A common condition caused by a variety of lifestyle factors, you’re likely to encounter clients suffering from rounded shoulders. Justin Price looks at the corrective exercise strategies you can use to help your PT clients alleviate the painful and limiting symptoms of this condition.
Rounded shoulders or excessive thoracic kyphosis refers to a disproportionate forward rounding or curvature of the middle and upper back.3 It is a common postural imbalance that can be caused by prolonged standing/sitting positions, exercise and/or activity choice, environmental factors, muscle dysfunction and psychological stress. Body responses to rounded shoulders include musculoskeletal aches and pains, breathing problems, limited function, impaired athletic performance and increased mental stress.1, 2, 6, 7, 9.
Postural imbalances anywhere in the body can cause rounded shoulders. For example, when a person moves their head forward of its optimal position to focus their eyes on an object, like their phone, the upper back must round forward to help hold up the head.3 This is akin to having a large fish on the end of a flexible fishing rod. The rod will bend forward to accommodate the extra weight. Over time, this forward head position can lead to rounded shoulders.8
Muscle imbalances and restrictions can also lead to rounded shoulders. For example, when the arms are across and in front of the body for prolonged periods during activities like cooking, driving, and typing, the chest muscles become chronically shortened. Over time this causes the shoulder blades to move forward on the ribcage and the entire upper back and shoulder region to round forward.7
Respiratory conditions such as asthma, COPD, and allergies to air pollutants can affect the body’s breathing mechanisms and ability of the diaphragm to contract and relax correctly. Ribcage restrictions caused by chronic breathing problems can result in immobility of the thoracic spine and eventually excessive rounding of the shoulders.9
Exercise and activity choices can also contribute to rounded shoulders. Prolonged periods of spine flexion, such as is required for bike riding and/or spinning, martial arts, freestyle swimming, and hobbies like knitting and gardening, all can cause rounded shoulders.7
When the brain perceives a threat, whether real or imagined, the body physically prepares to take action against the threat (i.e., “flight or fight response”). Typical reactions include jaw tensing, tightening the abdominals, holding one’s breath, and rounding of the shoulders.2 Consequently, ongoing psychological stressors such as career dissatisfaction, relationship troubles, money problems, or family issues can bring about changes in the body that result in rounded shoulders.
Rounded shoulders can manifest as a variety of symptoms.
Rounded shoulders are usually accompanied by overarching of both the lower back and neck. These positions of the spine can lead to pain, disc generation, and nerve compression.5
The excessive flexion of the middle and upper back characteristic of rounded shoulders limits shoulder function, which can make activities like raising your arms to wash your hair, putting dishes in an overhead cupboard, or pulling on a sweatshirt difficult.
Rounded shoulders can affect respiration, which in turn, can restrict blood supply to internal organs. The downward movement of the diaphragm as it contracts helps massage the liver and bring blood supply to other vital organs. Hence, the disruptive nature of rounded shoulders on respiration can lead to any number of intestinal problems and/or disease.9
When the body assumes a rounded shoulder posture, it is interpreted by the nervous system as stress. Over time this increased activity in the “stress areas” of the brain causes fatigue, resulting in the body (and brain) no longer being able to effectively cope.4
Self-massage techniques are very effective for improving a rounded shoulder posture.
This self-massage technique promotes extension in the thoracic spine.
Lie on the floor on your back with your knees bent. Place a tennis ball on either side of your spine in line with the bottom of your shoulder blades. Use a large pillow to support your head so you don’t feel too much pressure from the tennis balls. Bring your arms across your chest and hug yourself. Find a sore spot and maintain pressure on it until it releases (10-15 seconds). Then move the balls to another sore spot by scooting your butt and body down so the balls roll up your spine. Bring the pillow with you each time you scoot. Spend about 2–3 minutes each day on the entire area.
This self-massage technique helps releases tension in the muscles/fascia that can become painful as a result of rounded shoulders.
Lie on the floor with your knees bent and head resting on a pillow. Reach one arm across your chest and place a tennis ball beside the shoulder blade of that arm between the shoulder blade and the spine. Find a sore spot and hold to release tension (10-15 seconds). Move the balls to another sore spot by scooting your body up or down. Do each side for about 2 to 3 minutes.
Breathing and Relaxation Techniques are also great for helping cure rounded shoulders. They help mobilize the ribcage, strengthen the diaphragm, supply blood to the organs, and promote relaxation and decreased stress.
Lie on your back with your knees bent (support your head with a small pillow, if necessary). Place your hands, palm down, around the bottom of your ribcage. Practice breathing in and out through your nose. As you breathe in, focus on the lower ribs expanding and pushing into the palms of your hands. Hold the breath (i.e., a diaphragmatic contraction) for a few seconds and then slowly breathe out. Do a total of 10 – 15 breaths every day.
Knowing Your Stress Triggers can also help. Mental stress can manifest as rounded shoulders, muscular pain, breathing problems, dizziness and headaches. Once you become aware of your stress triggers, concentrate on making choices that limit your exposure to these types of situations whenever possible to help fix rounded shoulders.
The key to keeping rounded shoulders under control is paying attention to symptoms such as musculoskeletal pain, mental stress and decreased performance. Employ strategies, such as those outlined above, to help moderate the impact of your lifestyle and activities on your body and avoid the potentially harmful effects of this common postural problem.
1. Cook, Gray. 2010. Movement. Aptos, CA: On Target Publications.
2. Hanna, Thomas. 1988. Somatics. Reawakening the Mind’s Control Of Movement, Flexibility and Health. Cambridge, MA: Da Capo Press.
3. Kendall, F.P. et al. 2005. Muscles Testing and Function with Posture and Pain (5th ed.). Baltimore, MD: Lippincott Williams & Wilkins.
4. Lawlis, Frank. 2008. The Stress Answer. London: Penguin Books.
5. McGill, Stuart. 2002. Low Back Disorders: Evidence Based Prevention and Rehabilitation. Champaign, IL: Human Kinetics.
6. Myers, T. 2001. Anatomy Trains. Myofascial Meridians for Manual and Movement Therapists. Edinburgh: Churchill Livingstone.
7. Price, J., and M. Bratcher. 2018. The BioMechanics Method Corrective Exercise Specialist Certification Program. 2nd Ed. San Diego, CA: The BioMechanics Press.
8. Price, J. 2018. The Biomechanics Method for Corrective Exercise. Champaign, IL: Human Kinetics.
9. Rolf, I. P. 1989. Rolfing: Reestablishing the Natural Alignment and Structural Integration of the Human Body for Vitality and Well-Being (revised edition). Rochester, VT: Healing Arts Press
To learn more from Justin Price about the causes and cures for both your own and your clients’ aches and pains, check out The BioMechanics Method Corrective Exercise Specialist course available through Network.
Disclaimer: Where Certificate III in Fitness or Cert III/cert 3 is mentioned, it refers to SIS30315 Certificate III in Fitness. Where Certificate IV in Fitness or Cert IV/Cert 4 is mentioned, it refers to SIS40215 Certificate IV in Fitness. Where Certificate IV in Massage or Cert IV/Cert 4 is mentioned, it refers to HLT42015 Certificate IV in Massage Therapy. Where Diploma of Remedial Massage is mentioned, it refers to HLT52015 Diploma of Remedial Massage.
Important Information: As of 9th November 2021 SIS40215 Certificate IV in Fitness and SIS30315 Certificate III in Fitness have been replaced by SIS40221 Certificate IV in Fitness and SIS30321 Certificate III in Fitness. A transition period applies to enable currently enrolled students to fulfil their study goals and complete their qualification. The transition period concludes on 8th November 2022. If you have not completed all the requirements by this date you will be transitioned and enrolled into the replacement qualification SIS40221 Certificate IV in Fitness and SIS30321 Certificate III in Fitness. View the SIS40221 Master Trainer Program Flyer here. View the SIS30321 Certificate III – Fitness Coach Flyer here.