumbbell pullovers and it needs a sharp warning because now it is time for heavy weights and extreme stretching of the sternum and the flared ribs. Beware of injuries.

After some time with my first version I can say that they have helped a lot but after many weeks I have reached a point where heavier weights is a must to make it possible to lift the sternum even more. This one is according to my experience even more effective against flared ribs than the first modified version.

What is new?

I have added more powerful activation of the abs by lifting the legs with the form of the letter “V”. The best is to lie down on a floor or any other flat horizontal surface.

1.       Start in the same position as the ordinary version or my modified first version (start is always the same for all of them).

2.       Lower the quite heavy weight and lift your upper body from the surface at the same time as you lift the legs. The “V-form” of the legs is to minimize the risk for injuries in the lower back and it is strongly recommended to not skip this part.

3.       Repeat 10 reps 2-3 sets.

Sternum to the Right Strong Ergonomic Indication

In some cases the sternum is twisted to the right. Why?

This fits very well into my “ergonomics+genetics-theory”. The reason for the sternum to be more dragged to the right is according to my theory the fact that most people are right handed.

What do we humans do that can explain the asymmetry of the sternum to the right?

 

 

The illustration shows what happens while using a computer with an ordinary mouse.

1.       The whole arm moves sideways.

2.       The shoulder rotates.

3.       The muscles in the upper back becomes shorter because of spasm and drags  the  sternum  inwards more on one side, in this case to the right.

Tip: Use of a track ball mouse is preferred from an ergonomic perspective and keeps (if used correctly) the shoulder in an “un-rotated” position. I personally prefer a handheld track ball mouse. A little tricky in the beginning but after a while very easy to use and ergonomically; I would say perfect.

This means that I believe that all types of positions that rotates the shoulder may be a potential reason to the twist to the right. Another reason could be to sleep on the right side most of the time.

Foot Recovery Update Before/After

During my research about PE I also found out that flat feet are linked to the condition and after strictly using only professional barefoot shoes (zero drop) my feet have recovered in an almost miraculous way. Today my “ex-torture feet” are healthy and almost completely healed, no pain at all. My philosophy is to not use any support, which I believe makes the muscles in the feet to work in a natural way. The more I walk the more healthy my feet gets. When I put my feet on the ground the arches falls a little down but that is the type of feet I have. Now compared to then; they are not extremely flattened and deformed anymore.

It is tree months between the two pictures. The first one was uploaded here on my blog after some progress in December 2013.

This proves to me that ordinary shoes can cause a lot of damage to the feet.

 

 

Note: During the healing process it may occur some pain when they are being transformed to normal. I recommend to strictly not running during the healing process.    

Nuss-procedure vs “Do-it-yourself-procedure”

The Nuss-procedure forces the sternum out with a metal-bar and because of that also forces the rest of the upper body into a correct position.

The Do-it-yourself-procedure, developed by me (B. RL Åkerström) forces the surroundings of the sternum (the rest of the upper body) by natural ergonomics, towards a correct position and as a consequence of that forces the sternum towards a correct position.

People whom have undergone the Nuss-surgery (I have followed forums) in general complains about pain in the upper back. The reason is of course the fact that the ribs that are attached to the sternum also are attached to the shortened kyphotic upper back. The lift of the sternum will cause an enormous stretching in the upper back when the ribs moves forwards together with the sternum.

A little pain may occur during the Do-it-yourself-procedure as well (in the upper back) at some points in time. From my experience; the pain is very mild (like doing weight lifting). You will slowly move the sternum and the rest of the body towards a correct position (like moving teeth). From my experience the recovery process is very fast in the beginning if it is followed 100%, and it will be more and more slow the closer to full correction one gets. My record for now is:  A little more than 90% corrected.

The illustration shows that the "Do-it-yourself-procedure” is a non-surgical “mirror-image-effect” of the Nuss-surgery.

Nuss

1.       A force under the sternum push it out (a metal-bar).

2.       The ribs moves in the direction of the lifted sternum.

3.       The spine straightens.

Yourself

1.       The spine straightens because of natural ergonomics.

2.       The ribs are pushed in the direction of the sternum because

the spine straightens.

3.       The sternum is forced out by the ribs with help from the

                “natural metal-bar” the diaphragm.

For Me a Huge Improvement (flexing photo)

I have gained weight both muscles and fat. I think the total dip is around 1.9 cm (fat and muscles 1.5+sternum0.4). Once it was around two inch without muscles and fat included, so this is for me "almost completely out".

I have found it especially important to be up on the feet to keep the sternum in this position. If I sit down too much, it sinks back around 5 mm quite fast.

I think that my modified dumbbell pullovers have made a lot to the positive but it is very important to not do them too much, as all form of training. I have lately made some test to verify my shoe-theory and it has yet another time been confirmed that it is impossible for me to lift the heel. The sternum sinks in extremely fast because of the S-shaping posture they produces which is described in detail on my blog. 

After my healing process of my feet I can’t use shoes with heels for yet another reason. I immediately get pain and it is clearly visible that they get deformed. Once moving back to nature, there is no reason to look back.

As always: Zero drop/barefoot shoes is a must (the natural way). If Ignored=Mission Failed with the higest degree of certainty possible.

Biochemical Reasons to Development of PE

Biochemical base theory: Is there a possibility that biochemical reasons can cause pectus excavatum?

I made a post here on my blog about nutrition and PE and I have put a warning flag on especially wheat and the chemical substances that it contains as a possible biochemical reason to cause/worsen pectus excavatum or possibly make the recovery impossible. My whole blog have until now been mostly about the mechanical reasons. As I have already mentioned earlier last year on my blog; technical reasons causes the muscles in the upper back to malfunction (the blood flow decreases). When this happens, it will cause the upper back to be shortened. If it wasn’t for that reason (the shortening) it would be impossible to develop severe cases of the condition and it would also be a lot easier to recover from it.

The most difficult part of the recovery is not the sternum itself. The most difficult part is to stretch/make the muscles longer in the upper back. That is, as earlier mentioned, a prerequisite for the sternum to be able to pop out.

The following phrase is one of the most important phrases on my blog:

Anything that can make the muscles in the upper back to get them into a spastic condition can without doubt cause pectus excavatum to develop. When the muscles is getting shorter because of spasm, they will cause a free fall of the ribcage and make an already high mobility to become even more mobile, the same way it happens because of mechanical reasons. The connective tissue and the spine will be put under heavy muscular force vertically. The big question will be; can they withstand the force? Genetics will determine! If they can’t the ribs in the upper back will drag the sternum inwards the same way as described in other posts on my blog.

After this statement is made it also opens up for the possibility that pectus excavatum can be caused and/or worsened by chemical substances produced by the body itself during heavy loads of psychological stress. Many substances produced under such circumstances can cause muscular tension.

To understand why tension in those muscles can be so devastating, it is also important to know in what direction the muscle fibers are aligned.

Many of them are aligned in a way that will cause a vertical force during a spastic condition. This part of the body, the upper back, is ONE OF THE MOST NERVE RICH PARTS OF THE BODY and will therefore be more vulnerable for chemical substances.

I believe that biochemical factors and/or psychologic stress, in some cases, can be the last drop that makes the cup run over.