Pectus Excavatum (Funnel Chest)-Training/Racing Experiences

I’m curious to see if any other cyclists have pectus excavatum and how that’s affected their journey to get faster with TrainerRoad. If that sounds like you, please share your experience and whatever data you feel comfortable divulging.

I’ll go first:

I was born about 41 years ago with a bowl-shaped indentation in my chest. My parents were worried that it would have a negative impact on my heart/lung function as I grew up, so I had surgery before I started kindergarten.

Even after the surgery, my chest still dips in a bit and it appears that I have less room for heart and lungs “up there” than a “normal” person.

After almost 2 years on TrainerRoad, I’m struggling with existential questions about my cycling potential, and wondering how the volume of my chest cavity might play into things.

In 2019, I followed the low volume plans and brought my FTP up from 185 in January to a peak of 205 in November. I routinely finished in the bottom 25% of my Cat 4 cyclocross races (despite being modestly faster than I was as a Cat 5 on the same courses), picked up zero upgrade points throughout the course of the season, and capped things off by beating several guys in the non-championship race for my age group at #cxnats.

After taking December off the bike and doing some running, I started 2020 with an FTP of 185 watts (thought it was a bad day-retested twice, and nope-that’s where I was at). I followed mid-volume plans this year with more consistency and my FTP is currently around 220 watts (3.4 w/kg).

On one hand, I’m stronger than I was last year, so yay! #progressnotperfection

On the other hand, I feel like I’m way behind anyone else (figuratively, since without racing we’re all just sitting on trainers in our own homes) who did almost a full year of TR mid-volume plan.

I feel like I can do all the sweet spot workouts, no problem. Long VO2 and threshold intervals are more challenging, and those are the ones where I’m more likely not able to maintain the prescribed power.

I’m almost done with my 4th build phase, and have yet to experience a big FTP increase (more than 5 watts) after a build block of training (even when my compliance to the plan is very high). It feels like half the time, my ramp test results drop after the first half of a build plan and then recover to right around where I started by the end of the build period.

Since I have no idea how much of a limiting factor the physical structure of my chest might be, I’m hoping that there’s a few other cyclists in a similar condition who can chime in and help create a data set that’s more than just my experience.

I also have pectus excavatum, though I haven’t had surgery for it (but it was apparently one of the deeper pectuses (pecti?) that some doctors had seen), and have also wondered about how it might be impacting my cycling performance.

I seem to be slower than a lot of people who train less than I do, but that could be due to other differences - I basically hated any sort of sports until I started cycling, so I don’t have as much of an aerobic base established as people who’ve played sports all their life, for instance. I’m 25 now, and I’ve been cycling for about 3 years, and doing some sort of structured training for the last two. In 2018 I had plateaued at around 215-220w, doing a lot of unstructured riding (and probably resting too little). I became more diligent about recovery and structure in 2019, doing SSB and part of SPB (mid volume, with some other rides) and got up to around 240. Since then I’ve fluctuated between 220 and 250.

Long sweetspot and threshold workouts are my preference as well. It could just be the positive feedback loop of being good at what you train, but sustained subthreshold work has always been a relative strength of mine.

I suspect that limited chest space is only really impactful at high intensities, and probably more so for the heart than the lungs (I think I recall from the Kolie Moore podcasts on VO2max that the long-term limiter is typically heart stroke volume, not air intake rates or uptake rates by the muscle - but that might not be true if lung volume is significantly reduced. On the other hand, heart volume is also restricted, so maybe it’s still the limiter). The obvious compensation for a low stroke volume is a high heart rate - curious if your heart rate is on the higher end of what’s typical at various intensities - mine certainly is: zone 2 is around 155-160, and threshold is around 188-190. The highest I’ve seen is 204, but I’ve had poor luck with heart rate sensors giving reliable readings above threshold.

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Interesting. Kudos on your FTP gains.

I played soccer when I was a kid through high school, and I’m becoming more aware of how my aerobic capacity was the limiting factor in my lack of competitiveness at higher levels.

I had above-average touch and skill at comfortable levels of exertion, but if I had to work really hard for more than a few minutes at a time, I was pretty useless and even guys with zero soccer skill became more effective players than I was.

My skill-set meant that I was most effective in the center midfield position, but as the second or third best center mid on a competitive team, coaches would either play me out of position and watch me die on the wings or just stick me on the bench.

Transferring over to cycling as an adult, I could accelerate quickly and hit 1200 watts for short sprints (less than 10 seconds or so) if I was fresh, but if I had to ride in my VO2 zone for more than a few minutes, I’d be unable to even hold a wheel (forget about sprinting).

Regarding heart rate, apparently my heart is not beating faster to make up for reduced stroke volume. My resting HR is usually just under 50, endurance rides tend to get up into the 130s, longer-harder sweet spot intervals top out in the low 160s, threshold and ramp tests might get into the low 170s.

When my HR gets above 180, all systems are about to shut down and my body is trying to decide whether to vomit or just pass out (but I just end up gasping for air and not being able to pedal-It’s not as scary on the trainer as it is on a crowded multi-use trail).

I don’t think I’ve even been able to get up to 180 this year, though I’m training more. I fractured a couple vertebrae 2 years ago and I think that my “internal regulator” is being conservative and keeping me from being able to go as deep as I used to (which still didn’t seem very deep compared to my friends/competitors).