Contents · 12 sections
My lower ribs used to stick out on the left side. They improved, and not because anyone operated on me.
Most of what you will read about flared ribs treats them as a bone problem. For many people they are not. They are a ribcage stuck in the breathed-in position, and that is trainable.
Rib flare, or flared ribs, means the lower edge of your ribcage angles outward and forward instead of lying flat against your torso. That edge is called the costal margin: the arch formed by roughly ribs 6 to 10 where they join the cartilage running up to your breastbone. A flare can be on one side or both, and it ranges from barely visible to painful, as the Pectus Clinic, a surgeon-led chest wall clinic in London, describes it.
Whether your ribs settle when you breathe all the way out tells you more than whether they stick out, and the first check below answers that in about a minute.
First, check that it is actually rib flare
A lot of people arrive here having diagnosed themselves from a bad photo. Two checks sort it out. Neither is a diagnosis, but together they tell you which parts of this article apply to you.
The resting check
Stand relaxed in front of a mirror, arms at your sides, and breathe out fully. Not a polite exhale. Push the last of the air out until your stomach tightens on its own.
If the lower ribs settle flat against your torso at the bottom of that exhale, you do not have a structural flare. You have a breathing pattern that keeps your ribcage parked in the inhaled position. In my view that is the version that responds best to work.
If the bottom ribs still jut past the line of your waist at full exhale, keep reading. There is something structural underneath.
What a flared ribcage looks like next to a normal one
| Normal costal margin | Flared costal margin | |
|---|---|---|
| Widest point of torso | Shoulders or hips | Base of the ribcage |
| Margin at full exhale | Settles flat to the torso | Still protrudes |
| Angle of the lower ribs | Turns inward and down | Turns outward and up |
| Gap from ribs to pelvis | Short | Visibly long, front of the body looks open |
| Through a t-shirt | Not visible | A bump below the chest on one or both sides |
The confusing part is that being lean makes a normal margin visible, and people mistake visibility for flare. If your ribs show but the outline of your torso still narrows below your chest, they are just ribs.
The compression test
Press the protruding ribs inward with the flats of your hands, firmly but without forcing. If the margin gives and the contour improves, your chest wall is still flexible, and a flexible chest wall is the one that responds to pressure and to training.
If it barely moves, your chest wall is stiffer. Age matters here. The chest wall becomes less flexible as you get older, and the Pectus Clinic’s surgeons find bracing works best in adolescence, while the chest is still growing. In adults the bony structure is set, so expect compression to do less and more of the change to come from how the ribcage is held, from muscle and from body composition.
Find out which kind you have
Three different situations get called rib flare. This is my practical way of sorting them, not a medical classification. They need different work, which is why one generic routine does not fit everyone.
Which kind of rib flare is yours?
Four questions, using the checks in this article. It sorts you to the right section; it isn't a diagnosis.
Answer the first three questions to see where to start.
Pain, clicking, or ribs that change shape quickly? See a doctor first.
Flare that comes with pectus excavatum
This is my case. Pectus excavatum is a chest where the breastbone sits sunken, and the Pectus Clinic sees rib flare most often alongside it and alongside pectus carinatum, where the breastbone sticks out instead. Dr. Antonio Vendrami Malucelli, a pectus surgeon whose team has evaluated more than 7,000 patients, writes that about half of them show a raised lower rib margin.
Why the two travel together is not clear. Even the cause of pectus excavatum itself is not well understood, according to a 2012 review, so I will not hand you a neat mechanism. Breathing will not reshape a sunken breastbone, but the flare work below applies to you and runs alongside whatever you do for the dip, such as a vacuum bell (a suction cup worn on the chest to lift the breastbone).
Not sure you have pectus excavatum as well? Start with what pectus excavatum is and how to tell how severe yours is.
Flare that is really overextension
Here the ribs are a normal shape. The lower back is over-arched and the pelvis is tipped forward, so the bottom of the ribcage is carried up and away from the pelvis. An arched lower back and lower ribs that sit raised and turned outward tend to show up together.
To tell this one apart, lie on your back with your knees bent, flatten your lower back into the floor and breathe all the way out. If the flare largely disappears in that position, it was postural. I think this version changes fastest of the three, because nothing structural has to.
Flare from scoliosis or another structural cause
Scoliosis is a sideways curve of the spine that also rotates it. The ribcage rotates with it, so one side can turn outward, and an X-ray study of teenagers with scoliosis uses rib flare distance as a reliable measure of that rib cage deformity. If you have both scoliosis and pectus, how the two interact is covered separately.
Other structural causes belong in the same group: something you were born with, an old rib injury, or costal cartilage that is looser than usual. That last one goes with hypermobility (joints and cartilage that move further than normal) and with Ehlers-Danlos syndrome (EDS), a group of inherited conditions that make connective tissue unusually stretchy.
If your flare is clearly one-sided, or you know you have one of these, get it assessed before you spend six months on breathing drills. Symmetrical work on an asymmetric structure only goes so far.
If you are still not sure which of the three is yours, the free one-minute quiz asks the same questions and points you to a plan that fits.
Rib flare on one side (left rib flare)
One-sided or uneven flare is common. When both sides flare, the Pectus Clinic describes the left as more often the more prominent one. That is an observation from their clinical practice, not a measured rate, and they say the reason for it is not fully established.
Mine was on the left.
What can make one side flare more:
- Scoliosis, where the ribcage rotates with the spine.
- An uneven pectus excavatum or carinatum. The dip in pectus excavatum is often asymmetric to begin with.
- Something you were born with, or an old injury to the lower ribs.
- Posture and muscle balance. The Pectus Clinic links asymmetric flare with a rounded upper back, a forward head posture and muscle imbalance. One physical therapy model, Postural Restoration, describes a left rib flare as part of a common asymmetric posture pattern, but that comes from clinical commentary, not trials.
How to fix a left rib flare
The work is the same as for a flare on both sides, but you check each side separately and give the flared side more attention.
- Run the checks on each side. Compare left and right at full exhale and in the compression test. If the left settles, the extra flare is mostly position. If it stays out and barely gives, part of it is structural.
- Get assessed first if it is clearly one-sided, painful, or your shoulders or hips sit at different heights. Those can point to something underneath, such as a spinal curve.
- Do the same breathing and anti-extension work, with extra attention to the flared side. Watch which side lifts first when you breathe in or reach overhead, and slow down on that side. Side planks tend to show the difference clearly. The exercises are linked in the training section below.
- Consider compression for a structural one-sided flare, after assessment. A brace with adjustable pressure can press harder on one side than the other.
Expect improvement rather than perfect symmetry, especially as an adult.
Rib flare in women and after pregnancy
Rib flare is not only a men’s issue, and pregnancy changes the ribcage in a way that can look similar. During pregnancy the lower ribcage widens. The subcostal angle, the angle where the two sides of the lower ribcage meet below the breastbone, goes from about 68.5 degrees early in pregnancy to about 103.5 degrees at term, according to a 2015 review of breathing in pregnancy. The lower ribcage is also wider and larger around in the third trimester than after birth.
I have not found good data on how fully or how quickly it returns after birth, so I will not give you a timeline. If you have recently given birth, get the go-ahead from your doctor or midwife before you start core work.
Breast tissue can partly hide a flare, so the mirror check may be less obvious. The compression test and the lying flat-back check do not depend on how the front of your chest looks.
Lower ribs that stick forward can also make a bra band hard to settle. The guide to bras for pectus excavatum covers band fit, and pectus excavatum and pregnancy covers the rest if you have the dip as well.
What tends to travel with it
A flare can come as part of a set of linked findings, and those are often what push people to do something about it: shoulders that sit forward and rounded, a head carried in front of the body, tight chest muscles, a lower back that arches more than it should, and a stomach that can look distended even on someone lean, because the front of the torso is being held open.
Two are worth singling out. With the ribcage parked in the inhaled position, you may never fully empty your lungs, and breathing tends to shift to the top of the chest, which can feel like never quite getting a satisfying breath. And because your shoulder blade glides across the back of your ribcage, a ribcage out of position can leave the shoulder borrowing range from elsewhere, one reason shoulder pain can turn up alongside a flare.
None of this is dangerous by itself, but it makes the flare a mechanical problem worth solving, not only a cosmetic one.
When to see a doctor first
Self-checks are fine for sorting out what kind of flare you have. They are not fine for these. See a doctor before you start any of this work if you have:
- Pain along the lower ribs, especially with exercise, long sitting or pressure on the area.
- Clicking, catching or sharp pain at the rib tips with certain movements. That can overlap with slipping rib syndrome, where a lower rib moves more than it should and catches or clicks against its neighbour.
- Known hypermobility, Ehlers-Danlos syndrome or Marfan syndrome. Loose connective tissue changes both the assessment and the choice of approach.
- Chest pain or breathlessness, or a diagnosed heart or lung condition.
- A clearly asymmetric ribcage, a visible curve in your spine, or uneven shoulders or hips.
- Previous chest wall surgery.
Rib flare is mostly assessed by examination, and scans are not routinely needed.
The one thing that actually closes a flare
Part of your diaphragm, the dome-shaped breathing muscle under your lungs, lies flat against the inside of your lower ribs. That contact area is called the zone of apposition, and your abdominal muscles help control it. When they work, they pull the lower ribs down and in and help maintain that zone.
When your ribcage is held high and open, as it is in the breathed-in position, the zone shortens. A shorter zone and lower ribs that sit raised and turned outward go together, and that outward turn is what you see as flare.
So the training job is this: get the ribcage down, then learn to breathe without letting it come back up.
To be straight about the evidence: a PubMed search in October 2026 turned up no controlled trials of exercise or any other conservative correction for rib flare. This is reasoning from mechanism, not from trial results, so treat any rib flare success percentage with suspicion.
Get the ribs down first
Lie on your back, knees bent, and breathe out through pursed lips as though you are blowing out candles, past the point where you would normally stop. Near the end of that exhale your abs engage on their own and you will feel the lower ribs drop.
Now breathe in without losing that position. At first it will feel like you cannot get enough air. You can. Your body is simply not used to breathing with the ribs down.
Then learn to keep them there under load
The core work that matters for rib flare is anti-extension work, where your abs stop the lower back arching and the ribs lifting while something else moves. In the dead bug, an arm and a leg move while the ribs and lower back stay put. That is also why crunches do little for a flare: they train the abs to shorten, not to hold a position while you breathe and move.
The plank with a posterior pelvic tilt, tailbone tucked under, teaches the ribcage and pelvis to stay stacked.
If your ribs flare when you lift your arms, you have found your restriction. Practising the overhead reach without letting the back arch carries over into pressing, pull-ups and anything else overhead.
The full set, in order and with how much to do, is on the rib flare exercises page. This guide stays with the why.
Free up what holds the ribs open
Your lats, the wide muscles down the sides of your back, can pull on the pelvis and hold the ribcage open, which makes the work at the front harder to hold. A doorway lat stretch and a chest stretch make the breathing work easier to do well.
If you foam roll, stay off the lower ribs themselves. That area is thinly covered, and I would not risk it. Roll the lats high, near the armpit.
Hold the position when you are not training
This is what separates people who change a flare from people who own an impressive collection of exercises.
Your ribs spend every hour you are not training in their old position, and twenty minutes of good work does not outvote that. The habit I would put first is carrying the position around: a gentle abdominal engagement while walking, sitting or standing in a queue, held as long as you can and then let go.
Set a recurring alarm if you need to. When it goes off, breathe out fully, let the ribs settle, and carry on. It is unglamorous, and I rate it above any single exercise on this page.
Where braces and bandages fit
External compression is a real option for structural flare: steady pressure on the lower ribs while the chest wall is still flexible enough to respond. If you are young and your chest wall gives in the compression test, this is the window.
That is me in the brace above. The pads sit on the costal margin itself, not on the breastbone, which is the difference between a rib flare brace and a pectus carinatum brace that presses on the sternum.
Prof. Dr. Mustafa Yüksel, a cardiothoracic surgeon who founded PektusKlinik in Istanbul and is president of the Chest Wall International Group, uses a bandage for rib flare. When we spoke, he told me his team treated rib flare surgically until 2018, when they switched to the bandage, and that it needs to be worn at least eight hours a day. His clinic’s current page on the bandage describes wearing it around the clock for 6 to 12 months, and says surgery is now kept for older patients the bandage does not correct. Those wear times differ, so if you go down this route, follow what the clinic tells you at your assessment.
Bracing also works best paired with training rather than instead of it. Brazilian orthopaedists treat pectus excavatum with a dynamic compression brace whose pads rest on the lower ribs, combined with exercises, and their results were best in the patients who kept up both regularly. That is pectus excavatum data, not rib flare data, but the logic carries over. Compression changes the structure slowly. The breathing and core work changes what holds it there day to day.
Which is why I trained in it. Wearing it under a t-shirt also made the hours easier to build up. The rib flare brace I sell is made to your measurements with adjustable compression, and the rib flare brace guide covers how to wear it and what to expect.
When surgery is the honest answer
Many people with rib flare never need surgery. Some do, and pretending otherwise helps nobody.
A point worth knowing if you are heading for pectus surgery anyway: correcting the excavatum does not reliably correct the flare. In the Nuss procedure, a surgeon slides a curved metal bar behind the breastbone to push it forward. In a Korean series of 1,571 Nuss patients, the flare improved in children aged 11 and under, but the groups aged 12 to 20 and over 20 showed no improvement in flare.
The operation can also make the flare more noticeable. A 2010 report from Amsterdam describes this as rare in children and treated it in five of them, with good results, by removing part of the costal arch cartilage. In adults, a 2023 Japanese study of 63 patients says the standard Nuss often lifts the costal arch along with the breastbone, and found that separating the seventh rib cartilage from the breastbone during the operation prevented it. If you are having a Nuss and the flare bothers you, ask about this before the operation, not after.
For flare with no other deformity, there is no single standard operation. The Pectus Clinic describes surgery as a customised procedure: removing part of the costal cartilage in selected cases, usually where there is pain or instability, or stabilising the lower ribs. Raise it with a chest wall specialist rather than a general surgeon.
What actually happened to my ribs
I was diagnosed with pectus excavatum at 15, and I had rib flare too, on the left side. I declined surgery.
Dr. Blagoja Gjorgjieski, a physiatrist (a doctor of physical medicine and rehabilitation) and yoga professor at the hospital in my hometown of Prilep, was the one who told me the flare could be improved without surgery.
I wore the brace you saw above, and I trained in it. The pectus correction took about three years of daily vacuum bell use and structured training. The result was visible and measurable, and it is not complete. It is a real improvement, not a perfect ribcage.
How long this takes
Longer than you want, and it depends on which kind you have.
A postural flare, the overextension kind, can look different within weeks, because you are changing where your ribcage is parked, not its shape.
Structural flare runs on months to years. The only published figure I have found is the 6 to 12 months of full-time bandage wear on Prof. Yüksel’s clinic page, and that is a clinic describing its own results. I would expect training alone, without compression, to be slower.
The two things I would watch most are how flexible your chest wall is when you start, and whether you carry the position through the day rather than only during exercise. Age drives the first. You drive the second.
Frequently asked questions
Is rib flare dangerous?
On its own, usually not. Prof. Yüksel’s clinic notes that the protrusion does no harm to internal organs. What can matter is what comes with it: pain, a breathing pattern stuck high in the chest, and in one-sided cases a spinal curve underneath. If you have chest pain, breathlessness, clicking or catching at the rib tips, or a clearly asymmetric ribcage, get assessed rather than self-treating.
Is rib flare permanent, and can adults fix it?
Not necessarily. The postural kind can change a lot at any age. In teenagers a flare can get worse during growth spurts and then settle once growth finishes. In adults the bony structure is set, but the appearance can still change with posture, muscle and body composition, so expect improvement rather than resolution, and ask about bracing early if your chest wall still gives in the compression test. Anyone promising a complete fix without examining you is guessing.
Are flared ribs genetic?
Pectus excavatum often runs in families. One 2022 study of 78 people with isolated pectus excavatum found a family history in 54% of them, and no single gene has been identified. I have not found evidence that rib flare on its own is inherited in the same way, and the breathing and posture pattern that makes a flare more visible can change whatever you were born with.
Do rib belts or binders work?
Not as a substitute for a proper brace. A generic binder squeezes the whole ribcage rather than pressing on the costal margin, and a tight band around the ribs can make a full breath harder, which works against the breathing you are trying to retrain. If you are going to use compression, use a brace designed for chest wall deformity. I compare belts, binders and braces, and what the evidence says about each, in my rib flare braces guide.
If you want the exercises in order rather than as a list, the free rib flare plan lays out the phases and how to measure progress. No email required. If you want the whole route from free to hands-on, rib flare treatment without surgery walks through it. The rib flare course is open for pre-order while it is being filmed, and it will put all of it in order on video.
Flared ribs are a breathing and bracing problem before they are a core problem. The course is the sequencing that closes them, in the order it has to happen.
- The diaphragm work that pulls ribs down
- Anti-extension core that holds the position
- How to tell a flare from a carinatum
This article is for educational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional before starting any treatment plan. View full disclaimer →
